In 2024, Zoraya ter Beek, a 29-year-old Dutch woman, made headlines worldwide for her decision to end her life by assisted suicide. She received approval for euthanasia based on her terminal. unbearable mental suffering. She lived in Oldenzaal, a small village near the German border. Despite her being in perfect physical health, her mental anguish became too much to bear and decided to end her life. On May 22, 2024, Ter Beek was euthanised in her home surrounded by her partner and pets in her dying moments. Her case and subsequent death has sprung heated debates across Europe about assisted dying for psychiatric conditions. The news also sparked intense discussion amongst online users.
One user commented “I am a supporter of the right to die and death with dignity IF the person is terminally ill and is suffering. I always thought that other countries were ahead of their time when these laws were created.” Another user added that the news was depressing but “her body, her choice” sympathizing with her choice to euthanize. Other users commented with support and compassion, labelling Ter Beeks’ actions as courageous and brave.
Understanding Her Mental Health Battle
Since childhood, Ter Beek struggled with severe mental health conditions. She has been diagnosed with autism and suffers from depression, trauma, anxiety and unspecified personality disorder. While she hoped a safe environment and loving companionship would alleviate her conditions, she remained in distress. She still continued to harm herself and had suicidal ideation despite having a supportive partner and safe environment. Her condition continued to escalate resulting in unbearable psychological pain that felt impossible to escape.
Years of Intensive Treatment Attempts
Ter Beek endured intensive and aggressive treatments including countless therapy sessions and multiple medications prescribed by doctors. She also endured more than 30 sessions of electroconvulsive therapy. This dramatic treatment is typically reserved for severe, treatment-resistant depression. The invasive procedure involves passing electrical currents through the brain to trigger controlled seizures. She stated “In therapy, I learned a lot about myself and coping mechanisms, but it didn’t fix the main issues.” Despite the intensity of the treatments she endured, her core symptoms persisted. She said that initially she had hope but that soon began dwindling as treatment continued persistently.
After a decade of intense treatments and ECT, her psychiatrist eventually concluded they had exhausted every avenue. They delivered the devastating news to her that there were no more treatment options they could exploit to help her. She completed her final electroconvulsive therapy session in August 2020. After that point, she accepted that recovery was impossible for her. Ter Beek then decided on death by assisted suicide as her last option. She mentioned she had thought about going through with suicide but thought against it due to the loss of a school friend to suicide and the devastating emotional damage it had done to her school mate’s family.
The Dutch Legal Framework for Assisted Dying
According to Ter Beek, the application process for assisted suicide is long and complicated, where potential patients are put through a rigorous mental review before an appointment is made. In 2001, the Netherlands passed the Termination of Life on Request and Assisted Suicide Act, which came into effect in 2002. Under this law, physicians can legally end a patient’s life only if certain criteria are met. The person must experience unbearable suffering with no prospect of improvement. Their request must be voluntary and made with full mental capacity. Doctors must verify that no reasonable treatment alternatives exist. An independent physician must confirm the person meets all eligibility criteria. The physician must exercise appropriate medical care throughout the entire process.
Dutch law does not limit euthanasia to terminal physical illnesses alone. Psychiatric suffering can qualify as unbearable if it meets the legal standard. However, cases involving mental illness remain controversial and relatively uncommon. The law requires physicians to exercise extreme caution with psychiatric cases. Doctors must consult psychiatric specialists before approving such requests. Independent medical reviews ensure the decision follows all legal requirements.
Ter Beek’s Three-Year Approval Journey
Ter Beek initially applied for euthanasia in December 2020 and only after 3 and gruelling years was she finally approved. She endured extensive waiting periods for psychiatric assessments to take place. Due to the precarious nature of euthanasia cases, only a few Dutch physicians were willing to involved in assisted suicide for person with severe mental suffering. After an initial evaluation by a physician, a team of physicians assessed her for a second opinion and to verify her eligibility. Another independent physician reviewed those decisions for compliance.
Throughout this marathon process, Ter Beek never wavered in her conviction. “In the three and a half years this has taken, I’ve never hesitated about my decision,” she stated. However, she mentioned that she felt guilt about how her death will affect her loved ones, her friends, partner and family. Despite her deep understanding of the grief her loved ones may feel, she has expressed her determination to go through with the process.
Doctors repeatedly asked if she remained certain and could stop anytime. Her partner attended most consultations to provide emotional support. However, physicians periodically asked him to leave the room to ensure that Ter Beek could speak without any potential coercion. This is also to protect and respect her autonomy and her steadfast conviction.
International Media Backlash and Personal Pain
When an article about Ter Beek’s case was published in April 2024, international media outlets immediately blew up the story. She had noted that the coverage of her case contained numerous inaccuracies and misrepresentations in the published article. Her email inbox “exploded” with messages mostly from people outside of the Netherlands, particularly from the United States.
People urged her not to take her own life, insisting her life had value. Others offered miracle cures ranging from special diets to experimental drugs. Some commenters told her to embrace religion or warned of eternal damnation. Eventually the media attention and public scrutiny caused her severe distress and she subsequently deleted all her social media accounts. This removed her from public scrutiny but also severed her from supportive communities.
Defending Mental Competence and Legal Protections
Ter Beek fully understood why cases like hers were controversial. There are many mixed feelings from the public on whether or not assisted suicide should be legal. She also emphasized that mental illness does not automatically prevent sound decision-making. “People think that when you’re mentally ill, you can’t think straight, which is insulting,” she explained in an interview with The Guardian. This stigmatizing assumption is both inaccurate and deeply insulting, she argued. She acknowledged legitimate concerns from disability advocates about potential coercion.
She understood why people worried about vulnerable populations facing pressure toward death. Yet she consistently stressed the rigor of Dutch legal safeguards. The Netherlands had implemented these laws for over 20 years successfully. The incredibly strict rules built into the system ensured safety was a top priority.
Her Final Days and Peaceful Death
In early May 2024, Ter Beek received final approval for her euthanasia. She felt overwhelming relief after the long bureaucratic struggle. The medical team would visit her home rather than requiring hospitalization. They would first administer sedative medications to calm her. The physician would repeatedly confirm her willingness to proceed. She would recline on her familiar sofa surrounded by loved ones. The doctor would not administer heart-stopping medication until she entered a deep coma. From her perspective, death would feel like falling asleep peacefully. Her partner could remain nearby but had the option to leave before the final moment.
On May 22, 2024, Zoraya ter Beek died by euthanasia at her home in Oldenzaal. She was 29 years old. She had celebrated her birthday just 20 days earlier. The euthanasia review committee later evaluated her death to ensure proper protocols were followed. The Dutch government declared that her life was lawfully ended according to established criteria. She was cremated as planned. She had specifically requested cremation to avoid burdening her partner with having to maintain her grave.
The Alarming Rise in Psychiatric Euthanasia Cases
In the subsequent years following Ter Beek’s death, there has been a significant rise in mental health euthanasia cases. In 2010, only 2 people in the Netherlands died by euthanasia for psychiatric reasons. By 2023, that number had skyrocketed to 138 cases. In 2024, psychiatric euthanasia cases rose again to 219 deaths. This is just over a 10,000% increase in mental health related assisted suicides over a period of 14 years. The trend has alarmed medical professionals and ethicists across Europe.
The total number of euthanasia deaths in the Netherlands reached 9,958 in 2024, a 10% increase from 2023. Euthanasia currently accounts for 5.8% of all deaths in the Netherlands. This is the highest percentage recorded since the practice’s legalization in 2002. This drastic rise prompted Dutch euthanasia review committees (RTE) to issue urgent warnings to physicians. They instructed physicians to exercise “great caution” with psychiatric cases. The RTE advises that psychiatric specialistists should always be consulted by doctors before granting mental health euthanasia requests.
Growing Concerns About Young People
The significant increase in young people seeking euthanasia for mental illness has raised concerns, especially for those under 30 with mental illness. Professor Damiaan Denys of Amsterdam University Medical Center noted this raises alarm and urgent ethical concerns that should be addressed. He questioned whether young people with still-developing brains can truly meet legal standards.
“How can one, at that age, determine with certainty that a young person with a still-developing brain definitely wants to die, that life is experienced as hopeless and without prospects, and that all treatments have already been carried out?” he asked. These questions become especially urgent given that the human brain continues developing until age 25.
A recent study examined euthanasia requests from Dutch patients under age 24. Researchers found that most applications were retracted or rejected. Those who died by either euthanasia or suicide were predominantly female. They had long psychiatric treatment histories and prominent suicidal thoughts. The study called for urgent development of effective suicide prevention strategies. The findings suggested a critical need for better understanding of persistent death wishes in young people.
Systemic Problems and Protocol Violations
The Dutch euthanasia review committees found 6 deaths in 2024 that failed to follow proper protocols. One case involved a doctor granting euthanasia to a woman with obsessive-compulsive cleaning behaviors. The physician had not consulted a psychiatrist before approving the request. This violated mandatory consultation requirements for psychiatric cases. Such violations undermine the safety mechanisms built into the system. They suggest that some physicians may be taking shortcuts with vulnerable patients.
Research analyzing Dutch psychiatric euthanasia cases between 2017 and 2022 revealed concerning patterns. In every case where review committees found violations, the issues involved independent physician consultations. Some doctors proceeded despite independent consultants recommending against euthanasia. Other physicians failed to obtain adequate psychiatric expert assessments. These findings indicate systemic problems with how doctors handle dissenting opinions.
International Impact and Legislative Debates
Ter Beek’s death started debates on the ethics on assisted dying across Europe and beyond. Her case was cited in legislative discussions in multiple countries considering euthanasia expansion. France advanced legislation in 2025 allowing assisted dying under restricted circumstances. The French bill would permit euthanasia for people with incurable illnesses at advanced stages. However, it specifically excludes people with neurodegenerative disorders or severe psychiatric conditions. This exclusion reflects concerns raised by cases like Ter Beek’s.
The United Kingdom’s House of Commons voted in favor of an assisted dying bill in June 2025. The legislation applies only to terminally ill adults with six months or less to live. It requires approval from physicians and a panel including legal and psychiatric professionals. The bill includes provisions for independent advocates to assist people with learning disabilities, autism, or mental health issues. Scotland is separately debating its own assisted dying legislation. These developments demonstrate how Ter Beek’s story continues shaping policy discussions worldwide.
Critics of assisted dying expansion point to the Netherlands as a cautionary example. They argue that legal protections inevitably erode over time once euthanasia is permitted. The dramatic increase in psychiatric cases supports concerns about “slippery slope” effects. Cardinal Willem Eijk, Archbishop of Utrecht, warned about the gradual erosion of respect for human life. He noted that accepting death for one level of suffering leads to pressure for broader categories. The prelate expressed concern that euthanasia undermines trust between doctors and patients.
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Her Lasting Legacy and Ongoing Debates
Zoraya ter Beek’s death at age 29 remains deeply controversial 18 months later. Her case forced difficult conversations about psychiatric suffering and patient autonomy. It challenged assumptions about mental illness and decision-making capacity. The extensive legal process she underwent demonstrated both safeguards and limitations of the Dutch system. Her courage in publicly discussing her decision humanized complex end-of-life debates.
Yet significant questions remain unanswered about whether her death was necessary or preventable. Could different therapeutic approaches have provided relief she never experienced. Did the availability of euthanasia as an option influence her treatment trajectory? These questions haunt the broader debate about psychiatric euthanasia policies. Her story continues to influence how societies worldwide grapple with suffering, autonomy, mercy, and medicine’s fundamental mission.
The surge in psychiatric euthanasia cases following her death suggests her story may have influenced other vulnerable young people. This raises troubling questions about social contagion effects of publicized euthanasia cases. Some experts worry that media coverage may normalize suicide for people with mental illness. Others argue that discussing death openly with compassionate professionals can actually prevent suicide attempts. These competing perspectives reflect the profound complexity surrounding end-of-life choices for psychiatric patients.
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