The number of people whose request for euthanasia was granted on the ground of intolerable mental suffering has increased significantly, according to new figures from the regional monitoring body RTE.

The RTE received 138 notifications of euthanasia from people with psychiatric illnesses in 2023, 20% up from the year before.

In total, some 9,000 people died through euthanasia in 2023, or some 5.4% of the total number of deaths recorded in that year. Almost 90% of them were suffering from cancer.

In just five of the cases, the RTE found that the rules surrounding euthanasia were not adhered to properly and will be investigated.

As the number of cases of euthanasia for people with psychiatric illnesses rises, the RTE also found that more psychiatrists directly involved in the treatment of a patient had carried out requests.

Five years ago, the Expertise Centrum Euthanasie, set up to help people whose doctors are unwilling to help, was involved in over three quarters of euthanasia requests due to mental suffering. That has gone down to 50%, the RTE said.

“Psychiatrists know their patients best,” said Gerty Casteelen, who is one of the five psychiatrists employed by the centre.

“They have a long history with that patient and they know what treatments have been tried. They know about what has happened in their lives, their resilience and vulnerabilities and how they cope with problems,” she told Nieuwsuur.

Psychiatrist Annerieke Luijendijk, who recently carried out a patient’s request for euthanasia because of intolerable mental suffering for the first time, said that in many cases patients retract their request because they recuperate over time.

“Some cases inspire humility and reality among our profession. Sometimes mental suffering is so serious and so all-pervasive that euthanasia becomes a part of good medical practice,” she said.

To qualify for euthanasia in the Netherlands, the patient must be experiencing unbearable suffering with no prospect of improvement. Two doctors must also be involved, and meet detailed criteria covering duty of care.

Longer procedure

Requests for euthanasia because of mental suffering require a longer procedure to assess the seriousness of the affliction and the patient’s willingness to go through with it.

Just 10% of requests made to the centre for euthanasia due to unbearable psychiatric problems are actually granted.

“Most do not fit the legal framework,” Casteelen said. “Sometimes procedures take years. That involves many sessions and perhaps a decision to try more treatment. And sometimes the wish to die disappears completely. That is good news.”