Should Psychiatrists Serve as Gatekeepers for Physician-Assisted Suicide?

Mandating psychiatric evaluation for patients who request physician-assisted suicide may not offer the clearcut protection from possible coercion or other abuse that proponents assert. Competence itself is a complex concept & determinations of decision-making capacity are not straightforward, nor is the relationship between mental illness & decision-making capacity in dying patients clearly understood. Casting psychiatrists as gatekeepers in end-of-life decisions poses risks to the profession itself. (50 refs.)