Euthanasia for mental illness

Euthanasia for mental illness involves a physician intentionally ending the life of a patient who has requested euthanasia due to a psychiatric condition. The practice is legal in Belgium,^[1] the Netherlands,^[2] Luxembourg,^[3] Spain^[4] and Colombia.^[5] In Canada, legislation authorizing the procedure was passed, but has since been repeatedly postponed.^[6]

The practice is considered controversial as unlike with other types of euthanasia, a patient euthanized for mental illness alone is usually not terminally ill, and may have their decisional capacity impeded by their condition.^[7][8][9] It is also considered more difficult with psychological conditions to determine an objective prognosis, or whether a disorder is irremediable.^[10][11]

By country

Belgium

In Belgium, euthanasia for mental illness is legal if the patient is mentally competent to make the decision; the patient requests euthanasia on two separate occasions in writing; the patient is suffering from an incurable disease or mental illness, and all treatment options have been exhausted; and the patient is experiencing "unbearable suffering" from the illness, either physically or psychologically.^[12] Three doctors must agree to grant euthanasia in psychiatric cases.^[13][14] Euthanasia for mental suffering is not available for children.^[15]

As of 2017, approximately 40 patients per year received euthanasia due to mental illness, out of approximately 2,000 total yearly euthanasia deaths.^[15]

In 2020, a Belgian court acquitted three doctors who had euthanized Tine Nys, a physically healthy 38-year-old woman with autism, of manslaughter charges.^[16] Nys' sister Sophie Nys had filed a lawsuit alleging that the doctors did not properly attempt to treat her condition, and that Nys had not been incurably ill as the law required.^[16]

Netherlands

Euthanasia for mental illness has been legal since 2002 in the Netherlands provided the patient has "unbearable suffering with no prospect of improvement" and has requested to die in a way that is "voluntary, well considered and with full conviction", among other criteria.^[17][18] In 2020, the Supreme Court of the Netherlands ruled that physicians could euthanize patients with dementia if they had expressed a wish to die before the onset of their condition.^[19]

The 2016 euthanasia of Eelco de Gooijer, a 38-year-old man from Tilburg who had depression and autism, was one of the first high-profile euthanasia cases involving a young person with a neurodevelopmental condition and mental illness.^[18][20]

In 2023, 138 people in the Netherlands received euthanasia due to psychiatric conditions, a 20% increase from 2022.^[21] The first minor euthanized for a psychiatric condition (who was between 16 and 18-years-old) was in 2023.^[21]