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 and determinations of decisionmaking capacity are not straightforward, nor is the relationship between mental illness and decisionmaking capacity in dying patients clearly understood. And casting psychiatrists as gatekeepers in end-of-life decisions poses risks to the profession itself.