I think that's a very important issue. What I will say to people is this: “We have discussed your case very carefully. I have thought about this very carefully. I can see that you're trying to deal with this situation, which is incredibly difficult. I honestly don't feel at this time that we can proceed by approving MAID for you. That does not mean it will never be approved, but I think you need to spend more time around the following issues.” I would then detail the things I thought needed to be addressed.
I think it's very important that these people do not feel rejected, because many of them are very ill and suffering in various ways. But I think in a kind but firm way assessors need to be clear in their own conscience and their own mind that what they are approving is correct.