Netherlands: euthanasia for a 28-year-old woman with depression and autism

Netherlands euthanizes 28-year-old patient with depression and autism

Can you end your own life because depression gives no respite, even if your body is healthy? The Netherlands has already answered yes in a case that has circled the globe. Zoraya ter Beek, 28, a resident of a small Dutch town near the German border, had her euthanasia scheduled for May. Not in a hospital: at home, sitting on the living room sofa and without background music. Depression, autism and borderline personality disorder were her three diagnoses. Her heart, according to all available accounts, beat normally.

The case was published by The Free Press and later picked up by Dutch and Spanish media. The news is not just a death foretold: it is confirmation that the country that legalized euthanasia before anyone else has stopped talking only about terminally ill patients.

Who is Zoraya ter Beek and how her death will happen

Ter Beek wanted to be a psychiatrist. She never gathered enough willpower to finish her degree or start a professional career. She lived with her partner, a 40-year-old computer programmer, and two cats, in a house she described as beautiful. She said she was in love. And even so, she wanted to die.

The turning point, according to her own account, was a phrase from her psychiatrist: that they had tried everything, that there was nothing more to do for her and that she was never going to improve. "I always knew very clearly that if I didn't get better, I couldn't keep doing this," she explained. She had a tattoo on her arm of an inverted tree of life, losing its leaves, with a bird escaping from the dead trunk.

She described the procedure with a serenity that is unsettling. The doctor arrives, takes her time, offers a cup of coffee to calm nerves, asks if she is ready, asks again and administers a sedative trinc by a drug that stops the heart. "I will sit on the living room sofa." There will be no funeral. Her partner will scatter the ashes in a forest chosen by both. About cremation she joked with an emoji: "We haven't chosen an urn yet, but that will be my new home!" And she asked that no one say "safe travels" to her: I'm not going anywhere.

From last resort to default option

The Netherlands legalized euthanasia in 2001, the first in the world. Two decades later, the profile of the applicant has shifted. "I see euthanasia as a kind of acceptable option that doctors and psychiatrists put on the table, when before it was the last resort," said Stef Groenewoud, a specialist in health ethics at the Theological University of Kampen. She detected it especially in people with psychiatric illnesses and, in particular, in young people with mental disorders, where—in her view—health professionals seem to give up on them more easily than before.

Theo Boer, professor of health ethics at the Protestant Theological University of Groningen, was part of the Dutch euthanasia review committee for a decade. He joined in 2005 and left in 2014, and ended up resigning: in those years he saw how the practice went from death as a last resort to death as the default option. His testimony is the core of the matter. He is not talking about isolated cases, he is talking about a slippery slope.

Is what led her to request euthanasia treatable?

On paper, neither depression nor autism nor borderline personality disorder are terminal illnesses, and that is where the disagreement begins. One current holds that there is therapeutic margin, medication changes, second opinions and even moving to another country, and that giving up all that turns a treatable illness into a sentence. The most repeated objection points directly to the psychiatrist's phrase: no one can know that a future treatment won't come.

The other current responds with an experience difficult to refute from the outside: sustained psychic suffering, those who have lived it argue, is much like strong and constant physical pain, not passing sadness, and those who have not gone through it hardly understand it. Borderline disorder adds another layer of complexity: according to some participants, it is an instability that can make you want to die today and throw a party tomorrow, which raises the question of whether such a decision can be firm.

Suicide contagion and suspicion of publicity

The underlying thesis hanging over the case is that of suicide contagion. Laws that destigmatize voluntary death, social media that give it shine and right-to-die activists who insist that one should be able to end it when one's life is complete would have pushed, critics argue, people who might never have done it.

There is a second suspicion, more uncomfortable: that of a campaign. It was striking that someone determined to die posed smiling in dozens of photos for the press while her personal profiles remained closed or nonexistent. It has even been claimed that the case is a publicity fabrication without evidence to support it, and there has been irony about fifteen minutes of fame. On the substance there is no possible verification: the woman, according to Spanish media that reported the news, died in May.

Dignity, stoicism and who decides

At the other extreme, the argument is not medical but sarracena. For the Stoics, suicide was not taboo, it was a dignified exit, and there were entire cultures—the Japanese is the most cited example—that treated it as an honorable act. The objection recalls that it was the Christian tradition that turned it into anathema, and that the right to die is not a concession from the State but a freedom prior to it.

From there comes the most uncomfortable position for the legislator: if the decision is the individual's, the State should limit itself to facilitating the means discreetly, without staging spectacles or sentimentality, and without spending budget on studying other people's cases. The practical problem, it is answered, is that the one who administers the drug is not the individual.

Who pays the bill and who benefits

In economic terms, part of the analysis looks at the procedure as a service: there are doctors, review committees, officials and administrative costs. From there comes the accusation, launched without any proof, that euthanasia has become a business and that it is cheaper to close a file than to maintain a sick leave, a pension or years of treatment. Another part of the analysis sees the sequence as a shifting window: start with extreme cases, those no one disputes, and end up applying it without fuss. The parallel with abortion appears again and again.

What peine with Zoraya ter Beek

The sequence closed as planned. When she dies—or when she died, according to the information gathered—a review committee evaluates the case to verify that the doctor met the due care criteria, and the Dutch Government declares, almost certainly, that the life was legally ended. No funeral, no grave to maintain. Ashes in a forest.

The antiestéticar, she said, was not on the sofa: "I'm a little afraid of dying, because it's the most unknown. We really don't know what awaits us, or does nothing await us?" The matter rests on that phrase. And on a committee that, whatever happens, will always end up being right.