In October 2023, Dutch physician Menno Oosterhoff undertook an unusual home visit with a profoundly different aim. The mission was not that of preserving life, but rather to bring a carefully considered end to one.
His patient was seventeen-year-old Milou Verhoof, a young woman whose life was shattered by the harrowing experience of sexual assault, leaving her with deep psychological scars.
Enduring numerous treatments without success, Milou requested euthanasia, a decision that found its executor in Dr. Oosterhoff.
Years later, this decision has spiraled into legal complexities, as Milou’s family and Dr. Oosterhoff face scrutiny. A group of 14 medical professionals privately urged the Dutch public prosecutor to initiate a criminal investigation into the circumstances surrounding Milou’s euthanasia.
The investigation seeks to evaluate whether Milou’s decision was influenced significantly by her parents and two psychiatrists, raising concerns about her mental competence at the time of decision-making.
Her parents are now filing a disciplinary case, arguing the letter has seriously harmed them.
But behind the legal disputes is the story of a young girl whose life was defined by years of trauma.
Milou had once been described by her mother as a cheerful, sensitive girl who enjoyed a happy middle-class upbringing.
Milou Verhoof, 17, had once been described by her mother as a cheerful, sensitive girl who enjoyed a happy middle-class upbringing
During a stay as an inpatient in a secure psychiatric facility, Milou was sexually abused by another patient
Her parents said she was ‘so nice and so sweet. Always, always laughing’
But her life changed dramatically after her older brother, Daan, who has Down’s syndrome, became critically ill when she was 11, spending a month in a coma.
The ordeal left her plagued by nightmares and flashbacks, and within two years she had been raped, sending her into a spiral of post-traumatic stress disorder, depression and self-harm.
During a later stay as an inpatient in a secure psychiatric facility, she was sexually abused again by another patient.
The years that followed were dominated by repeated treatments, medication, psychiatric admissions and suicide attempts.
Her parents were shocked. Speaking to The Telegraph, her mother Mireille said: ‘We always said to each other, my husband and I, that the only one we were not going to expect any trouble from is our girl.
‘She was so nice and so sweet. Always, always laughing… That was what made her vulnerable, I think.’
While doctors continued trying to help her, Milou repeatedly requested euthanasia, convinced that her suffering had become unbearable.
Most psychiatrists rejected those requests, arguing she was simply too young, while another delayed her application altogether.
Her family says this was a severe blow to the teenager, who felt like her suffering was being ignored and her voice was silenced.
Desperate, Milou sought out Mr Oosterhoff after learning about him through media coverage.
By then, the doctor had already become synonymous with one of the Netherlands’ most controversial medical practices.
Supporters had lauded him as a compassionate doctor who helps patients whose psychological suffering has become unbearable, while critics denounced him as crossing an ethical line.
He had increasingly specialised in psychiatric cases since the country legalised euthanasia in 2002 for patients making a ‘voluntary and well considered’ request to end ‘unbearable’ suffering where there is ‘no prospect of improvement’ and ‘no reasonable alternative’.
Although the overwhelming majority of physician-assisted deaths still involve terminal physical illness, the number granted solely on the grounds of psychological suffering has risen sharply in recent years.
Unlike many of his colleagues, Mr Oosterhoff believes severe psychiatric illness can be every bit as unbearable and untreatable as terminal cancer.
Over more than four decades as a psychiatrist, he says he concluded that some patients have exhausted every realistic treatment option and deserve the same right to what he considers a peaceful death.
Mr Oosterhoff told The Telegraph: ‘It is quite unnatural to give a person that is physically healthy a lethal injection.
‘But we underestimate the burden of psychiatric illnesses. We say, “come on, the sun is shining,” and so on. The other way is that people suffer unbearably, or that they commit suicide.’
At first, Mr Oosterhoff suggested Milou should try deep brain stimulation, a procedure sometimes used to treat severe OCD. But the teenager insisted she simply wanted to die.
On October 2, 2023, Mr Oosterhoff travelled to the Verhoof family home, where Milou had chosen to spend her final hours in her childhood bedroom.
Menno Oosterhoff had already become synonymous with one of the Netherlands’ most controversial medical practices
A documentary titled Milou’s Battle Continues, which followed the teenager’s path to euthanasia, became Dutch public television’s most watched programme of the year
She had done her nails and selected the evening gown and high heels she wanted to be buried in.
As her parents stood beside her, Mr Oosterhoff administered the lethal injection, consisting first of lidocaine to numb the area where the needle would prick her, a coma-inducing drug and a muscle relaxer called rocuronium, which made her stop breathing.
‘Have a good trip,’ he told the teenager, ‘You’ve been through so much.’
Her parents have never hidden their support for the decision. Milou’s mother, Mireille Verhoof, has consistently argued that Mr Oosterhoff’s careful assessment confirmed what they had witnessed for years.
‘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,’ she said.
Keeping close to the family in the process, Oosterhoff later spoke at Milou’s funeral. However, the case was far from over.
A documentary titled Milou’s Battle Continues, which followed the teenager’s path to euthanasia, became Dutch public television’s most watched programme of the year and brought the issue of psychiatric euthanasia into homes across the country.
To supporters, it portrayed a young woman whose suffering had been acknowledged after years of failed treatment.
But to critics, it represented a devastating indictment of a mental health system that had ultimately offered a vulnerable and defeated teenager death instead of recovery.
Within months of Milou’s death, 14 psychiatrists and doctors privately wrote to the Dutch public prosecutor expressing concerns about Mr Oosterhoff’s handling of the case, including his decision to publicly share a filmed conversation with Milou discussing her wish to die.
They argued she ‘may not have been fully decision-competent to assess her own right to life or adequately safeguard her care needs in a situation of acute distress’.
The footage included Milou reflecting on the future she believed had been denied to her.
‘I would have liked to have had another life, but that was not granted to me,’ she said.
When Mr Oosterhoff asked how she would answer people who said she was still too young, Milou replied: ‘It’s not about age; it’s about the suffering. I tried everything I could to make it better.’
The doctors never explicitly called for a criminal investigation but Mr Oosterhoff responded publicly, demanding they apologise, which they refused to do.
In July of this year, Milou’s parents launched disciplinary proceedings in an effort to uncover the identities of the 14 doctors and psychiatrists who signed the letter, arguing that its allegations caused them serious harm and that they should have the opportunity to defend themselves.
Their lawyer said the letter had a profound impact on the family. By the time it became public, the regional euthanasia review committee had already concluded that Milou’s death had been carried out with due care and in full compliance with Dutch law.
The disclosure came while her parents were still grieving their daughter’s death, after years spent fearing she would instead kill herself.
One case that reverberated across Spain was that of 25-year-old Noelia Castillo Ramos, a paraplegic woman who died through the country’s euthanasia law in March
Speaking to Dutch media, Milou’s mother said: ‘These psychiatrists never treated Milou. They never saw her. They didn’t know her medical file, yet they portrayed us to the justice system as parents who drove our child to her death. We still suffer from that, day and night.’
Mr Oosterhoff has continued to defend both his actions and the wider principle of psychiatric euthanasia.
The doctor has maintained that everything he did complied with Dutch law and argued that ‘Milou wanted attention for her situation’.
Milou’s story is far from unique. In the Netherlands, statistics reveal that women attempt suicide at roughly twice the rate of men.
Among young people aged 12 to 30 who have died through euthanasia, more than three-quarters are female.
The debate extends well beyond the Netherlands, with assisted dying laws dividing opinion all across Europe.
One case that reverberated across Spain was that of 25-year-old Noelia Castillo Ramos, a paraplegic woman who died through the country’s euthanasia law in March after surviving a gang rape and a suicide attempt.
Unlike Milou, whose parents supported her decision, Noelia’s father fought relentlessly to stop the procedure, taking his challenge through the Spanish courts and ultimately to the European Court of Human Rights.
His unsuccessful legal battle fractured his relationship with his daughter in the months before her death.
Months later, however, Noelia’s mother, who had supported her daughter’s decision at the time, publicly appealed to opposition leader Alberto Núñez Feijóo to repeal Spain’s euthanasia law.
‘My daughter did not have a terminal illness,’ Yolanda Castillo said in a social media video. ‘She had borderline personality disorder and obsessive-compulsive disorder. She had her whole life ahead of her.’
She said Noelia had never received the psychiatric care she needed after a 2022 gang rape, after which she attempted suicide by jumping from a fifth-floor window.
She survived but was left permanently paralysed from the waist down and in chronic neuropathic pain.
‘We’ve been told euthanasia is for people with terminal illnesses, but that’s not true,’ she said. ‘My daughter didn’t have any terminal illness.’
Around the same time, another young Dutch woman, Iris, ended her life through voluntary stopping eating and drinking (VSED) after spending years on a waiting list for euthanasia.
The Daily Mail spoke to Iris’s parents, who said they had exhausted every avenue in search of treatment for their daughter’s severe depression and suicidal illness, but nothing brought lasting improvement.
And similarly to Mr Oosterhoff, her father, Omar, a nurse and medical educator trained in the Dutch healthcare system, believes society applies a double standard to psychiatric illness.
Omar and Cissy Dekker with their daughter Iris, who ended her life through voluntary stopping eating and drinking
‘We’re taught to take a holistic view, that the body and mind work together,’ he said. ‘But when it comes to psychiatry and euthanasia, people see it differently.
‘If someone has cancer and they’ve gone through every available treatment, most people in the Netherlands accept euthanasia if several doctors agree they’re not going to get better.
‘But if someone has a psychiatric illness, and five doctors all agree the illness isn’t going away and the person isn’t going to recover, people are much more judgmental.
‘I think that’s something we need to have a much deeper discussion about.’
Mr Oosterhoff personally carried out 12 euthanasia procedures for patients suffering solely from psychiatric illnesses over a 13-month period in 2023 and 2024.
Among them were the first legally approved euthanasia cases involving minors aged 16 and 17 on the grounds of mental illness.
The psychiatrist, who has become one of the most prominent defenders of euthanasia for psychiatric suffering, argues that, in carefully assessed cases, it can be the least harmful option.
He sees euthanasia as a middle path between two difficult outcomes – allowing a patient’s suffering to continue indefinitely or forcing them towards what may be a violent or impulsive suicide.
‘Not giving euthanasia has consequences too,’ Mr Oosterhoff said in an interview with The Atlantic.
One of those consequences, he said, is that people who are ‘mentally terminal’ may ultimately take their own lives.
Mr Oosterhoff acknowledges that psychiatric diagnoses and prognoses are far less certain than those for physical illnesses.
‘The scientific basis of psychiatry is still very, very unclear,’ he said. ‘A lot of things people say are just based on nothing.’
Yet he does not believe that uncertainty should prevent psychiatrists from making life-or-death decisions.
Instead, he argues, they should rely on clinical judgment, their patients’ autonomy and the intention to relieve unbearable suffering.
For Mr Oosterhoff, the reactions of patients after their requests are approved reinforce that belief. ‘The gratitude for what I did is so immense sometimes,’ he said.
