Dr. Mark Komrad:

There are two concepts here that have a lot of overlap. One is informed consent and the other is capacity evaluation. The state-of-the-art of capacity evaluation has been developed for people who cannot consent to such things as surgery or competency to stand trial. These are extraordinarily different contexts. One of the things that one evaluates in capacity is the ability to understand informed consent, where you are told the benefits and the risks, what will happen if you engage in a procedure or do not engage in a procedure, and that is on the basis of our understanding about what the consequences are of going forward or not going forward with certain medical procedures. In fact, informed consent does not make any sense in this particular context because we do not know what the consequences are of dying, at least for the experience of the person. As a matter of fact, as part of those discussions, we also need to think about what are the consequences for the person's family and so forth.

In terms of one’s personal experience, we do not have that information so this really does not even fit into our established models of what informed consent means. In assessing informed consent through capacity, which as I pointed out is a highly specialised skill, there is no statutory requirement in any jurisdiction that the physicians who make these evaluations and decision get any training whatsoever. In regard to the experts Professor Battin notes in Oregon, this is a fait accompli. The state says “We are going to do this so you must provide for us guidelines” and so people prepare to do that. In Canada they tried to do the same in coming up with guidelines for psychiatric evaluation for the impending psychiatric euthanasia that is occurring there and ultimately-----