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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.
LOS ANGELES - illiNews -- By CCHR International
As assisted-suicide laws expand worldwide to include individuals diagnosed with mental disorders, the Citizens Commission on Human Rights International (CCHR) warns that psychiatry's diagnostic system—lacking objective medical tests—should never justify ending a human life. The watchdog group says the trend reflects a dangerous shift toward psychiatric-sanctioned death.
CCHR President Jan Eastgate said the development exposes a fundamental contradiction in modern psychiatry: "Psychiatrists can involuntarily commit and forcibly treat someone who attempts suicide," she notes, "yet in some countries they can legally assist the same person to die—and be paid for it."
At the center of the controversy are psychiatry's diagnostic manuals: the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) and its global counterpart, the International Classification of Diseases (ICD) mental disorders section used in most countries.[1]
The debate has taken on new urgency as assisted-suicide programs expand internationally to include individuals diagnosed with psychiatric disorders.
A recent article in Psychiatric Times criticized the growing use of euthanasia in the Netherlands for patients with psychiatric conditions, including younger individuals.[2] The Netherlands' Termination of Life on Request and Assisted Suicide Act from 2002 codified an already existing medical practice that had largely involved individuals with severe physical illness."
Euthanasia was already in practice, 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.
National Review reported that individuals suffering from psychiatric problems could effectively be "put down like unwanted pets," even when they have "no diagnosed medical condition whatsoever."[4]
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In 2010, two psychiatric patients in the Netherlands were legally killed. This number increased to 13 patients in 2011 and 14 in 2012. By 2020, the Netherlands reported 88 euthanasia cases involving psychiatric disorders—an average of roughly one per week. 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.
The Psychiatric Times article noted that psychiatry lacks reliable tools to determine concepts such as "irremediable suffering," decisional capacity, or unbearable psychological pain—particularly in young people.
"When euthanasia deaths are considered alongside suicides," Psychiatric Times also noted, "assisted dying now accounts for a growing proportion of premature deaths among young adults, particularly young women."
Adding to the controversy is the debate over whether a desire to die may itself be a symptom of mental disorder. A 2024 article in Annals of Palliative Medicine reported arguments that a wish to die could be interpreted as a manifestation of mental disease rather than a rational decision. 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."[5]
The debate echoes darker historical precedents. During the Nazi era, German psychiatrists implemented state-run euthanasia programs targeting and killing people deemed mentally ill or disabled.
CCHR says the underlying problem is psychiatry's diagnostic framework itself. Unlike diseases such as cancer or diabetes, psychiatric diagnoses are not confirmed through laboratory tests, brain scans, or other objective medical evidence. Instead, they are based on clusters of behavioral symptoms voted by peers to include in the DSM.
Professor Allen Frances, who chaired the DSM-IV task force, said the latest update of the DSM was not supported by new scientific discoveries. Further, "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."
Yet these diagnostic labels increasingly influence major legal decisions, including eligibility for assisted suicide. As of 2020, euthanasia or physician-assisted suicide was legal in Belgium, the Netherlands, Luxembourg, Switzerland, Colombia, Canada, Spain, Victoria in Australia, and several U.S. states. In six of those non-U.S. jurisdictions, mental disorders may qualify as grounds for euthanasia. Belgium has abolished any minimum age requirement for euthanasia, while Colombia permits assisted suicide for children over six under strict criteria. U.S. laws have not been expanded to include mental disorders, but critics warn that such changes could follow international precedent.
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Eastgate says that labeling emotional distress as chronic mental illness can leave individuals feeling hopeless after years of failed psychiatric treatment, making euthanasia appear to be a medical solution to suffering psychiatry itself has been unable to resolve or has worsened.
Psychiatrist Dr. Niall McLaren recently argued that the profession continues to expand diagnostic categories without understanding what mental disorders actually are.
"They're like people on a mythical island who can describe and name clouds but don't know what clouds actually are," he said.[6]
For CCHR, a mental health watchdog established in 1969 by the Church of Scientology and Professor of Psychiatry, Thomas Szasz, the implications are stark. Psychiatry cannot scientifically establish mental disorders as physical diseases, cannot identify a biological cause, and cannot cure them. "Yet it now participates in authorizing death on the basis of those same unproven diagnoses," said Eastgate. "To shroud murder in the mantle of medical practice—'assisted suicide' for 'mental illness'—is fraud dressed up as healthcare."
Sources:
[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, psptraining.com/wp-content/uploads/Demazeux-S.2015.-The-DSM-5-in-perspective.pdf
[2] "Psychiatric Euthanasia in the Netherlands: Young People, Procedural Medicine, and the Limits of Psychiatry," Psychiatric Times, 5 Mar. 2026, 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, www.sciencedirect.com/science/article/abs/pii/S0160252713000745
[4] "The Week." National Review, vol. 68, no. 5, March 28, 2016, p. 14, www.nationalreview.com/wp-content/uploads/2016/03/20160328-1.pdf
[5] 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, apm.amegroups.org/article/view/122896/html
[6] Naill McLaren, M.D., "Announcing … DSM-6: More of the same," Critical Psychiatry, 10 Mar. 2026, www.niallmclaren.com/p/announcing-dsm-6?publication_id=1209273&post_id=190475956&isFreemail=true&r=1gr4xq&triedRedirect=true
As assisted-suicide laws expand worldwide to include individuals diagnosed with mental disorders, the Citizens Commission on Human Rights International (CCHR) warns that psychiatry's diagnostic system—lacking objective medical tests—should never justify ending a human life. The watchdog group says the trend reflects a dangerous shift toward psychiatric-sanctioned death.
CCHR President Jan Eastgate said the development exposes a fundamental contradiction in modern psychiatry: "Psychiatrists can involuntarily commit and forcibly treat someone who attempts suicide," she notes, "yet in some countries they can legally assist the same person to die—and be paid for it."
At the center of the controversy are psychiatry's diagnostic manuals: the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) and its global counterpart, the International Classification of Diseases (ICD) mental disorders section used in most countries.[1]
The debate has taken on new urgency as assisted-suicide programs expand internationally to include individuals diagnosed with psychiatric disorders.
A recent article in Psychiatric Times criticized the growing use of euthanasia in the Netherlands for patients with psychiatric conditions, including younger individuals.[2] The Netherlands' Termination of Life on Request and Assisted Suicide Act from 2002 codified an already existing medical practice that had largely involved individuals with severe physical illness."
Euthanasia was already in practice, 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.
National Review reported that individuals suffering from psychiatric problems could effectively be "put down like unwanted pets," even when they have "no diagnosed medical condition whatsoever."[4]
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In 2010, two psychiatric patients in the Netherlands were legally killed. This number increased to 13 patients in 2011 and 14 in 2012. By 2020, the Netherlands reported 88 euthanasia cases involving psychiatric disorders—an average of roughly one per week. 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.
The Psychiatric Times article noted that psychiatry lacks reliable tools to determine concepts such as "irremediable suffering," decisional capacity, or unbearable psychological pain—particularly in young people.
"When euthanasia deaths are considered alongside suicides," Psychiatric Times also noted, "assisted dying now accounts for a growing proportion of premature deaths among young adults, particularly young women."
Adding to the controversy is the debate over whether a desire to die may itself be a symptom of mental disorder. A 2024 article in Annals of Palliative Medicine reported arguments that a wish to die could be interpreted as a manifestation of mental disease rather than a rational decision. 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."[5]
The debate echoes darker historical precedents. During the Nazi era, German psychiatrists implemented state-run euthanasia programs targeting and killing people deemed mentally ill or disabled.
CCHR says the underlying problem is psychiatry's diagnostic framework itself. Unlike diseases such as cancer or diabetes, psychiatric diagnoses are not confirmed through laboratory tests, brain scans, or other objective medical evidence. Instead, they are based on clusters of behavioral symptoms voted by peers to include in the DSM.
Professor Allen Frances, who chaired the DSM-IV task force, said the latest update of the DSM was not supported by new scientific discoveries. Further, "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."
Yet these diagnostic labels increasingly influence major legal decisions, including eligibility for assisted suicide. As of 2020, euthanasia or physician-assisted suicide was legal in Belgium, the Netherlands, Luxembourg, Switzerland, Colombia, Canada, Spain, Victoria in Australia, and several U.S. states. In six of those non-U.S. jurisdictions, mental disorders may qualify as grounds for euthanasia. Belgium has abolished any minimum age requirement for euthanasia, while Colombia permits assisted suicide for children over six under strict criteria. U.S. laws have not been expanded to include mental disorders, but critics warn that such changes could follow international precedent.
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Eastgate says that labeling emotional distress as chronic mental illness can leave individuals feeling hopeless after years of failed psychiatric treatment, making euthanasia appear to be a medical solution to suffering psychiatry itself has been unable to resolve or has worsened.
Psychiatrist Dr. Niall McLaren recently argued that the profession continues to expand diagnostic categories without understanding what mental disorders actually are.
"They're like people on a mythical island who can describe and name clouds but don't know what clouds actually are," he said.[6]
For CCHR, a mental health watchdog established in 1969 by the Church of Scientology and Professor of Psychiatry, Thomas Szasz, the implications are stark. Psychiatry cannot scientifically establish mental disorders as physical diseases, cannot identify a biological cause, and cannot cure them. "Yet it now participates in authorizing death on the basis of those same unproven diagnoses," said Eastgate. "To shroud murder in the mantle of medical practice—'assisted suicide' for 'mental illness'—is fraud dressed up as healthcare."
Sources:
[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, psptraining.com/wp-content/uploads/Demazeux-S.2015.-The-DSM-5-in-perspective.pdf
[2] "Psychiatric Euthanasia in the Netherlands: Young People, Procedural Medicine, and the Limits of Psychiatry," Psychiatric Times, 5 Mar. 2026, 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, www.sciencedirect.com/science/article/abs/pii/S0160252713000745
[4] "The Week." National Review, vol. 68, no. 5, March 28, 2016, p. 14, www.nationalreview.com/wp-content/uploads/2016/03/20160328-1.pdf
[5] 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, apm.amegroups.org/article/view/122896/html
[6] Naill McLaren, M.D., "Announcing … DSM-6: More of the same," Critical Psychiatry, 10 Mar. 2026, www.niallmclaren.com/p/announcing-dsm-6?publication_id=1209273&post_id=190475956&isFreemail=true&r=1gr4xq&triedRedirect=true
Source: Citizens Commission on Human Rights International
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