Zoraya ter Beek, 28, lives in a small, peaceful town in the eastern Netherlands, not far from the German border. She shares her home with her boyfriend and their two cats, leading what might appear from the outside to be an ordinary, quiet life. Physically, she is healthy. There is no terminal diagnosis, no degenerative disease steadily shutting down her body. Yet she says her inner world has long been defined by relentless psychological pain. Years of depression, autism, and borderline personality disorder, she explains, have combined to make daily existence feel intolerable. After what she describes as exhausting every available treatment option, she has decided that she no longer wishes to continue living. In early May, she plans to undergo euthanasia, referring to it gently as a “nice nap” that will carry her into permanent sleep. In the Netherlands, euthanasia and physician-assisted suicide are legal under strict and carefully regulated conditions. The law requires that a patient’s request be voluntary and well considered, free from external pressure. Doctors must also conclude that the patient’s suffering is unbearable and that there is no reasonable prospect of improvement. When the procedure takes place, a physician either administers life-ending medication directly or provides it for the patient to take, and an independent review committee later evaluates whether all legal criteria were met.

Ter Beek says her psychiatrist ultimately told her that no additional therapies remained to be tried, no new interventions likely to bring meaningful relief. She has undergone years of psychiatric care, attempting medications, therapies, and other forms of support. According to her account, nothing has eased the persistent despair or instability she experiences. Rather than a hospital setting, she has chosen to die at home. She envisions a quiet room, no music playing, her partner seated beside her. The process will begin with a sedative to induce sleep. Once she is unconscious, medication will be administered to stop her heart. She has also considered what comes after: she does not want a traditional burial but prefers to have her ashes scattered in a forest, returning to nature in a way she finds more comforting. Her preparations reflect deliberation and a desire for calm control over her final moments. Yet her decision has sparked renewed debate in the Netherlands and beyond, particularly because her suffering is psychiatric rather than physical.

Opponents of euthanasia for mental illness argue that the practice was originally intended as a last resort for people facing imminent death from terminal physical conditions. They fear that expanding it to include psychiatric disorders risks redefining suicide as a medical solution to emotional pain. Mental illness, critics emphasize, can fluctuate over time. Symptoms that feel overwhelming in one period may lessen in another. New treatments continue to emerge, and recovery, even after years of struggle, is possible for some. Because of this unpredictability, they question whether it is ever possible to determine with certainty that there is “no chance of improvement.” Some also worry about societal messages: if assisted dying becomes an accepted option for psychiatric suffering, vulnerable individuals might perceive their lives as less valued or feel subtle pressure to choose death. From this perspective, the irreversibility of euthanasia demands extreme caution. Once carried out, there is no opportunity for reconsideration, no possibility that a future breakthrough or shift in circumstances might change the trajectory of a person’s life.

Supporters, however, frame the issue differently. They argue that autonomy—the right of competent adults to make profound decisions about their own bodies and lives—should not disappear simply because suffering is psychological rather than physical. For some individuals, they contend, psychiatric pain can be as relentless and debilitating as any terminal illness. If every recognized treatment has been attempted without success, and if multiple physicians agree that improvement is unlikely, supporters believe it is compassionate to allow a person to end that suffering under medical supervision rather than alone and violently. In their view, strict safeguards, careful assessments, and mandatory review processes exist precisely to prevent abuse or rash decisions. They maintain that respecting a person’s informed, persistent request for euthanasia acknowledges the depth of their experience rather than dismissing it. To them, the core issue is not whether suffering is visible on a scan or measured in months to live, but whether it is enduring, intolerable, and without realistic hope of relief.

The Netherlands is among several countries that permit assisted dying under regulated frameworks. Alongside the Netherlands, countries such as Belgium and Canada, as well as parts of Australia and the United States, have enacted laws allowing some form of euthanasia or physician-assisted death. Each jurisdiction has developed its own safeguards, eligibility criteria, and oversight mechanisms. In the Netherlands, review committees assess each reported case to ensure that legal standards were upheld. Still, ethical debates persist within medical communities, religious groups, disability advocates, and the broader public. Questions arise about how to define “unbearable suffering,” how to evaluate decision-making capacity in the context of mental illness, and how to balance compassion with protection. Policymakers and physicians continue to wrestle with these dilemmas, aware that any shift in interpretation can have profound consequences. Ter Beek’s case has therefore become part of a wider international conversation about where boundaries should be drawn and how societies should respond to deep psychological distress.

Before her conditions intensified, Ter Beek once dreamed of becoming a psychiatrist herself. She hoped to help others navigate the kinds of mental health challenges she would later experience so acutely. She says those ambitions gradually dissolved as her own symptoms made sustained study and professional work impossible. To her, choosing euthanasia represents a final act of agency, a way to shape at least one outcome in a life she feels has been dominated by forces beyond her control. To her critics, however, her calm and methodical planning may signal something else: a system that, despite years of care, could not provide sufficient hope or healing. Her story compels difficult reflection. When someone says their suffering will never end, how should that claim be weighed? Who determines whether every avenue has truly been exhausted? And how should society balance the protection of vulnerable people with respect for their autonomy? These questions have no simple answers. What is clear is that the decision is irreversible, and once carried out, it closes off all future possibilities—both the feared continuation of pain and the uncertain chance of change.