I don't think the actual procedure itself is that complex; I think the ability to respond compassionately to a request to hasten death is complex.
If you look at why people request euthanasia, it breaks down into four areas. It's often an expression of despair. As well, for some people it's a hypothetical exit plan, and that means in Oregon about 40% of people who get a prescription never use it, and they derive benefit from it. These kinds of requests also come along when someone is imminently dying. Then there is that group of people who persistently request and follow through, and in that group such things as burden and autonomy and dignity tend to be reasons much more common than pain or uncontrolled symptoms.