In some countries, there is euthanasia for "psychological suffering"S

In Belgium, euthanasia is legal, which means the state will assist people who wish to commit suicide. Most cases involve people who are dying, and want to avoid unnecessary physical pain. But a growing number are for people who are in mental pain, and want to end it all.

The most recent case came earlier this year. A man named Nathan Verhelst, who had PTSD from being raped by his brothers when he was young, requested assisted suicide after his sex change operation left him feeling "like a monster." Verhelst was a transgender man who grew up as a woman, and the difficult surgery to construct his penis hadn't worked. Though surgeons built an organ for him, his body rejected it. As a result, he told friends and doctors, he lost his will to live.

This may be the most high-profile case of euthanasia in Belgium since the process was legalized over a decade ago — mostly because Verhelst granted an interview with a major newspaper the day before his lethal injection in Brussels. But there have been a few other well-known cases of euthanasia for people suffering mental anguish. An anorexic woman suffering memories of childhood trauma was euthanized at her request, as were deaf twins who learned they had a genetic condition that would likely make them blind.

What links these cases is that the people requesting assisted suicide were suffering both mentally and physically. Belgian law requires at least two doctors to be consulted before euthanasia is granted; for psychological cases like Verhelst's, three doctors must consult. There is also a long waiting period when the patient is under medical supervision before the suicide is allowed to proceed.

In countries where suicide is illegal, people who commit suicide are often isolated and alone. Verhelst, however, had a strong circle of friends who gave him a going-away party and tried to persuade him to reconsider. According to his close friend Marisol Mesot, nothing could make him want to live. He woke up every day "feeling like a monster."

Now the Canadian province of Quebec is considering adopting a law similar to Belgium's, which would allow assisted suicide for the terminally ill as well as the mentally anguished. If the province adopts the law, it will one of only a few regions in the world — including Luxembourg, the Netherlands, Switzerland, and the US states of Washington and Oregon — to legalize voluntary euthanasia or assisted suicide. This might be a window on our future, where personal freedom takes forms we never expected.

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