Abstract
Amongst the latest, and ever-changing, pathways of death and dying, “suicide tourism” presents distinctive ethical, legal and practical challenges. The international media report that citizens from across the world are travelling or seeking to travel to Switzerland, where they hope to be helped to die. In this paper I aim to explore three issues associated with this phenomenon: how to define “suicide tourism” and “assisted suicide tourism”, in which the suicidal individual is helped to travel to take up the option of assisted dying; the (il)legality of assisted suicide tourism, particularly in the English legal system where there has been considerable recent activity; and the ethical dimensions of the practice. I will suggest that the suicide tourist—and specifically any accomplice thereof—risks springing a legal trap, but that there is good reason to prefer a more tolerant policy, premised on compromise and ethical pluralism.
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Notes
Neither of these forms of travel can be dismissed as wholly unrealistic (e.g. Pennings 2002; Huxtable 2007, 56), although there is another form which looks much more remote: the situation in which someone seeks to move from a permissive to a prohibitive jurisdiction (provided there is someone in the latter jurisdiction willing, covertly, to help). The distinct questions raised by these sorts of travel are unfortunately beyond the scope of this paper.
Examples include complicity in female circumcision which is undertaken outside the UK: see the Female Genital Mutilation Act 2003 and, for a related discussion of conspiracy and “sex tourism”, Alldridge (1997).
In this regard it will be essential to monitor developments in relation to Dignitas, as there have been reports of investigations into profit-making (Sawer 2009) plus more general calls for tighter regulation of the assistance offered and greater transparency in the organisation’s activities (Boyes 2008).
There is undoubtedly more to say here, not least because the option does still seem to be limited to e.g. those who are still sufficiently well to travel and arguably also to those who can draw on help to travel. There will always be people who will lose (or miss) out in some way, particularly under a policy premised on compromise, but (for now) I will leave it to others to assess whether this is appropriate or just.
References
AAP. 2008. Shirley Justins gets periodic detention for Graeme Wylie killing. The Australian 12 November. http://www.theaustralian.news.com.au/story/0,25197,24640271-23289,00.html (accessed 15 March, 2009).
Alldridge, P. 1997. Sex Offenders Act 1997: Territoriality provisions. Criminal Law Review September: 655–658.
BBC. 2008. More Britons seeking suicide help. BBC News Online. 17 November. http://news.bbc.co.uk/1/hi/uk/7732640.stm (accessed 14 March, 2009).
Benjamin, M. 1994. Conflict, compromise, and moral integrity. In Duties to others, ed. C.S. Campbell and B.A. Lustig, 261–278. Dordrecht: Kluwer Academic Publishers.
Bosshard, G., E. Ulrich, and W. Bär. 2003. 748 cases of suicide assisted by a Swiss right-to-die organisation. Swiss Med Wkly 133: 310–317.
Boyes, R. 2008. Murky truth behind Swiss suicide “clinic” Dignitas. The Times 25 October 25.
Brownsword, R. 1993. Towards a rational law of contract. In Perspectives of Critical Contract Law, ed. T. Wilhelmsson, 241–272. Aldershot: Dartmouth.
Charlesworth, M. 2005. Don’t blame the “bio”—blame the “ethics”: Varieties of (bio)ethics and the challenge of pluralism. Journal of Bioethical Inquiry 2(1): 10–17.
Coggon, J. 2008. Assisting “death tourism”: Possible prosecution or pragmatic immunity? Cardiff Centre for Ethics, Law, and Society. http://www.ccels.cf.ac.uk/ (accessed 14 March, 2009).
Coggon, J. and S. Holm. 2007. The assisted dying bill: “Death tourism” and European law. In Ethics, law and society, Volume III, ed. J. Gunning and S. Holm, 233–236. Aldershot: Ashgate.
Crown Prosecution Service. 2004. The code for crown prosecutors. London: Crown Prosecution Service.
de Bruxelles, S. 2009. Devoted couple made secret pact after terminal diagnosis. The Times. 6 March.
Foster, C. 2004. Rapid response: Time to test the law. British Medical Journal. 16 June. http://www.bmj.com (accessed 12 December, 2006).
Fuller, L.L. 1969. The morality of law, revisedth ed. New Haven: Yale University Press.
Hurst, S.A. and A. Mauron. 2003. Assisted suicide and euthanasia in Switzerland: Allowing a role for non-physicians’. British Medical Journal 326: 271–273.
Huxtable, R. 2004. Assisted suicide. British Medical Journal 328: 1088–1089.
Huxtable, R. 2007. Euthanasia, ethics and the law: From conflict to compromise. London: Routledge-Cavendish.
Kamisar, Y. 1997. Physician-assisted suicide: The last bridge to active voluntary euthanasia. In Euthanasia examined: Ethical, clinical and legal perspectives, ed. J. Keown, 225–260. Cambridge: Cambridge University Press.
Kamm, F.M. 1998. Physician-assisted suicide, euthanasia, and intending death. In Physician assisted suicide: Expanding the debate, ed. M.P. Battin, R. Rhodes, and A. Silvers, 28–62. New York and London: Routledge.
May, W.F. 2003. Oral evidence to President’s Council on Bioethics. http://bioethics.gov/transcripts/oct03/oct17full.html (accessed 28 March, 2007).
Minelli, L.A. 2007. Dignitas in Switzerland: Its philosophy, the legal situation, actual problems, and possibilities for Britons who wish to end their lives. 1 December. http://www.dignitas.ch (accessed 15 March, 2009).
Pennings, G. 2002. Reproductive tourism as moral pluralism in motion. Journal of Medical Ethics 28: 337–341.
Rothschild, A. 2008. Just when you thought the euthanasia debate had died. Journal of Bioethical Inquiry 5(1): 69–78.
Sawer, P. 2009. Dignitas founder accused of profiting from assisted suicides. The Daily Telegraph. 10 January.
Starmer, K. 2008. Decision on prosecution: The death by suicide of Daniel James. 9 December. http://www.cps.gov.uk/news/nationalnews/death_by_suicide_of_daniel_james.html (accessed 15 March, 2009).
Acknowledgements
Thanks to Genevieve Liveley, Lois Bibbings, James Kennedy and participants at the Centre for Ethics in Medicine (Bristol) seminar series for helping me to develop my arguments.
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Huxtable, R. The Suicide Tourist Trap: Compromise Across Boundaries. Bioethical Inquiry 6, 327–336 (2009). https://doi.org/10.1007/s11673-009-9170-5
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DOI: https://doi.org/10.1007/s11673-009-9170-5