The Dutch Euthanasia Act seems to be set in stone. Since it took effect in 2002, it has not seen any significant amendments. Recent developments, however, indicate that a major component of the act—the review procedure—is due for revision. The review practice of the regional euthanasia review committees—responsible for applying and interpreting the law—now also extends to instances of euthanasia and assisted suicide for special categories of patients: psychiatric patients, patients with early-stage dementia, and patients whose suffering is derived from a combination of medical and existential causes. In this article, it is argued that a reconsideration of the review practice for these new cases is necessary primarily because review committees lack the legitimacy needed for the development of policies with such a large impact on society.