If the youth is in distress or in foster care, these are all things that I would think would result in a physician concluding that they weren't making a free decision, if they came to them seeking medical assistance in dying.
I don't know if you're hearing from the voices of families with youth who are living with complex and painful illnesses. I would hope that you are. I would also hope that you continue a robust consultation with indigenous communities, because I certainly couldn't purport to speak for their views here.