Active euthanasia in the Netherlands remains a topic for both professional and public debate. However, many aspects of the medical practice of active euthanasia remain unclear, and no figures on the actual incidence of this practice exist. Legally, active euthanasia is a criminal offense, but a pattern of jurisprudence has developed since the first court case in 1973 that has allowed physicians to practice euthanasia under certain strict conditions. Two proposals, one from the Royal Dutch Medical Association and one from a government-appointed state commission, have advised that the current law be changed. While the debate continues, a number of Dutch institutions have developed procedures and policies to enable physicians and health care providers to participate in active euthanasia in an acceptable and controllable manner. However, many Dutch physicians remain uncomfortable with the professional and public tolerance of this practice.