Department of Nursing, University of Haifa, Haifa, Israel.
BMC Med Ethics. 2022 Apr 30;23(1):48. doi: 10.1186/s12910-022-00785-w.
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.
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.
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.
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.
随着“死亡权利”运动的兴起、临终选择的改善以及全球安乐死的政治和法律地位的变化，自杀旅游已成为那些希望结束生命的人的一种有前途的选择。然而，从参与这一现象的人的角度来看，人们对此知之甚少。
本研究采用定性研究方法，遵循扎根理论传统。它包括对考虑前往瑞士接受协助自杀的 11 名以色列 Dignitas 非营利组织成员进行的 11 次深入半结构化访谈。
从数据分析中出现了七个主题，包括健康和功能；对生存和存在的感受；与卫生部门的互动；对死亡和临终的态度；自杀；选择死亡；和选择自杀旅游。一部分参与者经历过自杀念头，甚至曾经尝试过自杀，有些人不止一次。他们中的大多数人提到了慢性疾病、功能障碍和社会孤立。他们在主观维度理解痛苦，即只有实际承受疾病、疾病和残疾的人才能理解。参与者将瑞士的协助自杀视为积极的，因为它保证了“美丽的死亡”的结果，与“处于不利地位的死亡”相比，后者给参与者的亲人带来了整个漫长死亡过程中的负担。他们中的大多数人并不一定希望在他们去世时他们的亲人在身边，他们认为在没有情感或公民依恋的外国去世没有什么意义。
Dignitas 对参与者自杀旅游请求的渴望批准或悲惨拒绝，增强了人们对协助自杀的看法，这种看法将其视为实现控制死亡的机制与它的官僚主义和唯物主义特征之间的悖论，特别是体现在付费、正式的协助自杀方法中，这种方法培养了依赖性和合作性。
