This is an issue that we've heard crop up a number of times, on whether or not there should be a retrospective review or pre-review of all cases. We've spent a lot of time thinking about this, and we've heard testimony about it as well.
One of the concerns often raised was that, look, unless we have pre-review, then we're going to see physician abuses happening. Our concern with raising such a concern is that this would actually apply to almost every end-of-life decision we currently have in Canada today. We do not pre-review end-of-life decisions on a regular basis in hospitals and hospices all across Canada now, so there would need to be a strong justification for diverging from this practice in the case of physician-assisted death.
We are also concerned that by introducing a pre-review process it would actually create an undue burden on Canadians, many of whom will be entirely competent to make these decisions, will be very settled in their views, will have gone through the process, and will be very clear that this is the choice they would like to make. There will be no controversy about whether or not they are competent. Again, many of our health professionals are very skilled at being able to assess that level of competency. To introduce a pre-review would actually create an undue burden in many of those cases.
We have gone in the direction of retrospective review, and that's an important step. The retrospective review is extremely important because it gives us an opportunity to be able to learn from the experience within our system. We need to be able to monitor. We do need to be able to track data. We also need to understand where we are seeing certain patterns emerge. It will enable us to continue to evolve and improve the policies that support this work.
In our recommendations, we were trying to find the right balance, not unduly burdening patients but ensuring that there were sufficient safeguards through the process, up to the point of that individual finally having self-administered or physician-assisted death, and not adding an additional judicial review, tribunal or otherwise.