Zoraya ter Beek, a 28-year-old woman living in a quiet town in the eastern Netherlands near the German border, appears from the outside to lead an ordinary life with her boyfriend and their two cats. Physically healthy and not suffering from any terminal or degenerative illness, she nonetheless describes her internal experience as one of persistent and overwhelming psychological pain. Diagnosed with depression, autism, and borderline personality disorder, she says that her mental health struggles have shaped her daily existence into something she finds unbearable. After years of treatment attempts that she believes have failed to provide relief, she has decided to pursue euthanasia, which is legally permitted in the Netherlands under strict conditions. She refers to the planned procedure as a “nice nap,” a peaceful transition into permanent sleep. Dutch law requires that such a request be voluntary, well considered, and free from external pressure, and that physicians determine the patient’s suffering to be unbearable with no reasonable prospect of improvement. Once the procedure is completed, a regional review committee evaluates whether all legal criteria were satisfied.

Ter Beek explains that she has spent years in psychiatric care, trying a wide range of medications, therapies, and supportive interventions. According to her account, none have brought lasting or meaningful relief from her despair and emotional instability. Her psychiatrist ultimately concluded that no additional viable treatment options remained, reinforcing her sense that her condition is unlikely to improve. Rather than undergoing euthanasia in a clinical setting, she has chosen to die at home in a controlled and familiar environment. She envisions a quiet room without music, her partner by her side. The process will begin with a sedative to induce sleep, followed by medication to stop her heart once she is unconscious. She has also made arrangements for what happens afterward, preferring cremation and the scattering of her ashes in a forest rather than a traditional burial. Her preparations reflect deliberation, calmness, and a desire to exercise control over the manner and setting of her death. At the same time, her case has reignited debate both within the Netherlands and internationally, particularly because her suffering stems from psychiatric rather than physical illness.

Critics of euthanasia for mental illness argue that assisted dying was originally intended for patients facing imminent death due to terminal physical conditions. They contend that expanding eligibility to include psychiatric disorders risks redefining suicide as a medically sanctioned response to emotional suffering. Mental illnesses, they emphasize, can fluctuate in severity over time, and symptoms that feel intolerable during one period may lessen during another. Furthermore, new treatments and therapeutic approaches continue to emerge, offering potential hope even after years of unsuccessful attempts. Because of this unpredictability, opponents question whether physicians can ever confidently conclude that there is no possibility of improvement. They also express concern about broader societal implications, fearing that normalizing assisted death for psychiatric suffering could send harmful messages to vulnerable individuals. Some worry that it may subtly suggest that certain lives are less worth living or create indirect pressure on those who already feel like burdens. Given that euthanasia is irreversible, critics insist that extreme caution is necessary, as it eliminates any chance of future change or recovery.

Supporters of allowing euthanasia in cases of psychiatric suffering frame the issue around autonomy and compassion. They argue that competent adults should retain the right to make profound decisions about their own lives and bodies, regardless of whether their suffering is physical or psychological. For some individuals, they maintain, mental anguish can be just as severe and enduring as the pain associated with terminal illness. If every recognized treatment has been thoroughly attempted and multiple medical professionals agree that no realistic prospect of improvement remains, supporters believe it can be humane to allow a medically supervised death. In their view, regulated frameworks with strict safeguards, comprehensive assessments, and mandatory post-procedure reviews are designed precisely to prevent impulsive or coerced decisions. Respecting a persistent and informed request for euthanasia, they argue, acknowledges the legitimacy of psychiatric suffering rather than minimizing it. From this perspective, the critical question is not whether suffering is visible or tied to a fatal diagnosis, but whether it is enduring, intolerable, and unlikely to be alleviated.

The Netherlands is one of several jurisdictions that permit euthanasia or physician-assisted death within a regulated legal structure. Alongside countries such as Belgium and Canada, as well as certain states in Australia and the United States, the Netherlands has developed a framework intended to balance individual choice with protective oversight. Each region establishes its own eligibility requirements, procedural safeguards, and review mechanisms. In the Dutch system, independent committees evaluate reported cases to confirm compliance with the law. Despite these safeguards, ethical debate continues among medical professionals, religious organizations, disability rights advocates, policymakers, and the public. Central questions include how to define “unbearable suffering,” how to assess decision-making capacity in individuals with mental illness, and how to ensure that vulnerable people are protected without undermining their autonomy. The interpretation of these standards can have far-reaching consequences, and Ter Beek’s case has become part of a broader international discussion about the boundaries of assisted dying and society’s responsibilities toward those experiencing profound psychological distress.

Before her mental health conditions became overwhelming, Ter Beek once aspired to become a psychiatrist, hoping to help others navigate psychological challenges similar to those she would later endure. Over time, she says, her symptoms made sustained education and professional work impossible, gradually dissolving her ambitions. For her, choosing euthanasia represents an assertion of agency in a life she feels has largely been shaped by forces beyond her control. To critics, however, her situation may signal systemic shortcomings in mental health care and a failure to sustain hope. Her story raises complex and unresolved questions: how should society evaluate a person’s claim that their suffering will never improve? Who determines when all reasonable treatment options have truly been exhausted? And how can communities balance the imperative to protect vulnerable individuals with respect for their considered choices? The decision to proceed with euthanasia is final and eliminates all future possibilities—both the continuation of suffering and the uncertain potential for recovery. As such, her case underscores the profound moral, medical, and societal challenges inherent in addressing assisted death for psychiatric conditions.