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| Professor Jim van Os |
Executive Director, Euthanasia Prevention Coalition
Research by Jim van Os, a Professor of Psychiatric Epidemiology and Public Health at Utrecht University Medical Centre, in The Netherlands, that was published on April 22, 2026 by Cambridge University Press, examines the relationship between suicide and youth psychiatric euthanasia.
van Os responded to the claim that youth psychiatric euthanasia is necessary to prevent violent suicide deaths. Based on research on 353 young euthanasia applicants, van Os concludes that for every 10 youth psychiatric euthanasia deaths, 9 would not have died by suicide. van Os writes:
Thus, ten youths would need to undergo assisted dying to prevent one suicide, and nine would die without a preventive purpose having been served. Empirically and ethically, the prevention argument does not appear to hold; real prevention requires other, previously well-debated factors such as relational continuity, trauma-informed care and social inclusion in response to mental suffering.
van Os presents his concerns that the number of youth psychiatric euthanasia deaths in the Netherlands has increased substantially. He writes:
Between 2020 and 2024, the number of euthanasia procedures for individuals under 30 rose from 5 to 30, a sixfold increase, representing over 9% of all premature deaths (suicide + assisted dying) in that age group.
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The "suicide prevention" argument was promoted by Menno Oosterhoff, a retired Dutch Psychiatrist. van Os explains:
The suicide prevention argument in The Netherlands was most notably advocated by a retired psychiatrist, who admitted in a national newspaper to having performed euthanasia 12 times in 11 months, including young people and minors. Introducing deterministic terminology like calling patients ‘mentally terminal’, the retired psychiatrist argued that refusing assisted dying to a suicidal patient can be catastrophic in the case of a ‘false-negative’ event.
The prevention argument has received sympathetic and emotionally charged media coverage. There is anecdotal evidence that, as a result, clinicians in The Netherlands are increasingly faced with demands by young people – and sometimes their families – that euthanasia is indicated in order to prevent a suicide.
van Os explains the data concerning young people who request euthanasia:
The recent study by Schweren and colleagues on 353 young people (<24) who applied for psychiatric assisted dying at the Dutch Euthanasia Expertise Centre found that: 47% of applicants withdrew their request, 45% were rejected, 3% died by assisted dying and 4% died by suicide during the evaluation process, translating to an annual suicide risk of around 2.9%. So in this group explicitly requesting euthanasia, the annualised suicide rate is about five-fold higher than in other high-risk psychiatric populations – but still far from universal, meaning most do not die by suicide, even after requesting assisted dying.
No jurisdiction that has legalized euthanasia has experienced a decrease in the suicide rate, van Os explains:
Empirically, there is no population-level evidence that assisted dying reduces suicide mortality. A systematic review by Doherty and colleagues found no consistent reduction in suicide rates in countries that legalised assisted dying; in some, suicides even increased. In The Netherlands, despite growing numbers of psychiatric euthanasia cases, suicide among young women continues to rise.
van Os then examined the theory that permitting euthanasia for youth with mental illness will decrease suicide. van Os uses "generous assumptions" and found:
Thus, even under generous assumptions, and realistic sensitivity scenarios thereof, the ‘preventive’ justification for assisted dying is not convincing. The intervention eliminates far more lives than it plausibly saves.
van Os examines several other factors and concludes that theory that permitting psychiatric euthanasia reduces other suicides creates a form of collusion:
When suicide prevention morphs into medicalised facilitation of death, prevention logic collapses into complicity. The preventive claim – ‘better assisted dying than a violent suicide’ – assumes a causal substitution that cannot be empirically or ethically established. It risks transforming demoralised youth into ‘false positives’ of a system that mistakes despair for autonomy.
From a strictly epidemiological standpoint, that facts are that: (a) suicide remains a rare outcome, even among those requesting assisted dying; (b) predictive accuracy for suicide is low; positive predictive value in youth is <20%; and (c) no evidence exists that assisted dying reduces suicide rates; in any realistic model, around 10 young people die for each suicide theoretically prevented by assisted dying.
Therefore, the argument that youth euthanasia prevents suicide appears to be scientifically unfounded and morally inverted. True suicide prevention lies not in medical facilitation of death but in restoring relational continuity, trauma-informed care and societal inclusion. Compassion without critical reasoning risks becoming cruelty by proxy.
The research by Jim van Os is important as Canadian debates extending euthanasia to people for psychiatric reasons alone.
Recently, euthanasia activist and academic, Jocelyn Downie, argued before a Parliamentary Committee that preventing euthanasia for mental illness alone will lead to violent suicide deaths.
Jocelyn Downie
Downie is a long-time activist who has bought into the Oosterhoff theory that euthanasia reduces other suicides. But Downie, like the others, didn't test the theory with actual data.
Canada has experienced a massive increase in euthanasia deaths and has also experienced a massive increase in suicide deaths. If Oosterhoff and Downie are correct, the suicide rate would actually be going down, or minimally speaking, not increasing.
There is no jurisdiction, over a long period of time, that experienced a lowering of the suicide rate after legalizing euthanasia or assisted suicide.
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