RED DEER, ALTA. -- A man accused of killing a family doctor at a medical clinic in central Alberta made a second rambling court appearance on Wednesday.

Deng Mabiour, 54, is charged with first-degree murder in the death of Dr. Walter Reynolds.

Reynolds, who was 45, was attacked Aug. 10 while working at the Village Mall Walk-In Clinic in Red Deer.

In court on Wednesday, Mabiour appeared via closed circuit television and was asked if he understood the charges he faces. 

"I don't recognize that," he said in part of a rambling response. 

"Nobody should speak on my behalf," he said in declining a lawyer. He also said he cancelled an application for legal aid. 

Mabiour didn't respond to queries from duty counsel attempting to explain the charges. 

The judge requested a psychiatric assessment to see if Mabiour is fit to stand trial. 

Barring further delays, he is scheduled to be back in court on the morning of Sept. 14.

RCMP have said the crime was not random and the two men knew each other through the clinic, although they have not said if Mabiour was a patient of Reynolds.

One witness told media that she was in the waiting room when she heard cries for help and that a man in the clinic had a hammer and a machete.

Mabiour appeared confused during his first court appearance last month and told a judge that he doesn't remember and is sick.

“Listen to me. I don't remember anything because I'm sick. I want a doctor,” Mabiour told court on Aug. 12.

“I'm telling you I didn't remember anything because I am sick.”

The Alberta Medical Association has said that Reynolds's death highlights a need to increase safety for doctors across Canada.

Dr. Peter Bouch, who knew Reynolds, said members of the Red Deer Primary Care Network have set up a committee to work with Alberta Health Services and Occupational Health and Safety in an effort to make clinics safer.

He said some clinics have started asking patients to leave their bags and backpacks at the front desk and, going forward, there needs to be standards for how to manage difficult patients.

With files from the Canadian Press