The story of Noa Pothoven, the Dutch 17yo who the world believed was legally euthanised.

NOTE: This story has been edited from its original form. 

Warning: This article deals with an account of an eating disorder, rape/sexual assault and mental health and may be triggering for some readers.

On Sunday, 17-year-old Dutch teenager Noa Pothoven died.

Reports worldwide attributed the case to ‘legal euthanasia’, but a statement from Noa’s friends confirmed it was not euthanasia, the Guardian reported on Wednesday night.

Noa, from the eastern Dutch city of Arnhem, died in her bed at home, but the teen had previously contacted end of life clinics for help.

The Guardian stated her parents and doctors reportedly agreed not to force-feed her. Dutch medical guidelines state that if a patient does not consent, care providers may not provide treatment or care.

Noa said in her final social media post on Saturday that she “breathes but no longer lives” after being sexually assaulted and raped three times, first when she was 11. These assaults had led her to develop post-traumatic stress disorder, depression and anorexia.

“After years of battling and fighting, I am drained,” Noa wrote in her native Dutch on Saturday. “After many discussions and evaluations, it was decided to let me go because my suffering is unbearable.”

Noa Pothoven’s story.

For years, Noa kept her trauma a secret.

Up until age 11, she had been a good student and a happy child. Then, seemingly overnight, Noa changed. She began to starve herself and her parents were totally in the dark as to why. They would not find out for years.

In November last year, Noa’s autobiography Winning or Learning was published.

 

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The book documented three sexual assaults she survived as a child and a young teen, and her work to try and overcome the mental health ramifications they had left her with.

Noa claimed the first two incidents were molestations when she attended children’s parties aged 11 and 12, before she was raped by two men when she was 14.

She said she had kept the assaults secret for many years due to fear and a deep sense of shame. She subsequently struggled with PTSD, depression and anorexia.

“Out of fear and shame, I relive the fear, that pain every day. Always scared, always on my guard. And to this day my body still feels dirty,” Noa wrote in her book.

“My house has been broken into, my body, that can never be undone.”

At the time of her assaults she did not report them. In December, her mother told Dutch newspaper De Gelderlander Noa was still not able to talk about them and could not “get the word ‘rape’ out of her mouth.”

Noa had been in and out of youth care institutions and treatment centres for years, but never found one where all her physical and mental problems could be addressed, she told De Gelderlander.

Institutions were focused on ensuring she didn't die by suicide, and she believed the treatment of her anorexia and trauma was not a priority.

Last year, Noa was admitted to hospital in a critical condition and put into a medically-induced coma as her anorexia had left her organs on the brink of failure.

According to De Gelderlander, Noa approached an end of life clinic in The Hague a year ago without her parents' knowledge to ask if she could be considered for assisted dying, but she was told she could not.

In December, the then-16-year-old said she had almost completed her bucket list, ticking off 14/15 of her goals.

These included riding a scooter for the first time, smoking a cigarette, trying alcohol and getting a tattoo.

Her final goal was hampered by her anorexia.

"There is one wish left: eating a bar of white chocolate," she told De Gelderlander. "That is my favourite candy, but I haven't tasted it in years. That is because of my anorexia. I don't dare to eat it yet."

Noa Pothoven's family.

While cleaning her daughter's room last year, Noa's mother Lisette discovered a plastic envelope filled with farewell letters addressed to friends and family. It was only then that she learned of her daughter's plan for euthanasia.

"I was in shock. We didn't get it. Noa is sweet, beautiful, smart, social and always cheerful. How is it possible that she wants to die? We have never received a real answer. We just heard that life was no longer meaningful. Only since a year and a half do we know what secret she has carried with her over the years," Lisette told De Gelderlander.

Lisette said her daughter's book should be mandatory reading for social workers and those working in adolescent psychological care.

When Noa first requested euthanasia as a 16-year-old her parents refused to give her permission as they believed she should complete trauma treatment.

"They consider that I am too young to die,” Noa told De Gelderlander last year. “They think I should finish my trauma treatment and that my brain must first be fully grown. That lasts until your 21st birthday. It’s broken me, because I can’t wait that long."

Noa wrote on social media that her mother had "always been there for her", but in her last post asked her family, friends and followers not to try and change her mind about giving up food and drink, which led to her death.

"This is my decision and it is final," she said. "Love is letting go, in this case."

Dutch euthanasia law.

Noa first approached a euthanasia clinic when she was 16, but they denied her request to be euthanised. She was not euthanised, instead dying at home after ceasing treatment for her mental illness.

While it is legal in the Netherlands for children as young as 12 to be euthanised, but a doctor must first determine that the patient's pain is "hopeless and unbearable". Children aged 12-16 require parental consent.

The law was intended for patients suffering from terminal illnesses such as cancer and similar painful conditions, but in rare cases it also allows those with severe psychological pain to seek euthanasia. The Guardian reported only one per cent of Dutch euthanasia cases were down to a psychiatric disorder, and only one person was under 18.

Under the law, which passed in 2001, patients must repeatedly ask to die and be of sound mind, then a second doctor must agree in writing that death is justified.

After a patient has been euthanised, a post-mortem panel made up of medical, legal and ethical experts must confirm those requirements have been met.

Correction: This story originally stated Noa Pothoven had died via legal euthanasia. Further information has come to light and Ms Pothoven passed away at home after ceasing treatment for her mental illness. 

If you think you may be experiencing depression or another mental health problem, please contact your general practitioner or in Australia, contact Lifeline 13 11 14 for support or beyondblue at 1300 22 4636.

For help and support for eating disorders, contact the Butterfly Foundation’s National Support line and online service on 1800 ED HOPE (1800 33 4673) or email support@thebutterflyfoundation.org.au. You can also visit their website, here.