Dr. Mark Komrad:

For the record, I understand the arguments that are supportive and see some of the positive aspects of this issue. I am trying to make a case for the fact that the problems with it vastly outweigh that. These are practical problems as well as the philosophical issues, including the profound changes in the course of a society and civilisation and, indeed, in the profession of medicine, in which a certain group of people, doctors of all people, are given the privilege of taking a life. They would not be getting out of the way of death, which is a standard of practice with palliative care in order to make people comfortable, but would be able to provide death.

I will also address the issue of psychiatric referrals. As I said, it started with one out of every three patients being referred to psychiatrists. It is optional in all states and has now dropped to one out of a hundred. On the ability to evaluate whether a patient has a psychiatric disorder and to evaluate capacity, a number of researchers have shown that most physicians miss psychiatric diagnoses. Capacity evaluation and competency evaluation is a very elaborate specialised skill set of a subspecialty of psychiatry, namely, forensic psychiatry. It is also called consultation liaison psychiatry in hospitals. As a general psychiatrist, I do not feel that I or my colleagues like me are competent in capacity evaluation and there are no standards for the evaluation of capacity in this particular context in order to make the irreversible decision to die.