Thank you for asking that. I'm not sure I have the answers for those either.
I think the role of telemedicine was mentioned. If we're looking at a patient who has requested a physician-assisted death and is in one of these communities in which there is only one physician group, it would be most appropriate that this patient be assessed by a second physician. If that can't be done in person, then it needs to be done in some other fashion; that would presumably be via video or telephone link, preferably video.
If you had a small community in which there was no physician willing to participate in this process, other than informing a patient about the process when a patient requested the information, that would create a great challenge. I really don't think it's appropriate for these decisions to be made without actually sitting in the room with the patient.