I think any assessment should be done on a case-by-case basis. There should be a certain amount of flexibility built into the assessment process, but for something like advance directives for MAID, and advance directives in general, I think they should be reaffirmed or rewritten periodically. That should be written into whatever rules or regulations come out with advance requests.
I don't think a clinician could reasonably be expected to act on an advance request that was written 25 years ago and was never revisited or reaffirmed. That affirmation could be as simple as adding a line to an advance directive with a statement saying, “I confirm the wishes above of this advance directive”. That could be done periodically. I do think an advance directive or an advance request for MAID has to be reaffirmed periodically.