Some examples are: how assessment of competency is done; how physicians have the conversation with their patients; whether or not the patients feel comfortable enough to broach the subject knowing that there are going to be physicians who are not comfortable providing that kind of care; whether the institution has enough resources to support both the patient and its own medical personnel when these conversations are going on; whether two physicians are present, if that makes a difference in terms of the request from the patient; what kind of medication is used; and whether there are requests from the patient to self-terminate or whether the medication is going to be administered by a physician. Whether or not the family members are involved I think is important. That also speaks to matters of coercion and protecting the vulnerable. Patients might feel subtle pressure from family members to act either one way or another way. I think these intangibles are also important for the review process to pick up on.
One of the important things—I've talked about the equitable access—is how patients in the remote areas access this care. His Eminence has talked about having a third party referral process. In principle we don't object to that, but if it puts more barriers and roadblocks in the way of the patients requesting this care, and if it doesn't work very well, then a better mechanism needs to be produced.