Executive Director, Euthanasia Prevention Coalition
I had the opportunity to speak to the Joint Committee on Medical Assistance in Dying (euthanasia) on May 5, 2026 (Link to my testimony).
Before my presentation, the committee featured three Psychiatrists from the Netherlands explaining their experience with euthanasia for mental illness. Dr Jim van Os, a Professor of Psychiary at Utrecht University warned Canada not to extend euthanasia to mental illness.
Professor van Os told the Parliamentary committee:
The Dutch experience, in my opinon, offers a warning for Canada. For 20 years our euthanasia law left psychiatric cases largely untouched. However, over the past decade, a small group of activist physicians and organizations built a practice through sustained media campaigns.
In 2024, the Dutch Euthanasia Expertise Center (euthanasia clinic) received around 5000 requests, roughly 1000 on psychiatric grounds. Among people under 30, requests rose from about 30 per year to nearly 900 in six years. Completed euthanasia rose fivefold.
This pattern has been widely interpreted as a so-called suicide contagion effect amplified by the institutions that should safeguard against it.
This committee perhaps should keep in mind under the Dutch law physicians must agree that there are no reasonable options. Euthanasia is in principle the very last resort. Canadian law does not work this way.
In Canada patient choice trumps the physician's professional judgment. So a doctor cannot insist that other options be tried first. That single difference will in our assessment drive Canadian numbers beyond ours.
In 2024 the UN Committee on the Rights of Persons with Disabilities warned that the Dutch practice was unsafe. Persons with psychosocial disabilities have a fundamental human right of protection against premature death.
Euthanasia for mental suffering cannot be cleanly separated from physician performed suicide. It is in many cases suicide carried out by a psychiatrist.
Our research and clinical work reveal a minefield on every side.
Autonomy. Most who request euthanasia for mental suffering are traumatized, marginalized, often living in poverty without prospects.
Mental illness, by definition, compromises autonomy. Calling such a request a free expression of choice ignores the substance of the suffering.
Discrimination. The arguments that refusing euthanasia for mental suffering is discriminatory equates psychiatric suffering with terminal cancer. It is a false equivalence.
Cancer with a two-month prognosis is linear and progressive. Mental suffering is not. Recovery happens often unexpectedly through relationships, purpose, meaningful work, bonding with another person or even an animal.
The patient recovery movement insists that recovery is possible for everyone. Plasticity is the rule.
Criteria. Clinicians do not agree on irremediability, on futility, on competence. The result is something like a lottery.
Whether you receive suicide prevention or a lethal injection depends on which clinician you meet.
Substance. Recent Dutch analysis show that many who receive euthanasia for mental illness are women with unaddressed trauma. Their unconscious self-destructive dynamics get enacted in the procedure. The psychiatrist becomes recruited into a deadly outcome.
Toffrey Wayne and colleagues describe how, in the Netherlands, people with autism spectrum traits increasingly receive euthanasia for what is at root social suffering framed in medical language. The intervention should be social and existential, not lethal.
Psychiatry claims it can prevent suicide n one patient and help finalize suicide in another with the same suffering. That is incoherent. It is not autonomy, it is not anti-discrimination, it is a contradiction at the heart or our profession.
My message to Canada.
Do not expand euthanasia to those with mental illness. The evidence is not there. The UN, the International Association for Suicide Prevention and our lived experience point the same way.
The social trials that we run in the Netherlands show another path. Care that builds relational continuity, hope and connectedness. That is the system worth building, not procedural pathways to death.
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