A 1981 Court ruling established broad and loose guidelines which would allow for non-prosecution of doctors who euthanized patients experiencing 'unbearable pain', having made a voluntary and conscious. This was superseded by a 2001 law, effective in 2002, predicated on a patient's suffering being "unbearable, with no prospect of improvement". Children as young as 12 can request death, and the legislation also does not exclude non-residents, despite efforts to claim that only Dutch residents are covered.

The statistics demonstrate a steep rise in the number of euthanasia cases since liberalisation through the courts and then legalisation. 4,188 notifications were received in 2012, with non-reporting standing at 23% in 2010, further undermining much-vaunted safeguards. Equally troubling are the continued and substantial rise in people dying through 'deep sedation' - sometimes called 'slow euthanasia' - and the numbers of those seeking euthanasia with dementia and with psychiatric problems.