Assisted deaths among individuals with mental disorders in the Netherlands have seen a significant increase in recent times. This trend has sparked concerns among some Dutch psychiatrists regarding its implications for Canada, although opinions on the matter vary.
The discussion emerged during recent hearings held by a federal committee tasked with advising the Canadian government on medical assistance in dying (MAID). The Special Joint Committee of Medical Assistance in Dying is currently examining whether Canada should permit individuals with solely a mental disorder to apply for MAID starting from March 2027. The final report is anticipated by June 17, coinciding with the 10th anniversary of MAID legalization in Canada. The federal government has postponed expanding eligibility twice, awaiting the committee’s recommendations.
The Netherlands was the pioneer in formally legalizing assisted dying in 2002, including for individuals with psychiatric conditions. Consequently, its experience often serves as a reference point in Canada’s deliberations.
Dr. Jim van Os, a professor of psychiatry and neuroscience at Utrecht University Academic Hospital in the Netherlands, emphasized during recent testimony that the Dutch situation should serve as a cautionary tale for Canada. Dr. van Os and psychiatrist Dr. Wilbert van Rooij highlighted a concerning uptick in individuals, particularly youth, seeking assisted death due to mental anguish.
Despite the rise in cases in recent years, not everyone shares the view that the situation is critical. Dr. Sisco van Veen, a geriatric psychiatrist leading the End-of-Life research group at Amsterdam University Medical Center, expressed that the Netherlands is still in an evolutionary phase that requires time to stabilize following the cultural shift in end-of-life practices.
Data indicates that while cases remain infrequent, they are on the rise. Between 2002 and 2010, the Netherlands reported only one or two psychiatric-related assisted deaths annually across all age groups. By 2024, psychiatric-related cases had surged to 219, with an increase in cases involving individuals under 30. In 2025, there were 19 cases involving individuals aged 29 or younger.
Dr. van Veen stressed the importance of recognizing the suffering of individuals in these cases while underscoring the relatively low numbers. The most recent report by the Regional Euthanasia Review Committee revealed a reduction in psychiatric assisted deaths in 2025, with such cases accounting for about 1.7% of all assisted deaths in the Netherlands.
Concerns persist over the limited availability of comprehensive data on total applications, as highlighted by critics like Dr. van Os. A study examining nearly 400 completed applications by Dutch individuals aged 24 or younger found that only 12 were approved, with the majority being women. The most common diagnoses included major depression disorder, autism spectrum disorder, and eating disorders.
While supportive of assisted dying in extreme psychiatric cases, Dr. van Os emphasized the need for improved safeguards and a greater focus on aiding young individuals before resorting to such measures.
The debate surrounding MAID for mental illness remains contentious in Canada. Should Canada proceed with MAID for psychiatric disorders, both Dr. van Os and Dr. van Veen advocate for enhanced safeguards and a robust due diligence process involving external expert review.
Dr. van Veen urged for a meticulous evaluation process, possibly through an expert committee representing diverse disciplines to assess each case thoroughly. As the discussions unfold, he emphasized the importance of compassion and understanding for individuals in vulnerable positions.
Overall, the complexities and sensitivities involved in this debate necessitate a collaborative and empathetic approach from all stakeholders involved.
