MPs have voted for euthanasia in the UK - so how do we stop psychiatry from using it against women?
Dr Jess discusses real cases of women being abused, diagnosed with mental disorders - and then offered euthanasia
One way women diagnosed with mental disorders die is through the relatively new practice of “psychiatric euthanasia.”
I write about this extensively in my 2022 book, ‘Sexy But Psycho’.
Currently, this practice - granting people permission to die via lethal drugs - is legal only in places like The Netherlands, Canada, and Belgium. The laws governing this form of euthanasia require that the individual must be in unbearable mental pain, three psychiatrists must agree there is no reasonable prospect of improvement, and there must be no reasonable alternative to dying.
So far, all young women who have died by euthanasia and whose cases have been reported in the media were subjected to sexual abuse and significant trauma. These cases are devastating, not least because they represent the worst possible outcome for women who are pathologised by a system that convinces them they have incurable mental illnesses that will affect them for the rest of their lives.
Has anyone considered that this narrative—rooted in centuries of misogyny, dubious science, and myths about the brain—would lead to young women seeking euthanasia to end their lives with the approval of doctors who believe there is no hope for their psychiatric conditions?
This is a vital question, especially for those who believe women and girls suffer from mental disorders, chemical imbalances, and genetic predispositions.
Do we truly believe in the medical model of mental health to such an extent that trauma is treated as a terminal illness, with death as the only escape?
In January 2018, 29-year-old Aurelia Brouwers from the Netherlands drank a lethal mixture of poisons to end her life through voluntary euthanasia. She explained in a statement, “I’m 29 years old and I’ve chosen to be voluntarily euthanised. I’ve chosen this because I have a lot of mental health issues. I suffer unbearably and hopelessly. Every breath I take is torture. When I was 12, I suffered from depression. When I was first diagnosed, they told me I had Borderline Personality Disorder. Other diagnoses followed—attachment disorder, chronic depression, I’m chronically suicidal, I have anxiety, psychoses, and I hear voices.”
There are several key reasons why this should never have been allowed to happen.
First, the psychiatric diagnoses themselves are highly contested, biased, and often misogynistic. They are frequently used in cases where women and girls have experienced significant trauma and abuse. If the diagnoses are so controversial and lack a robust evidence base, how can they be used with such lethal certainty to declare there is no hope for improvement?
Second, it is entirely normal for women and girls subjected to significant trauma to frequently consider suicide or death. This is a normal trauma response stemming from feelings of helplessness, hopelessness, powerlessness, exhaustion, oppression, or the need for closure. It is not a psychiatric illness or mental disorder—it is an understandable reaction to extreme harm. From Aurelia’s media appearances and writings, it is clear her diagnoses, medication, and institutionalisation only deepened her distress and trauma. She wrote that her diagnoses grew more complex until she was told there was no realistic hope for improvement, leading her to decide she no longer wanted to live.
This would make sense only if psychiatry and the medical model of mental health were indisputable facts. However, they are merely theories, and competing theories of mental health and illness exist. Many doctors would never agree to euthanise someone based on trauma and mental distress, as it is impossible to definitively prove that a person’s condition will never improve. In Aurelia’s case, even her own doctor refused to support her euthanasia application. The idea that her circumstances would never improve and that she would be better off dead is unprovable.
This is not comparable to someone with a terminal, late-stage disease causing severe pain and suffering, where death is inevitable within weeks or months. Mental illness is fundamentally different from physical illness. No matter how much funding, celebrity endorsements, or carefully worded campaigns have been poured into equating mental and physical health, this comparison is factually incorrect.
Third, this approach sets a dangerous precedent. It has already led to more young women seeking to end their lives through voluntary euthanasia for psychiatric conditions deemed incurable. Why would any professional advocate for or support a framework that treats women’s trauma as a legitimate reason for euthanasia?
Consider Noa Pothoven, a 17-year-old who starved herself to death in 2019 after being subjected to sexual violence. She had expressed a desire for voluntary euthanasia but was not granted approval. Instead, she decided to stop eating and drinking until she died, announcing her decision on social media. Doctors, rather than intervening to protect her, agreed there was no realistic prospect of improvement and withdrew her feeding tubes, effectively granting her wish to die.
In another case, an unnamed Dutch woman in her early twenties chose voluntary euthanasia after disclosing she had been sexually abused between the ages of 5 and 15. She was diagnosed with multiple psychiatric disorders, deemed incurable, and said to have no reasonable prospect of improvement, despite records indicating that intensive trauma therapy had significantly improved her mental health. Doctors concluded that her conditions were incurable and approved her euthanasia. Shockingly, this case was released by the Dutch government as an example of best practice, highlighting the supposedly rigorous decision-making process for euthanasia.
But how rigorous can this process be when it disregards the problematic evidence base of psychiatric diagnoses being incurable?
Moreover, what about the evidence showing women and girls are disproportionately diagnosed and medicated rather than having their traumas validated?
Are we witnessing the normalisation of using death as a treatment for women’s trauma? It seems that we already have.
I do not agree that euthanasia should be legalised in the UK unless there is absolutel guarantee that it can never be used for mental health, and there are absolutely watertight safeguarding laws around it.
We are already seeing mistakes being made in other countries. We are already seeing the huge increase in young women ending their lives via euthanasia because doctors are telling them that they will never ‘recover’ from ‘mental disorders’.
I cannot believe we are watching this system fail so dangerously elsewhere and then thinking that we should also adopt it here.
As a Dutch person I am proud that my country was the first to enact a law allowing euthanasia. I have always been in favour of it. I think this article paints an unbalanced negative picture with a fair bit of emotive language. It is presented as if euthanasia for (young) women on the basis of mental suffering is or is becoming common, is exclusively based on cases where the woman was sexually abused, and that allowing it is always unconscionable.
The article intentionally uses the word “incurable” near the end, instead of “unbearable”, which is misleading at best. To my knowledge, and in a simplified explanation, there is no requirement for a condition to be “incurable” even for physical illnesses, in order to be judged “unbearable”, although incurability is used as an indicator. And that is completely correct in my view, because it is a major flaw to assume that mental suffering can never be shown to be insufferable. That assumes not only that there is treatment available, but that a patient does not have agency for self determination. You thereby declare all people suffering from mental trauma universally incompetent. That is, in a way, ironically patriarchally arrogant, certainly if the underlying motivation is the wish to protect women. I see that as a slippery slope to pre-determining what someone with mental suffering will be allowed to do. Is the next step forced treatment if a doctor says it should continue? What about forced medication?
I do not see any statistics in the article about a “huge increase of young women ending their lives via euthanasia” or that it only is granted to women with certain backgrounds. A ten second Google search showed me that at present around 1.5% of euthanasia cases in The Netherlands is granted on basis of mental suffering. Between 2020 and 2023 this was in total 456 people (from 115 in 2020 to 138 in 2023). Of those 456 people, 11% (52) were younger than age 30. Of those, 43 were women. However, the reason for the requests was not disclosed in this report to the Tweede Kamer (the equivalent of the English Lower House). It would be helpful to have an article based on more thorough statistical evidence comparing not only cases granted, to whom and why, but also the number of requests and the split in male/female, physical/mental, and the medical background. Without that, an article lacks credibility in its basic premise.
It is also incorrect that euthanasia is “offered” as a way out. The request for euthanasia must always come from the patient, and there are many more requests refused than are granted. It isn’t an easy process getting approval for it, but the article makes it seem that women are forced by the medical profession on a path of no return. That's rather insulting to the psychiatrists involved and their teams which are included in the deliberations before making recommendations.
The mention of a patient’s own doctor not supporting the request cannot be taken as an indication that the request is unfounded. The article does not specify whether this was a GP (who may have limited psychiatric expertise). In any event, the view of the patient’s doctor should not take precedence over the patient’s wishes. If a doctor refused a particular course of action for a patient with a physical illness, you would probably be the first to proclaim that the patient should seek a second opinion. I do not see why this would be different for a mental issue.
I do not believe that mental suffering should never be a ground for allowing euthanasia. To me that would be cruel, and only increases the chance of people taking their own lives in far worse ways than by medically assisted methods. That would go against the basic premise that someone suffering unbearably has the right to end their own life. The fact that mental suffering is more difficult to determine should not be a reason to place a blanket prohibition on granting a request. There may be a case for different guidelines or a minimum age (the latter is, as I understand, the case in Belgium). But the picture your article paints that hordes of (young) women are willy nilly allowed and helped to die based on in your view insufficient grounds is too black & white. And that can never be helpful to people struggling with severe mental suffering seeking a solution. For some, euthanasia may be that solution.
We recently had a case in Australia where an elderly gentleman chose VAD because he couldn’t access the home care that he needed to live independently with his medical conditions (and did not have any family either), which should be considered absolutely appalling since the government should be funding adequate health and community services but unfortunately barely caused a ripple. The sad reality that I see, particularly as a nurse of 20 years, is that the government and society in general (particularly pro- capitalists) prefers that people choose VAD as it lifts the burden from them to provide and invest in adequate health and social services (which is expensive if you do it properly).
While in some cases such as terminal cancer or neurological conditions it does provide a more compassionate end to the inevitable, there is a much greyer area and a very slippery slope in my opinion in situations such as psychiatry and geriatrics where it is very convenient to provide VAD in place of adequate services for our most vulnerable members of our communities, demonstrating a complete lack of care and compassion to those often deemed “too much trouble/unworthy/ inconvenient”.
The future of health and social services is here…too much of a burden/too expensive/too damaged….VAD…..