Zoraya ter Beek was a 28- to 29-year-old Dutch woman who chose to end her life through legal euthanasia in the Netherlands due to unbearable psychiatric suffering, even though she was physically healthy. Her decision drew widespread international attention because it departs from the more typical cases of euthanasia involving terminal physical illness, bringing to the fore global debates about autonomy, suffering, and the ethical limits of assisted dying. Ter Beek had lived with chronic mental health conditions, including depression, anxiety, trauma, an unspecified personality disorder, and autism, and had pursued extensive treatments without lasting relief. Her case was approved under the Dutch euthanasia regime, where mental suffering — if deemed truly unbearable with no realistic hope of improvement — can qualify someone for assisted death.
In the Netherlands, euthanasia and physician-assisted suicide have been legal since 2002, but only under strict criteria codified in the Termination of Life on Request and Assisted Suicide Act. Under Dutch law, a person may request euthanasia if they are experiencing ** “unbearable suffering with no prospect of improvement,”** and the request must be voluntary, well-considered, and thoroughly evaluated by multiple physicians and review committees. The suffering must have a legitimate medical basis, which can include somatic diseases, terminal conditions, and, in exceptional cases, psychiatric disorders — but not mere feeling “finished with life.” Importantly, physicians are not obligated to perform euthanasia even if the criteria are met, and doctors must notify review committees who assess whether due care was exercised.
Ter Beek’s struggle with psychiatric illness began early in life, and after years of therapeutic interventions — including talking therapies, medications, and extensive psychiatric care — she found her suffering persistently intolerable. Despite trying hopeful treatments, she described continuous cycles of pain and disappointment. Over a three-and-a-half-year evaluation process, Dutch physicians repeatedly confirmed that her suffering met the legal threshold and that no reasonable alternatives could meaningfully improve her quality of life. She later explained her choice as a deeply considered act of self-determination, not impulsive or unreflective, and she expressed relief at the relief the decision brought after long turmoil.
Supporters of ter Beek’s decision frame her choice within the larger context of personal autonomy and compassion for mental suffering. Advocates argue that severe psychiatric anguish can be as debilitating as physical pain, and denying someone the right to choose euthanasia solely because their suffering is psychological could unjustly privilege visible physical illness over invisible psychological anguish. They point to the safeguards in Dutch law — multiple evaluations, voluntary consent, and careful review — as evidence that psychiatric euthanasia is not taken lightly, and that autonomy and dignity should extend to those whose illnesses are primarily mental. For supporters, ter Beek’s case is a powerful affirmation that suffering should be understood in its full human context, not only through physical disease.
Critics, however, see ter Beek’s case as deeply troubling. They argue that allowing euthanasia for psychiatric conditions risks normalizing death as a response to mental illness, especially since mental health conditions like depression can fluctuate over time and may respond to future treatments. Opponents contend that hopelessness itself is a symptom of depression, potentially undermining true autonomy at the moment of decision. Some physicians and ethicists warn that expanding euthanasia criteria to include mental suffering could blur the line between suicide prevention and suicide sanction, and some raise the specter of a slippery slope where eligibility expands further, especially among younger people. The significant rise in psychiatric euthanasia cases in the Netherlands — from just two such cases in 2010 to hundreds in recent years — feeds these concerns, prompting calls for greater ethical scrutiny and caution.
The response to ter Beek’s story has been varied and deeply emotional across cultures. In countries where euthanasia is illegal, critics use her case to argue that such laws reflect moral decline or inadequate support for mental health. In jurisdictions where assisted dying is permitted but limited to terminal illness, her story has reignited debates about whether legal frameworks are too narrow or too permissive. Social media amplified these divisions, with some praising her courage and others reacting with grief, horror, or anger. Within the Netherlands, authorities emphasize that psychiatric euthanasia remains rare and subject to rigorous safeguards, and they stress that it is considered a tragic exception rather than a norm of compassionate care. At the same time, mental health advocates have highlighted systemic gaps in care, cautioning that improving treatment and support should be a priority, lest euthanasia be perceived — wrongly or not — as a substitute for better psychiatric care.
