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Spaink is a free speech advocate and social critic. Some of her battles include:
- New-age writers who assert all diseases are only a psychological phenomenon;
- The Church of Scientology, who sued her for more than ten years;
- Opposition to a U.S. court decision which took down an anti-abortion site that contained names, addresses, photos and personal data of abortion providers along with calls for violence (Spaink describes herself as pro-choice on the issue of abortion, but felt that freedom of speech should prevail);
- The right to inform people about methods of suicide and to discuss the danger or reliability of various methods.
She was diagnosed with multiple sclerosis in 1986. She started writing freelance around this time.
She writes a regular column for Het Parool (1992 to present) and previously wrote for De Groene Amsterdammer (1998 to 2000).
From 2001 to 2004 she was an external adviser for the Freedom of the Media bureau (FOM) of the Organization for Security and Co-operation in Europe (OSCE), advising them on freedom of speech and the internet.
In 2005 she became the chief editor of a new book series, The Next Ten Years. The first book in the series, which dealt with electronic patient records (EPR) and the accompanying hack of two major hospitals, led to a debate in parliament. A few months later, the national introduction of EPR's was stalled by the Department of Health, citing Spaink's research. In that same year, she embarked on writing the history of XS4ALL and Hack-Tic.
 Disputes with New Age proponents over physical ailments
Spaink first came into the national limelight by accusing New Age writers such as Louise Hay, Thorwald Dethlefsen and Bernie Siegel of over-simplifying physical ailments by reducing them to a purely psychological phenomenon. Spaink, herself suffering from multiple sclerosis, was insulted by the suggestion that her disease was nothing more than the result of her own lack of willingness to heal. (Compare Idealism and responsibility assumption with Materialism; see also New Thought Movement.)
Her essay Het strafbare lichaam ("The Penal Body") coined neologisms such as kwakdenken ("quack thinking") and orenmaffia ("mind mob") that even made it into the Dutch language dictionary. The latter term derived from the expression that something is "all between the ears," in other words, "all in the mind."
In 1995, the Church of Scientology began a legal campaign to remove what it held were copyright infringements and trade secrets from the Internet; see Scientology vs. the Internet. Spaink was one of the first famous Dutch Internet personalities and was one of the first of what became about a hundred Dutch people to put up pages containing the Fishman Affidavit in protest against the actions of the church.
The Church of Scientology responded by suing Karin Spaink and a large number of Internet providers, including XS4ALL, for copyright infringement. Part of the Fishman Affidavit were documents that Fishman had asserted to be the official teachings of Scientology. The defendants responded by challenging the church to prove it was actually the copyright holder of the disputed documents.
The church allowed a Dutch notary to compare the church-copyrighted documents with the texts on Spaink's homepage. Through her lawyers, Karin Spaink received a copy and started rewriting her homepage, just a week away from the court date for handling the motion for summary judgement. Spaink replaced the contested documents with an analysis of the documents, quoting liberally, but not too liberally from them; Dutch copyright law does not have a fair use provision, but allows quotation for purposes of scientific dissemination. A representative of the Church of Scientology used this occurrence to back up an assertion that the church had won the court case.
The hearing on the merits was decided more along both lines: it was found that service providers do have a responsibility for documents that users put up on their web site; however, any claims that Karin Spaink was breaking the church's copyright were found unfounded, because Spaink had reworked her homepage as soon as she had discovered that the church indeed had valid claims to portions of the documents on that homepage. This implicitly meant that the scholarly study of the church's documents on Spaink's homepage was in fact legal according to the decision.
Court costs were divided equally between parties. In the Netherlands these usually run into (only) thousands of euros; contrast this with the hundreds of thousands of dollars that American Scientology adversaries had to pay after losing their own, US-based court cases. This may be an indication of why Spaink can still fight the church, and why it is claimed by Scientology critics that the barrage of law suits brought on by the church is not the making use of a legal right, but a form of harassment (barratry).
The Church of Scientology appealed this decision. A court date was originally planned for September 2002, but was postponed several times. Finally in September 2003, the court decided in favor of Spaink and the internet service providers on all points, including the below-mentioned decision on links.
The three judges found that Spaink and the providers might indeed have broken Dutch copyright law; quotation is not allowed of works that have not been previously published, and whether or not the release as evidence in a US court case counts as 'publication' was considered dubious. However, the judges felt that they did not have to rule on this subject, because European law states that quotation is legal in case the quotation serves a higher goal. The court held it proven that Scientology is an organisation that tries to undermine democracy, and therefore ruled that Spaink had the right to quote the Church in her exposé.
Scientology appealed once more, this time to the Supreme Court of Netherlands. In July 2005, a few days before the court was expected to rule, Scientology withdrew the appeal. The Supreme Court dismissed Scientology's claims while accepting Scientology's withdrawal. As a consequence of this withdrawal, Scientology has no possibility to appeal to the European Court, because this is only possible when all legal means on country level have been exhausted. The verdict of the appeal court stands, but the Supreme Court did not add an evaluation of its own.
 Effects of this court case
In the original court case, the judge upheld the law that ISPs whose customers on their homepages link to copyright infringement are as liable as if the customers infringed on that copyright themselves.
This part of the judge's decision caused an uproar in the Dutch internet community, where many claim that a link is not a mechanism for publishing works but merely a reference to a work, although there are a number of voices who feel the judge's decision was correct.
In the verdict of the appeal on September 4, 2003, this ruling was reversed.
 Right to Die
Karin Spaink is also involved in the Right to Die movement; she hosts a website which offers access to information concerning methods of suicide. This website has garnered much controversy when, in October 2005, Christopher Aston (25) and Maria Williams (42) from Liverpool and London respectively, entered into a suicide pact after meeting on a newsgroup discussing the same subject.
- 1982 – Pornografie, bekijk 't maar (The Politics of Pornography. Feminist Visions on Sexuality) (edited collection of essays)
- 1986 – De Venus van Milo in de betonmolen (The Venus de Milo in the Cement Mixer) (essay)
- 1991 – Aan hartstocht geen gebrek. Handicap, erotiek en lichaamsbeleving (Passionate Imperfections. Disability, Erotics, and the Perception of the Body) (with photos by Gon Buurman)
- 1992 – Het strafbare lichaam. De orenmaffia, kwakdenken en het placebo-effect (The Penal Body. The Mind Maffia, Quack Thinking, and the Placebo-Effect)
- 1993 – Stokken en stenen (Sticks and Stones) (short stories)
- 1994 – Vallende vrouw. Autobiografie van een lichaam (Falling Woman. Autobiography of a Body)
- 1994 – Cyborgs zijn heel gewone mensen (ze denken hooguit meer na) (Cyborgs Are Pretty Ordinary People (They Just Think More)) (Introduction to the Dutch translation of Donna Haraway's A Cyborg Manifesto)
- 1996 – M/V, doorhalen wat niet van toepassing is (M/F, Cross Out What Does Not Apply) (essays)
- 1998 – De man met de hamer (The Man with the Hammer) (theatre play; performed by Theatergroep Hollandia)
- 2001 – De dood in doordrukstrip (Death in a Blister Pack) (essays)
- 2005 – Medische Geheimen (Medical Secrets) (essays)
- "Interview with Karin Spaink: Media freedom and the Internet", Organisation for Security and Co-operation, osce.org, 7 May 2003, retrieved 12 June 2009
- "Uit de hiervoor onder 8.3 vermelde teksten blijkt dat Scientology c.s. met hun leer en organisatie de verwerping van democratische waarden niet schuwen. Uit die teksten volgt tevens dat met de geheimhouding van OT II en OT III mede wordt beoogd macht uit te oefenen over leden van de Scientology-organisatie en discussie over de leer en praktijken van de Scientology-organisatie te verhinderen."  Translation by Spaink: "The texts previously quoted show that in its teachings and its structure, Scientology c.s. do not shun the rejection of democratic values. From these texts it is also apparent that one of the objectives of keeping OT II and OT III secret is to wield power over members of the Scientology organisation and to prevent discussion about the teachings and practices of the Scientology organisation."
- "Demonstratie tegen Scientology". Algemeen Dagblad. 2008-02-10. Retrieved 2008-03-16.
- Cobain, Ian (11 October 2005). "Clampdown on chatrooms after two strangers die in first internet death pact". The Guardian. Retrieved 2008-05-25.