VAD Review Board Process: What Happens After an Assisted Death

What a Review Board Checks — and When Families May Hear From It

In the jurisdictions described below, a government body reviews the case. Routine oversight checks whether clinical and legal safeguards were followed; the review itself is not a criminal investigation. But receiving a letter or phone call while you're grieving can feel alarming if you don't know what to expect.

The jurisdictions below have retrospective review processes. The goal is to check compliance with clinical and legal safeguards, not to determine family fault. Understanding the process in your jurisdiction removes one source of anxiety during an already brutal time.

Canada: The Coroner's MAID Review

In Canada, federal monitoring applies to MAID, while coroner review mechanisms vary by province. Ontario's process includes review by the Office of the Chief Coroner (OCC).

Ontario: The Office of the Chief Coroner (OCC) receives a report from the administering clinician after every MAID provision. The OCC's MAID Review Team examines the clinical documentation — the written request, the two independent medical assessments, the waiting period compliance, and the final consent — to verify that all Criminal Code safeguards were met.

What families should know:

• The OCC treats this as an administrative oversight file, not a crime scene investigation
• Ontario provider guidance says that, when family or next of kin are involved and contact is wanted, they should be told a MAID Coroner Investigator will contact them about 72 hours after provision. This routine contact does not by itself mean an investigation.
• A routine file review is not a crime-scene investigation. The OCC decides whether an investigation is warranted based on the reported facts and circumstances, so an investigation or follow-up can occur.
• The review proceeds primarily through clinician documentation, though a family or next-of-kin contact may be asked for information as described above

Other provinces have different processes. British Columbia's Coroners Service published a Death Review Panel report on medically assisted deaths covering 2016; that report does not establish a current standing panel for every MAID death. Quebec's Commission on End-of-Life Care publishes reports on end-of-life care.

Australia: State-Level VAD Review Boards

Each Australian state has its own Voluntary Assisted Dying Review Board. These were established when each state legalised VAD, and they review every single case.

Victoria: The Voluntary Assisted Dying Review Board reviews all VAD deaths in the state. The board examines the coordinating practitioner's reports, the consulting practitioner's assessment, and the pharmacy dispensing records. If the deceased self-administered the medication, the board also reviews the contact person's report confirming that any unused medication was returned to the Statewide Pharmacy Service within 15 days.

Queensland: The Queensland VAD Review Board operates similarly, receiving mandatory reports from practitioners within two business days of the administration.

What this means for families: the review board may request confirmation about medication return (for self-administered cases). This is a routine compliance check. Responding promptly and factually closes the file. If you returned the medication on time and have a receipt, provide it. If you're unsure about the return deadline in your state, contact the prescribing practitioner's office — they handle this regularly.

The Netherlands: Regional Euthanasia Review Committees

The Dutch system is the most structured. After a euthanasia or assisted suicide, the attending physician cannot issue a natural death certificate. Instead:

1. The physician immediately notifies the municipal pathologist (gemeentelijk lijkschouwer)
2. The municipal pathologist reviews the remains and the clinical record
3. The complete dossier goes to one of five Regional Euthanasia Review Committees (Regionale Toetsingscommissies Euthanasie, or RTEs)
4. The RTE — composed of a medical expert, an ethicist, and a lawyer — evaluates whether the physician met all six statutory due care criteria

If the committee finds compliance: the case is closed. The vast majority of cases (over 99%) are found compliant.

If the committee finds non-compliance: the case is referred to the Board of Procurators General and the Health Care Inspectorate. This is extremely rare and targets the physician's conduct, not the family's.

For families: the formal Dutch review centers on the physician's report and the committee's assessment of due-care compliance.

Belgium: Federal Commission Review

Belgium's Federal Commission for the Control and Evaluation of Euthanasia receives a standardised registration document from the administering physician within four working days of the procedure. The document has two sections:

• Sealed section: contains patient and clinician identities (opened only if the unsealed section raises concerns)
• Unsealed section: details the diagnosis, the nature of the suffering, and the independent consultations

The physician submits the standard registration document, and the Commission reviews the due-care information in it.

What If a Review Finds a Problem?

Routine retrospective review focuses on the practitioner's compliance, not bereaved family conduct. If a separate issue is flagged, authorities may seek more information or investigate; the review process does not guarantee that a family member will never be contacted or investigated.

That said, receiving any official correspondence about your loved one's death is distressing. If a review board contacts you for any reason:

• Respond factually and promptly
• Ask what information is being sought and in what capacity you are being contacted. A routine request may concern a documentation detail, but confirm rather than assume.
• For a routine administrative request, respond based on what you know. If the authority raises possible wrongdoing or asks you to take part in an investigation, consider legal advice.

The Bigger Picture

Review boards exist because assisted dying is a heavily regulated medical practice. Their reviews check whether the clinical team followed the required safeguards; they do not determine insurance coverage or resolve family disputes.

For a full jurisdiction-by-jurisdiction breakdown of what happens after an assisted death — including review board timelines, medication return deadlines, and death certificate protocols — the After a Death by Euthanasia / Assisted Dying guide covers all of it in one place.