Consent can be given in various ways. The physician has to ensure a whole series of things. First he or she must ensure that his staff meets medical requirements. Afterwards, he must inform his patient about how the procedure will unfold. He must make sure that free consent is being given, and particularly that there is no external influence. That is why, for instance, if the patient is perceived as a burden by his family, the physician must ensure that no external influence is being brought to bear. Otherwise, physician-assisted death will not be granted.
The consent must also be informed consent. On that topic the law refers to the information the physician must provide to his or her patient. The jurisprudence is well established here. The physician must ensure that the patient has not only received the information, but also that he has understood it. This has to be well-documented in the file, and repeated a few days later, by the patient.
So, there are a series of processes. Ideally this can be done in a face-to-face conversation between two people, but it is also conceivable that it could be done through Telehealth. Other means may be used when they exist. The physician clearly has to ensure that the request is coming, quite personally, from the patient, that he or she is not being influenced at all, and that he is well-informed. The physician's role is to ensure that all of those conditions are met. That is a part of the safeguards. This has to be recorded, documented, and verified by the organizations that monitor the procedure.