In the Netherlands, physicians are not required to give treatment they view as “medically futile,” and they decide what constitutes this.(383) Euthanasia has been made legal in certain circumstances and there is a provision for children older than age 12 years.(388) Active euthanasia of neonates remains illegal although it has been reported.(389) Although there have not been any reported legal cases involving the foregoing of life-sustaining treatment for an extremely preterm infant, there were two cases in the 1990s that appeared in the Courts of Appeal, which addressed the deliberate termination of life of two severely disabled newborns.(390–392) In one, the Prins case, the baby had severe spina bifida, and in the other, the Kadijk case, the disorder was trisomy 18. In both these cases, the physicians, after discussion with the parents and colleagues, administered lethal doses of medication. The cases were brought by the Minister of Justice and the physicians were acquitted of the charge of murder on the basis that they had acted in accordance with the legal requirement for careful practice(392) (criteria relating to this are used to justify adult euthanasia). The reasoning was that several major surgical interventions would be necessary that would not offer a later reasonable quality of life and would be accompanied by pain and suffering. The courts accepted, on the testimony of expert medical opinion, that such intervention would be an example of medical futility.(392) The reasoning for the next step was more tenuous.