Travelling to die: views, attitudes and end-of-life preferences of Israeli considering receiving aid-in-dying in Switzerland

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Following the increased presence of the Right-to-Die Movement, improved end-of-life options, and the political and legal status of aid-in-dying around the globe, suicide tourism has become a promising alternative for individuals who wish to end their lives. Yet, little is known about this from the perspective of those who engage in the phenomenon. Methods: This study applied the qualitative research approach, following the grounded theory tradition. It includes 11 in-depth semi-structured interviews with Israeli members of the Swiss non-profit Dignitas who contemplated traveling to Switzerland for aid-in-dying. Results: Seven themes emerged from the data analysis, including health and functioning; feelings regarding survivorship and existence; interacting with the health sector; attitudes regarding death and dying; suicide; choosing death; and choosing suicide tourism. A significant portion of the participants had experienced suicidal thoughts and had even previously attempted suicide, some more than once. Most of them referred to chronic illnesses, functional disability, and social isolation. They understand suffering within the subjective dimension, namely only by the person who is actually subjected to the disease, ailments, and disability. Participants regarded aid-in-dying in Switzerland as positive thanks to its guaranteed outcome: "beautiful death", compared to "disadvantaged dying" which places a burden on the participants' loved ones throughout the prolonged dying. Most of them do not necessarily want to have their loved ones beside them when they die, and they see no significant meaning in dying in a foreign country to which they have no emotional or civil attachment. Conclusion: The desirable approval or tragic refusal by Dignitas to participants' requests for suicide tourism enhances the paradox between the perception of aid-in-dying as a mechanism for fulfilling controlled death and its bureaucratic and materialistic characteristics specifically reflected in a paid, formalized approach to aid-in-dying that cultivate dependency and collaboration.

Original languageEnglish
Article number48
JournalBMC Medical Ethics
Volume23
Issue number1
DOIs
StatePublished - Dec 2022

Bibliographical note

Funding Information:
DS is an Associate Professor in bioethics in the Department of Nursing at the University of Haifa, Israel. He holds an LL.B and B.A. (Philosophy) from the Hebrew University of Jerusalem and LL.M (Collaborative program in bioethics) and S.J.D. from the University of Toronto. Prof. DS is the author of three books: Suicide tourism: Understanding the legal, philosophical and socio-political dimensions (Oxford University Press: 2019); Posthumous Interests: Legal and Ethical Perspectives (Cambridge University Press: 2008), and Management of Post-Mortem Pregnancy: Legal and Philosophical Aspects (Ashgate: 2006) as well as other numerous articles and book chapters in the area of ethics, law and bioethics.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Aid-in-dying
  • Death and dying
  • Dignitas
  • Israel
  • Qualitative research
  • Suicide
  • Suicide tourism

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health(social science)
  • Health Policy

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