Wishes to Die of Palliative Cared People in Serious Illness

Alexandra Ridder

Transnational assisted dying. A qualitative pilot study

Transnational assisted dying (TAD) belongs to the field of euthanasia and means that people willing to die travel from one country to another in order to access a form of assisted dying that is not possible in their own country for legal reasons. From Germany, people travel to Switzerland and the Benelux countries in search of assisted suicide. There, it is possible to legally provide assisted suicide under certain conditions. In Switzerland, as the best-known destination for "death tourism," assisted suicide is unpunished as long as it is not done for selfish motives. Four assisted suicide organizations (Dignitas, EXIT International, Life Circle, Liberty Life) also help foreigners; 80 Germans died with Dignitas in 2014, 86 in 2015. On Nov. 6, 2015, the German Bundestag adopted the 'Gesetz zur Strafbarkeit der geschäftsmäßigen Förderung der Selbsttötung' ('Law on the Criminalization of the Businesslike Promotion of Suicide'), which criminalizes businesslike assisted suicide. However, on February 26, 2020, the German Constitutional Court repealed the according paragraph 217 of the German Criminal Law (StGB).

This qualitative pilot study will use an empirical-ethical research approach to identify the ethically relevant issues that concern those willing to die, as well as those close to them. Of particular interest are the questions beyond assisted suicide per se that are specific to TAD. What are the morally relevant questions that those affected and involved in these situations ask? What are the ethical issues they face? How do people who have "traveled to Switzerland (or to one of the Benelux countries)" reflect on the discourse and events in Germany?

Documentations as well as existing bioethical (as well as non-scientific) literature already provide some anecdotal evidence in this regard: Those willing to die may be forced to end their lives under different circumstances than they actually wish - not at home and too soon, because they still need to be able to travel. For those close to them, the return journey, without the person who has then died, is especially emotionally stressful.

This study is designed to allow affected family members to share their thoughts in a structured interview setting. It is designed as a qualitative pilot study with five retrospective interview case studies; as far as possible, several family members are interviewed per case. The interviews will start narratively and will include a semi-structured guideline in the further course; the analysis will be done in the style of Interpretative Phenomenological Analysis.