A significant challenge to the Dutch liberalism regarding Euthanasia has been made early this year by Jim Van Os, Wilbert Van Rooij, and Mark S Komrad, three psychiatrists in Holland who are persuasively arguing that activists have pushed the boundaries of psychiatry to seriously threaten the survival of the psychiatrically vulnerable. The 2002 legalization of assisted suicide in Holland has not led to a quiet and professional assessment of case by case with caring and thoughtful, but nonpolitical professionals, rather it has seen the growth of activist groups that are now actively involved in assisted dying of vulnerable patients.

Rightly the three psychiatrists keep the debate in the context of suicide statistics generally, as people will commit suicide anyway, but when there is a statistically significant rise in cases it needs professional and dispassionate assessment. In 2024 there was discovered to be a six-fold increase in suicides amongst the under thirties.  “Raising serious concerns about contagion effects, shifting cultural norms and the popular level consequences of introducing medicalized death into the care landscape for youth with mental health suffering.” 

I agree with the three authors concerns, especially when I hear the activists speaking of their encouragement of medical suicides, as “expression of compassion and respect for autonomy”. I am thinking of the 180-degree logic of the personality disordered! What are these activists up to? Why not just respectfully walk down the path with the suffering patient, rather than pushing your advice for termination of their life?

One doctor labelled himself as a “moral pioneer” with the term, “mentally terminal” to describe mental health patients who ought to be offered euthanasia.  It is certainly a cost saving to the State, but is it moral, ethical and a reflection of genuine care? I am pleased to see that the UN Committee for the Right of Persons with Disabilities has “formally urged the Netherlands to reconsider its euthanasia practices because of insufficient protection for vulnerable individuals.”

Let us always beware of any form of activism in either direction when quiet and thoughtful assessments are called for and genuine patient empowerment, in whatever direction they desire, is encouraged.