The practice of euthanasia in the Netherlands is often cited as an example of progressive social reform. While the Dutch penal code out laws active euthanasia, the courts have interpreted the law in such a way as to allow doctors to kill their patients under certain conditions, chiefly when the patient has asked to die in preference to enduring unbearable suffering. Current practice in the Netherlands now includes the killing of patients who do not have a terminal disease, the killing of older children without the consent of their parents, and the killing of patients without their consent in circumstances where consent could have been sought. Estimates of the number of euthanasia killings range up to 20 000 per year, but there is no accurate information because of the common medical practice of falsely certifying the cause of death to avoid the need to justify euthanasia. Euthanasia in the Netherlands is now an alarming practice that oversteps ethical bounds and administrative controls, compromising doctors' moral commitment to healing by allowing them to become medical killers.