As much as [a prominent forensic psychiatrist] is to be criticized for his foreseeing a role for us in determining the mental status of people wanting to be put to death legally, Dr. Diane Meier is to be praised for suggesting a pause for reflection.

For years we leaked bits of information about our patients to facilitate large insurance reimbursements. We thus set the precedent for releasing the flood of private information without which managed care could not function. Assisted suicide makes one wonder about exactly how much further we are going to stray from the oath we all idealistically took in our youth.

With regard to assisted suicide, couldn't the government train paraprofessional gatekeepers who could ascertain adherence to yet-to-be-established guidelines? Could we in any case do good, objective evaluation knowing the consequences over which we would have essential control? And if there really are some of us who think their help is crucial in some of these situations, couldn't they at least make this one a freebie?

I'm sure Hippocrates is turning over in his grave about our loose lips slowly sinking our medical ship. If we decide as a group to start deciding who's sane enough to die, he may just decide to come out and get us.

Eli Einbinder, M.D.

New York, N.Y.

(Psychiatric News, October 18, 1996)