A literal scorched earth strategy in war is often used while retreating from an enemy & deliberately damaging your own lands to help stop an enemy with the hope that if you ultimately won, you'll be able to rebuild.

This is why I label ECT scorched earth. It risks significant self-damage in what is often a last resort. I'm not dismissing it as a useful treatment, I'm saying it is broad and unfocussed as a result of our inability to do any better, to come up with a better tactic that doesn't risk wholesale destruction of the person. If it was a real war, perfect knowledge of the enemy might allow a less destructive strategy: the same applies here. But there are no medical treatments that don't carry significant risks. It's all a balance, with escalating risks taken when less risky options don't work.