Reading the PDF (<a href="http:&#x2F;&#x2F;www.nejm.org&#x2F;doi&#x2F;pdf&#x2F;10.1056&#x2F;nejmsa071143" rel="nofollow">http:&#x2F;&#x2F;www.nejm.org&#x2F;doi&#x2F;pdf&#x2F;10.1056&#x2F;nejmsa071143</a>):<p><i>&quot;When life was ended without the explicit request of the patient, there had been discussion about the act or a previous wish of the patient for the act in 60.0% of patients, as compared with 26.5% in 2001. In 2005, the ending of life was not discussed with patients because they were unconscious (10.4%) or incompetent owing to young age (14.4%) or because of other factors (15.3%). Of all cases of the ending of life in 2005 without an explicit request by the patient, 80.9% had been discussed with relatives. In 65.3% of cases, the physician had discussed the decision with one or more colleagues&quot;</i><p>So, part of this is due to the fact that the law states that doctors must check that the patient consents _now_ with the choice. A written statement that, for example, one doesn&#x27;t want to live on with Alzheimer&#x27;s when one has reached a well-described state is not sufficient.