The decision to forgo treatment—that is to say, to withdraw or withhold treatment before death—is often made because there is ‘little chance of improvement’, although specific reasons such as ‘loss of dignity’ are more common for certain patient groups, such as the very old and people with dementia. 5 – 8 General population samples, i.e. those without a terminal illness, show that most people would prefer to forgo treatment in some situations. 7 Previous studies using nationwide samples found that forgoing potentially life-sustaining treatment was the end-of-life decision with the greatest life-shortening impact in many countries, in up to 22% of deaths in Sweden, 23% in Denmark, and 37% in the Netherlands. 6, 9 In the German-speaking part of Switzerland, the decision to forgo treatment probably had the greatest life-shortening impact in 29% of deaths in 2001, rising to 35% in 2013. 10 However, all these studies prioritized medical end-of-life decisions (MELDs) according to the action that shortened life the most, which is a questionable approach, since in practice MELDs are often combined.