Dutch psychiatrists have issued a stark warning to Canadian lawmakers: do not expand medical assistance in dying (MAID) to people whose sole underlying condition is mental illness. During a special joint committee meeting, experts from the Netherlands shared their troubling experiences with psychiatric euthanasia, which has been legal there since 2002.
Sharp Rise in Requests
Requests for MAID on mental health grounds have skyrocketed in the Netherlands, from fewer than five cases per year to approximately 1,000 in 2024. Dr. Jim van Os, a professor of psychiatry at Utrecht University Medical Centre, noted that cutbacks in mental health services have left severely distressed patients languishing on waitlists, driving demand for euthanasia.
In 2024, 219 people were granted euthanasia for one or more psychiatric illnesses. Of these, 30 deaths were among individuals under 30, and 111 were aged 30 to 60. Depression was the most common condition cited.
Euthanasia as Physician-Performed Suicide
Van Os argued that euthanasia for mental suffering cannot be cleanly separated from physician-performed suicide. “It is, in many cases, suicide carried out by a psychiatrist,” he told parliamentarians. He emphasized that it is virtually impossible to distinguish between a rational, well-considered request for MAID and an impulsive one, leading to doctors performing what amounts to suicide.
Dutch law requires that euthanasia be a very last resort, with no reasonable treatment options left. However, Canadian law does not mandate that all possible treatments be tried first. “That single difference will, in our assessments, drive Canadian numbers beyond ours,” van Os warned.
Vulnerable Populations at Risk
The committee heard that most individuals requesting MAID for mental illness in the Netherlands are traumatized, marginalized, often living in poverty, and disproportionately women. Dr. Wilbert van Rooij, a Dutch psychiatrist with nearly 30 years of practice, reported seeing more vulnerable and often relatively young patients who are treatable but not receiving adequate care due to eroded mental health services.
Psychiatric euthanasia has gradually become normalized in the Netherlands, van Rooij added, raising concerns about the potential for similar trends in Canada.
“My message to Canada: do not expand. The evidence is not there,” van Os concluded, urging lawmakers to reconsider the proposed expansion.
