On October 2, 2023, Milou Verhoof ended her life in the Netherlands at the age of 17 following the administration of a lethal injection. The procedure was carried out by Dr. Menno Oosterhoff, a psychiatrist whose involvement in youth euthanasia cases has drawn significant scrutiny. Verhoof’s death has since become a focal point in the ongoing international discourse regarding medically assisted suicide for minors suffering from psychological distress.
Verhoof sought the procedure on psychological grounds, citing traumatic events experienced during her childhood as the primary driver of her decision. Her medical history indicates that at 11 years old, her family faced a crisis when her brother contracted a near-fatal illness. Two years later, at the age of 13, Verhoof was subjected to a sexual assault. Following the attack, she developed severe depression and lingering post-traumatic stress disorder.
As her condition deteriorated, Verhoof engaged in violent self-harm and survived two previous suicide attempts. She initially sought assistance from a psychiatrist to end her life through euthanasia, but that medical professional delayed the decision. She subsequently contacted Dr. Oosterhoff, who agreed to facilitate the request. On the day of her death, the physician administered the fatal injection in Verhoof’s childhood bedroom.
Reports indicate that Verhoof prepared extensively for the final moment. She had arranged for a manicure and selected an evening gown and high heels to be worn for her burial. Following the procedure, her mother, Mireille Verhoof, expressed support for the doctor’s actions. In a statement to The Atlantic, Mireille Verhoof said she trusted Dr. Oosterhoff’s cautious approach and his conclusion that her daughter’s days were unlivable.
“Because of Dr. Oosterhoff’s extremely careful and cautious approach, we as parents trusted that his conclusion-that Milou truly could not go on and that the days were unlivable for her-was the only correct one and confirmed what we as parents had long seen in our child,” Mireille Verhoof stated.
The circumstances surrounding Verhoof’s death were documented in a film titled Milou’s Battle Continues, produced by Illumina Films. The documentary chronicles her journey and the subsequent political fallout. Following the release of details regarding the case, various campaign groups utilized Verhoof’s situation to argue for an end to the provision of euthanasia for young people.
Rising Cases of Psychological Euthanasia
Data recorded in 2024 highlights a shift in the demographics of euthanasia cases within the Netherlands. Whereas the practice remains legal, the vast majority of the 9,958 recorded cases that year were associated with terminal physical illnesses, accounting for approximately 86% of the total. However, there has been a marked increase in procedures granted based purely on psychological suffering.
Official records show that cases categorized under psychological suffering climbed from 88 in 2020 to 219 in 2024. This statistical rise parallels the attention generated by cases involving minors and young adults, such as Verhoof’s.
Parallel Case in Spain
In a separate development this month, a similar case concluded in Barcelona, Spain. Noelia Castillo Ramos, a 25-year-old woman, died from medically assisted suicide. Ramos had become quadriplegic after jumping from a fifth-floor window following a gang rape. Her decision to pursue euthanasia sparked legal obstacles and conflict within her family.
Ramos faced opposition from her father, who was firmly against the decision. Despite the family conflict, she proceeded with the procedure. In a final interview given last week to a local outlet, Ramos outlined the timeline of her remaining days. “I have four days left because on the 26 they will perform euthanasia on me,” she said in Spanish.
During the interview, Ramos addressed the impact of her choice on her relatives. She noted that none of her family supported the euthanasia decision, acknowledging the pain it caused them while highlighting her own distress. “I am a pillar of the family. I leave them suffering. But what about my suffering?” she asked.
The completion of Ramos’s procedure on March 26 has intensified the debate regarding medically assisted suicide in Spain. While the Netherlands continues to record data on psychological euthanasia cases, the legal and ethical frameworks in neighboring countries remain subject to intense public scrutiny following these high-profile deaths.
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Campaign groups continue to leverage these cases to challenge existing provisions for youth euthanasia, leaving the regulatory future of psychological assisted dying in the region unsettled.
