Executive Director, Euthanasia Prevention Coalition
In the Netherlands, euthanasia for psychiatric reasons and for young people have increased substantially over the past few years.
Jim van Os, MD, PhD, Wilbert van Rooij, MD, Mark S. Komrad, MD, DFAPA wrote a research article that was published in the Psychiatric Times on March 5, 2026 examining these issues.
The numerical trend among youth underscores why concern has intensified. For many years, psychiatric euthanasia in the Netherlands was virtually nonexistent. Between 2002 and 2010, only 1 or 2 cases per year were reported across all age groups. This changed markedly after 2011. According to data published by the Regional Euthanasia Review Committees, the number of psychiatric euthanasia cases increased from 2 in 2011 to 138 in 2023, followed by a further sharp rise to 219 cases in 2024, representing an increase of roughly 60% in a single year.The authors suggest that the majority of Psychiatrists in the Netherlands remain reluctant to participate in euthanasia but a small group of psychiatrists have has actively promoted psychiatric euthanasia as an expression of compassion and respect for autonomy and they have established a group called the Dutch, Knowledge Center for Euthanasia in Mental Disorders (KEA) that is actually an activist group. The authors explain:
Within this expansion, youth euthanasia cases are increasingly prominent. Between 2020 and 2024, the number of euthanasia cases for individuals under 30 rose from 5 to 30, a 6-fold increase, representing over 9% of all premature deaths (suicide + assisted dying) in that age group in the Netherlands. When requests rather than completed euthanasia are considered, the numbers are worrying. Given that an estimated 3% of youthful (<24 years) applicants receive euthanasia, the estimated number of youthful applicants in 2024 would total 7300.
According to its website, its aim is to increase knowledge and societal acceptance of euthanasia for mental suffering, to improve access to euthanasia trajectories, and to support and advocate for patients with mental illness who request euthanasia, as well as their relatives and involved professionals. While presenting itself as a foundation for recognition and dignity, KEA operates as an activist organization, lobbying policymakers, engaging strategically with media, and exerting public pressure on dissenting professionals.The authors continue:
In this framing, complex mental suffering rooted in trauma, social marginalization, developmental vulnerability, and failures of care are increasingly presented as a medical dead end. Structural deficits in mental health services, including long waiting lists and fragmented care, fade into the background. Professional hesitation is reframed as cruelty or paternalism rather than as clinical prudence.This is an important statement for Canada to consider. Since Canada also has massive structural deficits in mental health services and long waiting times, promoters of euthanasia for mental illness would also argue that it is a cruel paternalism to deny a person death by euthanasia.
This shift has been personified by Menno Oosterhoff, a retired Dutch psychiatrist whose actions have profoundly shaped public perception. In an 11-month period, he performed 12 euthanasia procedures for mental suffering, including cases involving youth and at least 1 minor. He publicly described his trajectory as a moral awakening, introducing the term “mentally terminal” to suggest an analogy between mental suffering and terminal somatic illness.Canada has had a similar experience with Dr Ellen Wiebe's euthanasia practise.
The concept has no grounding in psychiatric science or developmental psychology, but it proved rhetorically powerful. Oosterhoff recorded euthanasia conversations with a minor and made them available online.9 The material was later removed as the footage caused significant distress among clinicians, ethicists, and child psychiatrists. Yet, rather than prompting restraint, it increased his visibility. He became a frequent guest on television talk shows and published a bestselling book, positioning himself as a moral pioneer.
Colleagues reported troubling practices.9 Young patients were sometimes redirected toward euthanasia pathways while their treating teams were still actively engaged and believed meaningful improvement was possible. The message implicit in such interventions was that persistence in treatment could be bypassed if even one clinician was willing to declare suffering irremediable. The clinical authority of ongoing therapeutic relationships was thus undermined by a parallel pathway oriented toward death.
A central justification advanced by proponents is that psychiatric euthanasia prevents violent or lonely suicides. While emotionally compelling, this claim fails empirically. Epidemiological analysis demonstrates that even under optimistic assumptions, euthanasia functions as a profoundly inefficient and harmful preventive strategy. Approximately 9 young individuals would need to die by euthanasia to prevent 1 suicide.
This result reflects a fundamental base-rate problem. Even among high-risk psychiatric populations, suicide remains a rare event. Introducing euthanasia as a sanctioned outcome reframes suicidality from a symptom requiring containment into a potential treatment endpoint, an acceptable “treatment plan.” For youth with trauma histories and narrowed future perspectives, this can entrench death-focused thinking rather than alleviate it.
A group of psychiatrists submitted a letter to the Dutch Public Prosecution Service to raise alarm about the activities of the KEA foundation and Thanet, a web-based pro-euthanasia initiative. This letter argued that the combined media activism of KEA and the policy-driven pressure created by Thanet substantially contributed to the well-known Werther or contagion effect,15 as repeated television appearances and newspaper stories were followed by a sharp rise in euthanasia requests from youth, raising serious concern that the Netherlands was drifting toward a harmful and irresponsible practice.





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