As assisted-suicide laws expand to include mental disorders, critics say psychiatry’s diagnostic system—lacking objective medical tests—risks turning treatment failure into state-sanctioned death.
By CCHR International
The Mental Health Industry Watchdog
March 16, 2026
Psychiatry has long been criticized for pathologizing normal behavior as mental disorders, leading to psychopharmacological interventions whose debilitating side effects can themselves become their own separate disorders. The American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) has been described as a “political document,” according to Stuart A. Kirk, Distinguished Professor Emeritus of Social Welfare at UCLA’s Luskin School of Public Affairs.[1]
Jan Eastgate, president of Citizens Commission on Human Rights International, says this trend has now extended to psychiatric conditions being considered for “assisted suicide,” despite the fact that none of the disorders constitute incurable physical illnesses. The dichotomy, Eastgate says, is that psychiatrists can involuntarily commit a person who attempts suicide, yet on the other hand, can legally assist the same person to end their life—and be paid for doing so.
Euthanasia Expands to Psychiatric Diagnoses
A recent article in Psychiatric Times criticized the growing use of euthanasia in the Netherlands for patients with psychiatric conditions, including younger individuals. The Netherlands enacted the Termination of Life on Request and Assisted Suicide Act in 2002, which codified an already existing medical practice that had largely involved individuals with severe physical illness.[2]
Euthanasia was already in practice there, but in 1994 the Dutch Supreme Court ruled that assisted suicide could be permitted in cases involving refractory mental illness.[3] Euthanasia had been defined since 1985 as the administration of drugs with the explicit intention to end life at the explicit request of a patient.[4]
The National Review reported “those suffering from psychiatric problems could be put down like unwanted pets” and are being eliminated when they “have no diagnosed medical condition whatsoever….”[5]
From Suicide Prevention to Suicide Facilitation: Psychiatric Euthanasia Cases Rising
In 2010, two psychiatric patients in the Netherlands were legally killed. This number increased to 13 patients in 2011 and 14 in 2012.[6] By 2020, the Netherlands reported 88 euthanasia cases involving psychiatric disorders—an average of roughly one per week.[7] The number of psychiatric euthanasia patients increased from 138 in 2023 to 219 in 2024, representing an increase of nearly 60% in a single year.[8]
When euthanasia requests, rather than completed procedures, are examined, the picture becomes even more troubling.The Psychiatric Times article is critical of the trend, arguing that psychiatry lacks reliable ways to determine concepts such as “irremediable suffering,” decisional capacity, and unbearable mental suffering in young people.[9]
“When euthanasia deaths are considered alongside suicides, assisted dying now accounts for a growing proportion of premature deaths among young adults, particularly young women,” it points out.
Adding to the hypocrisy is that some argue that a person’s wish to die may be a “symptom of their mental disease,” as reported in the Annals of Palliative Medicine in 2024. German researchers concluded that “the only ethically valid argument to exclude persons with mental disorders from suicide assistance is their potential inability to make a free, autonomous decision.”[10]
This, from a nation whose political use of euthanasia led to millions being killed in Nazi concentration camps during World War II. Psychiatrists pioneered extensive euthanasia programs, and for the most part, were not prosecuted or otherwise held responsible for their actions after the Nazi dictatorship ended.[11]
Diagnoses Without Medical Tests Now Used to Authorize Death
The underlying problem is psychiatry’s diagnostic framework itself. When DSM-I was first published in 1952, there were 106 disorders. DSM-II in 1968 increased the number to 182. DSM-III was published in 1980 and contained 265 categories. This third edition (revised in 1987) leaned even more toward German eugenicist Emil Kraepelin’s belief that biology and genetics played a key role in mental “illness.”[12] By the 1980s and 1990s, DSM diagnoses had become closely tied to insurance coding systems used in the U.S. health-care system, leading critics to refer to the manual as psychiatry’s “billing bible.”[13] In 1994, DSM-IV raised the bar to 297 disorders. DSM-5, published in 2013, embraced 298 disorders.[14]
Humans’ woes are now categorized, codified for billing, and the number of mental disorders has increased by 181% since 1952, while the U.S. population in the years between DSM–I and DSM-5 increased by only 100%.[15]
Psychiatry still had not solved its biggest problem, as Thomas Insel, Director of the National Institute of Mental Health (NIMH) from 2002-2015, noted: “The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”[16]
Professor Allen Frances,Chairman Emeritus of the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine and former chairman of the DSM-IV Task Force, said the 2022 revision, DSM-5-TR, was not worth buying. In the years since DSM5 was published, there have been no “new research findings that justify a revised edition at this time. The only purpose for publishing a DSM-5-TR is planned obsolescence, linked to financial gain: DSM-5-TR was published to sell more books and reap even greater publishing profits.” Further, DSM-5 went wrong because its experts were given free rein to expand their “pet” diagnoses. Experts always worry about missed patients and undertreatment, never about mislabeling “normal” or overtreatment.[17]
The DSM’s counterpart is the International Classification of Diseases (ICD) Mental Disorders section. During the development of the ICD‐11 and DSM‐5, the World Health Organization (WHO) and the APA collaborated on “harmonizing the two.” There are nineteen ICD‐11 disorder categories that do not appear in DSM‐5, and seven DSM‐5 disorder categories that do not appear in the ICD‐11.[18]
Throughout both their developments, psychiatrists have never had, and still do not have, knowledge of any etiology or cause of any mental disorder.
Despite more than 70 years of development, as Prof. Frances also points out, “There are no objective tests in psychiatry—no X-ray, laboratory or exam that says definitively that someone does or does not have a mental disorder.”[19]
Frances also candidly stated: “‘Mental illness’ is terribly misleading because the ‘mental disorders’ we diagnose are no more than descriptions of what clinicians observe people do or say, not at all well-established diseases.”[20] He went further: “There is no definition of a mental disorder. “It’s bull****—I mean, you just can’t define it.”[21]
Yet this lack of scientific definition can carry life-and-death consequences, as illustrated by the Netherlands’ euthanasia program.
Global Expansion of Assisted Suicide Laws
As of 2020, euthanasia or physician-assisted suicide (EAS) is legal in nine countries—Belgium, the Netherlands, Luxembourg, Switzerland, Colombia, Canada, Spain, Australia’s state of Victoria—and in 10 U.S. states. Of these, six non-U.S. jurisdictions accept mental disorders as conditions for which EAS may be granted, and four permit it for minors with such diagnoses. Studies also report EAS being performed for “personality disorders,” which lack definitive scientific tests. Colombia permits assisted suicide for children over age six under strict criteria, while Belgium has no minimum age limit.[22]
Starting in March 2024, Canada planned to make medical assistance in death available to people with mental illness, with the government announcing a three-year delay, saying the health care system needs more time to prepare.[23]
Oregon was the first state in the United States to approve medically assisted suicide, with a law going into effect in 1997. California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Vermont, Washington state, and Washington, D.C., have approved similar laws.[24] In May 2025, Delaware’s governor signed legislation to make it the 11th state to legalize medical assistance in dying.[25] The U.S. has yet to expand it to include mental disorders.[26] But easily could.
Meanwhile, psychiatry admits it has no treatment cures for any mental disorder—a reality that can leave some patients feeling hopeless or despairing—conditions that then make them candidates for euthanasia.
When Killing Is Framed as Mental Health “Care”
Psychiatrists are already gearing up for DSM-6. Psychiatrist Dr. Niall McLaren points out that subcommittees, with about 80 people in all, will decide on what disorders will remain or be expanded. He questions what has been achieved after having already spent a huge amount of time on this. “Nothing,” he says. “They’re like the people on the mythical island who could describe and name clouds but who didn’t know what clouds actually are.”[27]
He further states: “Clearly, there’s no line separating normal and abnormal, and a person can be feeling fine today and terrible tomorrow just because of what happens. His biology doesn’t change at all, only his experiences.”
Drug companies, he says will make a drug for each disorder and hey presto, humanity would be freed of the scourge of mental disorder.
The truth is that mental disorders such as depression are not incurable physical illnesses, yet euthanasia laws today have been expanded to include them. Depression and anxiety can emotionally incapacitate a person, but they are not bodily diseases. Malevolence is being approved as euthanasia, camouflaging psychiatry’s failed treatments. It is spiraling out of control as patients—like the feebleminded of the Nazi era—are being killed for problems psychiatrists have for more than 200 years purported to be able to help or cure, but, in fact, have not, cannot, and their “Final Solution” is passed off as “assisted suicide.”
Eastgate says, “To shroud murder in the mantle of medical practice—‘assisted suicide’ for ‘mental illness’—is a crime in and of itself.”
[1] Stuart A. Kirk, David Cohen, and Tomi Gomory, “DSM-5: The Delayed Demise of Descriptive Diagnosis,” History, Philosophy and Theory of the Life Sciences, (Springer Science+Business Media Dordrecht 2015), p. 65, https://psptraining.com/wp-content/uploads/Demazeux-S.2015.-The-DSM-5-in-perspective.pdf; https://luskin.ucla.edu/person/stuart-a-kirk
[2] “Psychiatric Euthanasia in the Netherlands: Young People, Procedural Medicine, and the Limits of Psychiatry,” Psychiatric Times, 5 Mar. 2026, https://www.psychiatrictimes.com/view/psychiatric-euthanasia-in-the-netherlands-young-people-procedural-medicine-and-the-limits-of-psychiatry
[3] Ron Berghmans, et al., “Physician-assisted suicide in psychiatry and loss of hope,” International Journal of Law and Psychiatry, Vol. 36, Issues 5–6, Sept. – Dec. 2013, https://www.sciencedirect.com/science/article/abs/pii/S0160252713000745
[4] “Two Decades of Research on Euthanasia from the Netherlands. What Have We Learnt and What Questions Remain?,” J Bioeth Inq, 28 July 2009, https://pmc.ncbi.nlm.nih.gov/articles/PMC2733179/
[5] “The Week.” National Review, vol. 68, no. 5, March 28, 2016, p. 14, https://www.nationalreview.com/wp-content/uploads/2016/03/20160328-1.pdf
[6] Regional Euthanasia Review Committees (Netherlands), Annual Report 2010 (The Hague: RTE, 2011), https://www.euthanasiecommissie.nl/site/binaries/site-content/collections/documents/2010/nl-en-du-fr/nl-en-du-fr/jaarverslag-2010/jv-rte-2010-engels-eu12.01-34.pdf; Regional Euthanasia Review Committees (Netherlands), Annual Report 2011 (The Hague: RTE, 2012), https://www.euthanasiecommissie.nl/site/binaries/site-content/collections/documents/2011/nl-en-du-fr/nl-en-du-fr/jaarverslag-2011/rte.jv2011.engels.def-36.pdf; Regional Euthanasia Review Committees (Netherlands), Annual Report 2012 (The Hague: RTE, 2013), https://www.euthanasiecommissie.nl/site/binaries/site-content/collections/documents/2012/nl-en-du-fr/nl-en-du-fr/jaarverslag-2012/jv.rte2012.engelsdef2-40.pdf
[7] Regional Euthanasia Review Committees (Netherlands), Annual Report 2020 (The Hague: RTE, 2021), https://english.euthanasiecommissie.nl/site/binaries/site-content/collections/documents/annual-reports/2002/annual-reports/annual-reports/RTE-jaarverslag2020_Annual+report.pdf
[8] Regional Euthanasia Review Committees (Netherlands), Annual Report 2020 (The Hague: RTE, 2021), https://english.euthanasiecommissie.nl/site/binaries/site-content/collections/documents/annual-reports/2002/annual-reports/annual-reports/RTE-jaarverslag2020_Annual+report.pdf; Regional Euthanasia Review Committees (Netherlands), Annual Report 2024 (The Hague: RTE, 2025), https://www.euthanasiecommissie.nl/site/binaries/site-content/collections/documents/2024/03/24/index/rte-annual-report-2024.pdf
[9] “Psychiatric Euthanasia in the Netherlands: Young People, Procedural Medicine, and the Limits of Psychiatry,” Psychiatric Times, 5 Mar. 2026, https://www.psychiatrictimes.com/view/psychiatric-euthanasia-in-the-netherlands-young-people-procedural-medicine-and-the-limits-of-psychiatry
[10] Georg Marckmann, Thomas Pollmäche, “Assisted suicide in persons with mental disorders: a review of clinical-ethical arguments and recommendations,” Annals of Palliative Medicine, 31 May 2024, https://apm.amegroups.org/article/view/122896/html
[11] “Nazi ‘Euthanasia’ Program,” United States Holocaust Memorial Museum, https://encyclopedia.ushmm.org/content/en/article/euthanasia-program; https://pubmed.ncbi.nlm.nih.gov/23511221/; “The Doctors Trial: The Medical Case of the Subsequent Nuremberg Proceedings,” United States Holocaust Memorial Museum, https://encyclopedia.ushmm.org/content/en/article/the-doctors-trial-the-medical-case-of-the-subsequent-nuremberg-proceedings; https://pubmed.ncbi.nlm.nih.gov/23511221/
[12] “How the DSM Developed: What You Might Not Know,” Psych Central, 2 July 2011, https://psychcentral.com/blog/how-the-dsm-developed-what-you-might-not-know#1
[13] Mayes, Rick & Allan V. Horwitz, “The DSM-III and the Revolution in the Classification of Mental Illness,” Journal of the History of the Behavioral Sciences, 2005
[14] https://pmc.ncbi.nlm.nih.gov/articles/PMC4810039/
[15] https://www.multpl.com/united-states-population/table/by-year
[16] Thomas Insel, “Transforming Diagnosis,” NIMH, 20 Apr. 2013, https://psychrights.org/2013/130429NIMHTransformingDiagnosis.htm
[17] Allen Frances, M.D., “Is DSM-5-TR Worth Buying?” Psychiatric Times, 23 Mar. 2022, https://www.psychiatrictimes.com/view/is-dsm5tr-worth-buying
[18] “An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in ICD‐11 and DSM‐5,” World Psychiatry, 12 Jan. 2021, https://pmc.ncbi.nlm.nih.gov/articles/PMC7801846/
[19] Allen Frances, “Normality Is an Endangered Species: Psychiatric Fads and Overdiagnosis,” Psychiatric Times, 6 July 2010, https://www.psychiatrictimes.com/view/normality-endangered-species-psychiatric-fads-and-overdiagnosis
[20] Allen Frances, “What’s in a Name?” Psychology Today, 5 Apr. 2015, https://www.psychologytoday.com/us/blog/dsm5-in-distress/201504/whats-in-a-name
[21] Jacob Sullen, “DSM Editor Says ‘Mental Disorders Most Certainly Are Not Diseases,’” Reason, 8 Oct. 2012, https://reason.com/2012/08/10/dsm-editor-says-mental-disorders-most-ce/
[22] Lars Mehlum, et al., “Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges,” BMC, 30 July 2020, https://bpded.biomedcentral.com/articles/10.1186/s40479-020-00131-9; https://onlinelibrary.wiley.com/doi/10.1002/wps.21153; Colombia, Ministry of Health and Social Protection, Resolution 825 of 2018 (March 9, 2018), https://derechoamorir.org/wp-content/uploads/2018/09/2018-resolucion-825-menores.pdf
[23] “Should Those Suffering from Mental Illness Be Eligible for Medically Assisted Death?” Gonzaga University, 25 May 2024, https://www.gonzaga.edu/news-events/stories/2024/3/25/should-those-suffering-from-mental-illness-be-eligible-for-medically-assisted-death
[24] Ashley Carnahan, Fox News, “Canada expanding assisted suicide law to the mentally ill,” New York Post, 28 Oct. 2022, https://nypost.com/2022/10/28/canada-expanding-assisted-suicide-law-to-the-mentally-ill/
[25] https://www.apa.org/monitor/2025/07-08/compassion-medical-aid-dying
[26] “Should Those Suffering from Mental Illness Be Eligible for Medically Assisted Death?” Gonzaga University, 25 May 2024, https://www.gonzaga.edu/news-events/stories/2024/3/25/should-those-suffering-from-mental-illness-be-eligible-for-medically-assisted-death
[27] Naill McLaren, M.D., “Announcing … DSM-6: More of the same,” Critical Psychiatry, 10 Mar. 2026, https://www.niallmclaren.com/p/announcing-dsm-6?publication_id=1209273&post_id=190475956&isFreemail=true&r=1gr4xq&triedRedirect=true
SHARE YOUR STORY/COMMENT