Thank you, Mr. Chair.
Honourable committee members, thank you for inviting me. I'm a Dutch psychiatrist. For nearly 30 years, I've worked with people with severe psychiatric disorders. In that time, I've seen mental health services in the Netherlands steadily erode, especially for those with the most complex conditions. This deepens despair and may contribute to a wish to die in some patients.
Since euthanasia was legalized in 2002, psychiatric euthanasia or MAID has gradually become normalized in the Netherlands. This trend has rapidly accelerated in the past decades.
In my practice, I now meet more vulnerable, often relatively young, patients who are, in principle, treatable. However, they request euthanasia because timely and adequate care for them has been eliminated for political and economic reasons. At the same time, a small group of activist physicians has adopted an increasingly permissive approach to MAID, often justified in the language of autonomy and compassion.
In 2024, with several colleagues, I raised the alarm about how broadly the legal due care criteria are being interpreted in psychiatric cases. The resulting debates revealed deep division and a lack of consensus among Dutch psychiatrists.
I speak today, out of care and responsibility, to warn of the dangers when structural shortages in mental health care and ideological convictions begin to shape decisions about life and death for some of the most vulnerable people in our society. Allow me to frame this with a story older than any of our laws.
When the Greek hero Odysseus finally sailed home, he was exhausted and wounded after years of war in Troy. On the last stretch, he faced the sirens, voices promising peace and an end to suffering. He knew that if he listened freely he would perish, so he asked his crew to bind him to the mast, not because he was weak but because he understood that the urge to escape pain can peak precisely when judgment is most vulnerable.
As a clinician, that image returns to me when I consider euthanasia for psychiatric patients. I have sat with many people who are tired in this Odyssean way, worn down by chronic depression, trauma or personality disorders. When they say to me, “I don't want to live anymore,” in most cases they are not asking to die. Often they are asking for pain to stop, for meaning to return and for someone to not give up on them.
For doctors, the central question can shift from “Is there still hope?” to “Have we followed the steps?” Suffering becomes something to be assessed, documented and, ultimately, validated by death.
Psychiatric euthanasia increasingly involves young people with conditions that fluctuate over time. These are not terminal illnesses; they are lives with uncertain trajectories. Euthanasia requires certainty, irremediable suffering. In psychiatry, that certainty is often an illusion. Moreover, vulnerability is not evenly distributed. In the Netherlands, women, young adults and people with trauma histories, autism, intellectual disability or personality disorders are overrepresented among those requesting and being granted psychiatric euthanasia. These are often people whose agency has been eroded by life experiences. To call this pure autonomy is clinically naive.
As a psychiatrist, I am trained to tolerate despair without endorsing it, to stay present and still say, “I don’t know the answer yet, but I am not done with you.” That stance is not paternalism. It's fidelity. It's what kept Odysseus alive until the voices had passed.
Canada now stands at a similar narrow strait. If you extend euthanasia to psychiatric suffering, you will not simply add an option. You will reshape the moral landscape of care.
You ask clinicians to decide not only when life can no longer be cured, but when it no longer should continue. That is a burden psychiatry was never designed to carry.
I ask you to pause to listen not only to legal arguments but to clinical experience, to those who have seen safeguards stretch, criteria soften and procedure replace presence.
Binding ourselves to the mast is not cruelty; sometimes it's the most humane act we have. Please do not ask psychiatrists and doctors to become the sirens for people who need our compassion, care and protection.
Thank you, Chair.