Even though there is at present in The Netherlands a widely accepted legal framework within which euthanasia is allowed, many doctors find euthanasia in cases of dementia too complex. There are several reasons for this cautious approach. Doctors fear the possibility of a judicial aftermath. Another factor is a faulty, if not downright mistaken, opinion about the nature of the mental anguish that people with dementia sometimes experience. Doctors find it difficult to realize just why dementia can be so terrible. A further reason for this restraint is the problem of deciding whether the patient is mentally still competent when it comes to formulating a wish to die.