Harding explains the technology and history behind electroshock therapy, which began when psychiatrists observed the calm cattle experienced following a blow to the head with a sledgehammer. The resulting convulsions in some of the cattle resembled epileptic seizures. Inspired, they used electricity to induce seizures to calm upset patients. Harding tells McMurphy that he shouldn't worry about electroshock because, like lobotomies, the procedure is "out of vogue." But he also informs McMurphy that Nurse Ratched has the authority to order both procedures. Harding calls lobotomies a "frontal-lobe castration," adding that if Nurse Ratched "can't cut below the belt she'll do it above the eyes."
The patients discuss if Ratched is the source of the hospital's problems, and McMurphy pronounces his opinion that she is only one symptom of something larger and more malevolent. This pronouncement confirms Chief's belief in the Combine. McMurphy tells the Acutes that he's disappointed that they didn't tell him that rebelling against Nurse Ratched would make his life worse in the long run. They admit to him that they are voluntary inmates at the hospital and can leave whenever they want. They tell McMurphy that they are not as strong as he, which is why they prefer to stay committed.
The descriptions of lobotomies and electroshock therapy are methods the Combine uses to control and change nonconformists. Once they are made to conform to society's standards, the patients are allowed to reenter society.
The Acutes' admission that they are voluntarily committed to the hospital comes after McMurphy admits he has been exhibiting good behavior in order to receive an early release. When he challenges the Acutes to actually attempt living their lives outside the hospital, Bibbit emotionally tells him that none of them are as big and tough as McMurphy. McMurphy puts his hat back on, much like Gary Cooper before the final gun battle in the film High Noon.