The authors describe national guidelines introduced in the Netherlands in late 1990 for carrying out euthanasia requests by medically ill patients. In about 49,000 of the 130,000 annual deaths in that country, doctors make a decision that may influence the duration of life. In 2,300 cases doctors perform euthanasia. Thus euthanasia accounts for 1.8 percent of all deaths and 5 percent of the cases in which doctors' decisions play a role. The authors point out cultural differences between the U.S. and the Netherlands, such as in access to health care and in social tolerance and pragmatism, that should be considered by American policymakers who address the issue of euthanasia. The role of Dutch consultation-liaison psychiatrists in euthanasia was assessed by a survey of members of the Netherlands Consortium of Consultation/Liaison Psychiatry. Most felt that involvement of psychiatrists in such cases should not be mandatory and that their most important role was to assess patients' decision-making capacity. Half of the psychiatrists felt that their role was to support the decision-making process of the ward staff.