For your first question, about refusing to give medical assistance in dying, I'll just repeat that it's against the code of ethics to refuse to administer medical assistance in dying to a patient who has requested it, and who, in the assessment by practitioners, meets the eligibility criteria.
Currently, some people are not complying with their code of ethics with respect to medical assistance in dying. These people might behave in the same way with respect to advance requests. I can't tell you any more than that. Strictly speaking, it would be against the law if the Criminal Code were to include provisions establishing procedures that could be applied with respect to medical assistance in dying.
The second question, I believe, was about what appears to be a difficult issue.