These experiences got me thinking. My feelings about the euthanasia process and legislation in the Netherlands, have become very complex.”

In our the Netherlands euthanasia is legal under very strict conditions

These conditions apply to psychological suffering, as well as physical suffering. The idea behind this may sound humane, but in practice it’s actually heartbreaking and raises important ethical questions. Young people, often with a background of serious traumas, sometimes reach the conclusion that death is the only solution. Once they’re determined, this conviction often becomes an obsession, especially because the option of euthanasia is legally permitted.

The nature of human behaviour is fundamentally unpredictable. People are plastic (as in: easily moulded) and variable; life can shape us  and reshape us in ways we don’t always directly understand. Affected by difficult life events, like mistreatment or abuse in our childhood, individuals may write themselves off and consider their lives intolerable. Dark moods, screaming voices in their heads, and existential fears can make their lives unbearable.

Euthanasia for Psychological Suffering ? Ability to change can lead to recovery

Yet time and time again I’ve seen how the same ability to change can lead to recovery, even from the deepest darkness. The problem with the way of practice nowadays is that once euthanasia is on the table, the process is no longer about trying different therapies, but about following a procedure.

Take for example a young woman that I know, aged 21

Before she was allowed euthanasia for psychological suffering, she had to have three different “evidence-based” protocol treatments: one for her eating disorder, one for her obsessive-compulsive disorder, and one for depression.

These treatments were carried out by professionals that didn’t know about each other and with whom she didn’t have personal relationship. Her underlying issue – a deep self-hatred because of abuse – was not addressed in any of those therapies. Now three years later, she’s still in a kind of limbo, unsure of her decision to pursue euthanasia.

This leads us to the question whether the Dutch mental health care sector can do better

It should be offering a process of hope and connection, in which therapy doesn’t necessarily have to be linear, or evidence-based, but humane, and tenacious, and in which therapy is continued for as long as necessary. An approach that mainly focuses on a person’s unique, individual needs, and that strives for recovery.

In our society, and definitely within the mental health care sector, we have to stay critical about how we deal with the option of euthanasia for psychological suffering. It’s time for a serious conversation about how we can realistically contribute to the recovery of the people who are the most vulnerable. We have to keep asking ourselves: are we doing enough? And more importantly: do we offer the right kind of support?

Translated from Dutch by SGM Taplin