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Sexual Abuse Victim in Her 20s Allowed Suicide by Doctors in Netherlands

After living with "unbearable" trauma despite psychiatric treatment, a Dutch woman was allowed to end her life. We spoke with a sexual trauma counselor about how to help patients who feel hopeless.
Photo by Tommaso Tuzj via Stocksy

A Dutch woman in her 20s was euthanized using a lethal injection after her doctors determined that the post-traumatic symptoms she suffered as a result of childhood sexual abuse were "unbearable."

"There was no prospect or hope for her," her psychiatrist said, according to the Daily Mail. According to Metro UK, the patient's symptoms included severe anorexia, chronic depression, hallucinations, and compulsions, all of which left her mostly bedridden.

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While the Daily Mail and other outlets have reported that the patient was deemed "totally competent" to choose to end her own life by multiple psychiatrists, her euthanasia has been met with intense scrutiny, as has the Netherlands' liberal policy on assisted suicide. "It almost sends the message that if you are the victim of abuse, and as a result you get a mental illness, you are punished by being killed, that the punishment for the crime of being a victim is death," one UK politician said.

"I would never say that, over the long term, anyone is absolutely untreatable," the sexual trauma counselor Dr. Yael Margolin-Rice told Broadly. "Certainly the symptoms can be absolutely insufferable, and the misery it causes can be unfathomable to anyone who has not experienced them."

Nevertheless, "people absolutely do recover" over years of therapy, she says. Many of her patients once felt hopeless but were able to overcome their anguish, but it's not something that can be achieved quickly. "I have to stress: This can take over 20 years of therapy."

Although several outlets have reported that the Dutch patient was deemed "incurable," according to Margolin-Rice, the idea of being "cured"—or not cured—of a long-term psychological disorder is fallacious. "The mind-body connection doesn't work that way," she says. "People heal. With good, skillful, patient, slow work, they heal," she said. She explained that there is an important distinction between an "incurable" disorder and one that causes insufferable emotional pain to the patient.

Of the many devastating aspects to this story, particularly tragic is the patient's young age. The Dutch woman was reportedly abused between the ages of five and 15 years old, and for people who experience trauma early in life, Margolin-Rice says, the consequences can be even more horrible than for those who experience it at a later age. Early trauma "prevents the normal course of development from taking place," Margolin-Rice says, explaining that abuse can delay or prevent "normal" mental and emotional development. Treatment in these cases can also be much longer and more challenging than that for people who were victimized later in life. Older people who experience trauma "have symptoms, but the symptoms are in the context of a person who has a normal developmental core and can probably lean on an external or an internal support system, which people with early trauma don't have," Margolin-Rice says.

Furthermore, ideal treatment for trauma survivors depends on the relationship they form with their therapist over time, Margolin-Rice says. "It is the relational quality between the patient and therapist that ultimately is the most healing factor," she says. However, it can be incredibly difficult to match a patient with the right therapist. "Sometimes takes years to find a good fit," Margolin-Rice says.

Ultimately, Margolin-Rice does not agree with the use of assisted suicide for sexual abuse victims suffering from post-traumatic conditions. "I wouldn't be in this business if I didn't believe that hope springs eternal," she says.