## Facts

- A psychiatrist, Dr. Boudewijn Chabot, provided assistance in suicide to his patient (“Mrs. B”), who suffered prolonged, severe psychological distress following multiple family tragedies, including the suic*de of one son and the death of her other son from cancer.
- After her younger son’s death, Mrs. B attempted suic*de and then sought help through a voluntary euthanasia organization, which referred her to Chabot.
- Over approximately four weeks, Chabot met with Mrs. B in several sessions totaling about 24 hours, diagnosed a depressive disorder without psychotic features in the context of complicated grief, and concluded her psychological suffering was severe and enduring.
- Mrs. B refused further psychiatric treatment and repeatedly requested assistance in ending her life.
- Chabot supplied lethal medication, which Mrs. B ingested in his presence and in the presence of her general practitioner and a friend, resulting in her death.
- Chabot was prosecuted under Article 294 of the Dutch Penal Code (assistance in suicide) and asserted necessity (*noodtoestand*) based on a conflict between preserving life and respecting the patient’s explicit wish to end unbearable suffering.
- The trial court and the court of appeal accepted necessity and discharged Chabot from criminal liability; the prosecution sought cassation review.

## Issues

1. Whether necessity can justify physician-assisted suicide when the patient’s suffering is purely psychological rather than based on somatic illness or a terminal condition.
2. What substantive and procedural conditions must be satisfied for a necessity justification in physician-assisted suicide cases.
3. Whether those conditions were satisfied on the facts of Chabot’s assistance to Mrs. B.

## Decision

- The Supreme Court held that necessity may, in principle, justify physician-assisted suicide even when suffering is purely psychic and not rooted in somatic disease.
- The Court concluded that the lower courts applied the necessity defense too broadly and that Chabot’s process did not satisfy required safeguards, particularly independent verification.
- The Court found a violation of Article 294 and entered a conviction, but imposed no punishment based on the defendant’s personal circumstances and the context of the conduct.

## Legal Principles

- Necessity may justify assistance in suicide only under strict conditions tied to a “medical necessity,” assessed by reference to medical knowledge and professional norms.
- Hopeless and unbearable suffering may qualify even if its source is psychological; the legal focus is on the persistence and hopelessness of suffering rather than whether it is somatic.
- The patient’s request must reflect a free and well-considered decision; heightened caution is required in assessing voluntariness where psychiatric illness may affect autonomy.
- Independent professional consultation is a key safeguard: a physician must obtain verification by a colleague that the criteria (hopeless suffering and free choice) are met, with meaningful independent assessment.
- The justification is limited to physicians because the necessity recognized is specifically medical in character.

## Conclusion

The Supreme Court recognized that severe, enduring psychological suffering can support a necessity justification for physician-assisted suicide, but it convicted Chabot because the required independent verification and assessment safeguards were not adequately satisfied, while declining to impose punishment.


Office of Pub. Prosecutions v. Chabot, No. 96.972 (Neth. 1994)