An aggressive new advanced directive would allow patients to decline food and water if they display signs of deep dementia.

A New York group that supports aid-in-dying recently approved the new document. It allows individuals to note in advance that they’ll want to stop eating and drinking if they develop severe dementia.

The controversial plan was approved by End of Life Choices New York’s board in late March. Questions abound about the directive’s legal standing and whether private facilities would agree to accept it.