Euthanasia for young people and Psychiatric reasons in the Netherlands.

Alex Schadenberg
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 authors examine the Netherlands euthanasia data and suggest that there was "professional restraint" in the early years of the euthanasia law since the law did not prohibit euthanasia for young people or based on mental illness. The authors explain that euthanasia for these groups, in the early years, was almost non-existent. They write:

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.

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.

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:

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.

The authors then describe the role of Menno Oosterhoff in creating an atmosphere of acceptance for youth and psychiatric euthanasia. The authors write:

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.

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.

Canada has had a similar experience with Dr Ellen Wiebe's euthanasia practise. 

Euthanasia for psychiatric issues in the Netherlands has turned suicide prevention efforts upside down. The authors write:

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.

The activities of KEA and the Thanet group caused a group of psychiatrists to submit their concerns. The authors explain:

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.

The authors call on International guidelines to fill in the blanks in countries like the Netherlands and Canada who lack defined guidelines. They write:

The emergence of such institutional guidelines should be understood not as a solution, but as a symptom. They reflect the absence of a coherent national framework capable of holding together legal permissibility, clinical uncertainty, developmental science, and moral responsibility. Youth with severe mental suffering do not primarily need more refined procedures for death. They need time, continuity, relational safety, and systems capable of holding despair without prematurely foreclosing the future. The Dutch system, as it currently functions, offers certainty where humility is required and procedural clarity where ethical wisdom is lacking. No one can say with confidence where this trajectory will end. What is increasingly clear is that psychiatry, positioned as arbiter of death in the lives of youth, is being asked to carry a responsibility it cannot ethically or scientifically sustain.

This article is particularly important for Canada. Canada also lacks definitive guidelines and Canada has approved euthanasia for mental illness to officially begin on March 17, 2027. Canadians need to examine the Netherlands data and then reject euthanasia for youth and for mental illness.