In recent years, the Netherlands has witnessed a striking and controversial increase in cases of assisted dying—commonly referred to as euthanasia—for individuals suffering primarily from psychiatric conditions. Particularly notable is the growing number of women in their twenties and late teens opting for this path. Once envisioned primarily for terminal physical illnesses, euthanasia under Dutch law has expanded into the realm of mental health, raising profound questions about autonomy, mental healthcare, societal norms, and the limits of medical intervention.
The 2002 Termination of Life on Request and Assisted Suicide Act legalized euthanasia in the Netherlands, provided strict due care criteria are met. These include a voluntary and well-considered request, unbearable suffering with no prospect of improvement (irremediability), and confirmation by independent physicians. While mental suffering was not explicitly excluded from the outset, psychiatric euthanasia remained exceedingly rare for nearly two decades due to professional reluctance among psychiatrists. They viewed concepts like decisional capacity and irremediability as far more uncertain in mental illness, especially among young people whose psychological development is ongoing.
That restraint has eroded. Official data from the Regional Euthanasia Review Committees reveal a dramatic surge. Psychiatric euthanasia cases climbed from just 2 in 2011 to 138 in 2023, then jumped another 60% to 219 in 2024. Within this expansion, youth cases stand out. Between 2020 and 2024, euthanasia for individuals under 30 increased six-fold from 5 to 30 cases. In 2024 alone, 30 people aged 15–29 received euthanasia for psychological suffering, representing about 3.1% of all deaths in that age bracket. Of these, 25 were female. When combined with suicides, assisted dying now accounts for a rising proportion of premature deaths among young adults, particularly women.
High-Profile Cases and Common Profiles
Several cases have captured public attention and fueled debate. In 2018, the story of Aurelia Brouwers, a 29-year-old woman with severe psychiatric issues, highlighted the application of euthanasia to non-terminal mental suffering. More recently, a 29-year-old Dutch woman was approved for assisted dying on grounds of unbearable mental pain, reigniting discussions across Europe.
Younger cases involve complex trauma. One documented instance featured an 18-year-old with obsessive-compulsive disorder, an eating disorder, and autism who, after years of treatment, requested death, describing her suffering as intolerable. Another involved a 17-year-old girl named Milou Verhoof, who endured PTSD, depression, self-harm, and multiple abuses. She received euthanasia after her family connected with a supportive clinician. Such stories often feature diagnoses including depression, anxiety disorders, PTSD, autism spectrum conditions, and personality disorders. Patients report chronic, unrelenting distress despite extensive therapy, medications, and hospitalizations.
Experts note that these young women frequently cite a profound sense of hopelessness—a belief that their condition is irremediable and that life holds no prospect of meaningful relief. Social marginalization, developmental vulnerabilities, and failures within the mental health system are recurring themes.
Drivers Behind the Increase
Several interconnected factors appear to drive this trend. First, evolving interpretations of the law have lowered practical thresholds. While the legislation itself has not changed, a more permissive stance on “unbearable suffering” and shorter assessment periods has emerged in some circles. A small but influential group of psychiatrists and advocacy organizations, such as the KEA foundation (Knowledge Center for Euthanasia in Mental Disorders), have actively promoted greater access. These groups, often including relatives of those who died, lobby for acceptance and support patients navigating the process.
Media coverage plays a significant role. High-profile documentaries, television appearances, and sympathetic reporting amplify stories, leading to contagion effects. Requests tend to spike following prominent cases, especially among young women vulnerable to social and media influences. Social media further accelerates this dynamic, normalizing assisted dying as a legitimate response to mental anguish.
Underlying these are systemic challenges in Dutch mental healthcare: long waiting lists, fragmented services, and a perception among some patients and clinicians that conventional treatments have been exhausted. In this context, euthanasia can appear as a compassionate option rather than a last resort. Proponents argue it respects individual autonomy and prevents more violent or solitary suicides. However, epidemiological analyses question this, suggesting that euthanasia is an inefficient prevention strategy and may reframe suicidality from a symptom to be treated into an acceptable endpoint.
Developmental psychology adds another layer of complexity. Brains continue maturing into the mid-20s, and conditions like depression or trauma responses in young people often fluctuate or improve with time, support, and evolving life circumstances. Critics contend that declaring such suffering “irremediable” at a young age risks prematurely ending lives that could recover.
Professional and Societal Concerns
The trend has provoked unease within the Dutch psychiatric community. Many professionals remain deeply reluctant, viewing psychiatric euthanasia—especially for youth—as incompatible with core duties of suicide prevention and long-term care. Surveys show moral discomfort and fears of role confusion. In one notable response, groups of psychiatrists have raised alarms through open letters, warning of unnecessary deaths and the risks of activist influence pressuring practitioners.
Figures like retired psychiatrist Menno Oosterhoff illustrate the divide. After a personal “moral awakening,” he performed multiple psychiatric euthanasias, including on minors, and publicly advocated through media, a book, and his foundation. While some hail him as a pioneer of compassion, others criticize practices such as redirecting patients from ongoing treatment teams and publicizing cases, arguing they undermine therapeutic relationships and exploit vulnerability.
Broader concerns include contagion risks, shifting cultural norms around death, and the potential for vulnerable individuals—particularly those with trauma or autism—to opt for death amid inadequate support. As one analysis noted, introducing medicalized death into youth mental health care carries population-level consequences that are difficult to reverse.
Internationally, the Dutch experience serves as a cautionary reference. Countries like Belgium have followed similar paths, while others, including Canada, debate expansions into psychiatric cases. The Netherlands’ model, once praised for its safeguards, now prompts questions about whether procedural flexibility has outpaced clinical certainty.
The rise in assisted dying among young Dutch women in their twenties reflects deeper societal tensions: the balance between autonomy and protection, the boundaries of medicine in addressing existential suffering, and the adequacy of mental health systems. Absolute numbers remain relatively low, yet the rapid acceleration and concentration among young females demand attention.
Supporters emphasize dignity and choice in the face of unrelenting pain. Detractors stress the need for greater investment in prevention, therapy, and social support, alongside stricter guardrails to protect those whose conditions may not be truly terminal. As debates continue, the Netherlands grapples with whether its pioneering approach to euthanasia has ventured into territory where psychiatry’s predictive powers are stretched too thin.
This phenomenon underscores a universal challenge: how societies care for those in profound mental distress without prematurely foreclosing the possibility of recovery and a meaningful life. Ongoing monitoring by review committees, professional reflection, and public discourse will shape whether this trend stabilizes or expands further. For now, it stands as a stark illustration of evolving attitudes toward life, suffering, and death in a modern welfare state.
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