Professor Margaret Battin:

The state of Washington I believe has an extensive document prepared by psychologists and psychiatrists on how to examine this. The claim that it is impossible to characterise capacity would be a problem for any medical procedure that involves significant risk. It is not only this issue. Also, keep in mind that this is not the difference between life and death, this is about a death that is by hypothesis and by requirement, already in the process of coming. It is very easy to forget that. In regard to self administration, the organisation I just mentioned, the American Clinicians Academy on Medical Aid in Dying, which includes several hundred physicians as well as others, has engaged and recently published an article on the dilemmas for people with neurological diseases, for example, amyotrophic lateral sclerosis, ALS, in which they do not retain sufficient physical strength to fully push a plunger or are no longer able to swallow medication or they cannot even engage a plunger to administer medications through a feeding tube or rectally. What this dilemma means is that somebody who is otherwise fully qualified but has endured their physically diminishing disease for so long that they lose the strength to do this, that is a serious ethical challenge which this committee is considering carefully. As I say, it has just published an article.