Dr. Anthony McCarthy:

Irrespective of the issue of termination, I am unsure of how someone attending a psychiatrist could prove a negative or how the psychiatrist could determine it. When someone comes to see me or any psychiatrist, the first and most important element will be the relationship in the room. Can that person talk to me? Does she feel heard and listened to? That is the key starting point.

I attended a lecture some years ago given by Professor Aidan Halligan, who was an Irish paediatrician and the deputy head of the NHS in England. Speaking about medicine, surgery or any specialty, he said that the first thing any patient attending any doctor wanted to know was whether the doctor cared. If the doctor cared, then it was likely that the patient would be heard. Even where there was a cardiac complaint, the patient would know that the doctor was listening. The doctor would take a proper history and hear the person's story. If a doctor is not interested, he or she will miss things and, often, the patient will not tell him or her things. This is particularly the case in mental health. For someone to tell me personal, difficult things about herself, her history, her feelings and her previous experiences requires a sense of trust. If that appointment is imposed on her or I approach the matter in some judgmental way or bring my personal attitudes or history to it in either direction, it will be a failure of an appointment. Insisting that a woman go through a particular process where she must see a series of psychiatrists, or even just one, when she is clear on the situation in her own mind will be a waste of an appointment and abusive of her and she will be unlikely to talk about what matters because she is being forced into a situation that is not helpful. It would waste her time and my time and be damaging.