In the Netherlands , the same legal demands are made of euthanasia for psychiatric patients as those made for people suffering from a physical disease. The patient must be subject to unbearable and hopeless suffering and there should be no other reasonable recourse. The issue with psychiatric patients is that further treatment is always available and that it is harder to determine if a patient is of sound mind. The first psychiatric patient who received assisted suicide was a woman with mysophobia. Psychiatrist Gerty Casteelen explains that she slowly started to understand the patient's desire to commit euthanasia. "I couldn't understand it at first. It was a long process. I came to understand that her fears completely controlled her life. All she could do was clean. It was impossible for the patient to maintain a relationship. Her whole development stalled." Another patient who received euthanasia was a healthy 63 year-old man. He worked for a
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