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Appreciating Death. Ethnography of Assisted Suicide in Switzerland

English title Appreciating Death. Ethnography of Assisted Suicide in Switzerland
Applicant Berthod Marc-Antoine
Number 169367
Funding scheme Project funding (Div. I-III)
Research institution Ecole d'études sociales et pédagogiques Haute école de travail social et de la santé HES-SO
Institution of higher education University of Applied Sciences and Arts Western Switzerland - HES-SO
Main discipline Ethnology
Start/End 01.09.2017 - 31.10.2020
Approved amount 341'749.00
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All Disciplines (2)

Discipline
Ethnology
Social work

Keywords (8)

Ethnography; Decision-making; Processes of assisted suicide; Ethical judgments; Switzerland; Professional and lay expertise ; Experiences of suffering; Styles of dying

Lay Summary (French)

Lead
Ce projet de recherche consiste en une ethnographie des pratiques relatives au suicide assisté en Suisse. Son but est d’observer le plus concrètement possible les pratiques sociales mises en œuvre par la pluralité d’individus concernés et sollicités dans l’élaboration d’une demande de suicide assisté jusqu’à son actualisation ; il s’agit aussi de prendre en considération les événements qui suivent immédiatement le décès et de rendre compte de la façon dont chaque suicide assisté observé est mis en récit, sous quelle forme et entre quels acteurs. Cette ethnographie du suicide assisté est réalisée en étroite collaboration avec un ensemble de partenaires de terrains, actifs dans toute la Suisse romande, la région de Bâle et au Tessin.
Lay summary

Le projet documentera environ 10-15 situations en lien avec le suicide assisté. L’accès à chacune de ces situations sera négocié via nos différents partenaires de recherche – tous impliqués dans ou concernés par l’une ou l’autre phase du suicide assisté – ainsi que par voie de presse. Une fois obtenu l’accord de la personne qui entend recourir au suicide assisté et en suivant tous les principes éthiques usuels, les chercheurs s’adapteront à la temporalité des procédures en cours et rencontreront, toujours avec leur accord et dans la mesure du possible à plusieurs reprises, le maximum d’acteurs impliqués dans chaque situation (soit entre 6 et 15 personnes) : médecins, personnel infirmier, travailleurs sociaux; pharmaciens ; équipes des associations d’assistance au suicide ; personne requérant l’assistance au suicide et ses proches ; policiers et employés des pompes funèbres. L’objectif est de combiner observations, échanges informels et entretiens approfondis avec ces différents acteurs pour analyser et mettre en perspective la réalité d’une modalité contemporaine de fin de vie et les appréciations différenciées qui la traversent. L’originalité de ce projet réside entièrement dans ce regard ethnographique qui n’a encore jamais été appliqué à cette modalité spécifique du mourir en Suisse. Ce projet fournira par conséquent une plus-value descriptive et scientifique à un enjeu de société hautement débattu de nos jours dans de nombreux pays, dans la mesure où cet enjeu est trop souvent abordé en termes idéologiques et moraux éloignés des relations effectives qu’entretiennent les acteurs impliqués dans le processus qui conduit à l’assistance au suicide.

Direct link to Lay Summary Last update: 14.07.2017

Responsible applicant and co-applicants

Employees

Name Institute

Publications

Publication
Le temps de mourir: réflexions sur les usages de la notion d'accélération en lien avec l'assistance au suicide
PillonelAlexandre, BerthodMarc-Antoine, Castelli DransartDolores Angela (2019), Le temps de mourir: réflexions sur les usages de la notion d'accélération en lien avec l'assistance au suicide, in Revue suisse de travail social, 25(1), 122-138.
Imagining terminality. Anticipations of suicide with assistance in Switzerland
BerthodMarc-Antoine, StavrianakisAnthony, PillonelAlexandre, Castelli DransartDolores Angela (2019), Imagining terminality. Anticipations of suicide with assistance in Switzerland, in Revista M, 4(7), 45-59.

Collaboration

Group / person Country
Types of collaboration
University centre of legal medicine, Prof. Dr. Silke Grabherr Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
EXIT A.D.M.D. Suisse romande, Dr. Jérôme Sobel Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
Anthony Stavrianakis, CERMES3, CNRS France (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Oncology Institute of Southern Switzerland, Bellinzona, Dr. Claudia Gamondi Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Industry/business/other use-inspired collaboration
Pharmacie 24, Lausanne, Jean-Marc Krähenbühl and Pierre-Alain Rey Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Industry/business/other use-inspired collaboration
Dominique Memmi, CNRS, Paris France (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Geneva University Hospital, Dr. Sophie Pautex Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Industry/business/other use-inspired collaboration
Official Funeral Home and Services, City of Lausanne, Chantal Montandon Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
Paul Rabinow, University of California, Berkeley United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
Police of the canton of Fribourg, Pierre Schuwey Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
Association of the canton Fribourg's institutions for the elderly, Fribourg, Emmanuel Michielan Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
lifecircle (assisted suicide association), Dr. Erika Preisig Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
6ième colloque international du REIACTIS « Société inclusive et avancée en âge » Talk given at a conference S’extraire de la souffrance par un lien social : la notion d’assistance dans l’aide à mourir 04.02.2020 Centre des congrès de Metz, France Berthod Marc-Antoine;
Unité de recherche en éthique pragmatique de la santé Individual talk Enjeux éthiques au sein des associations  25.10.2019 Institut de recherche clinique Montréal, Canada Castelli Dransart Dolores Angela;
Unité de recherche en éthique pragmatique de la santé, Montréal Individual talk Quelles délibérations professionnelles face à des requêtes de suicide assisté ? Réflexions à partir de deux situations  11.10.2019 Institut de recherche clinique Montréal, Canada Castelli Dransart Dolores Angela;
Conférences du CURML Individual talk Le médecin légiste, le chercheur et le suicide. Ethnographie d’une intervention  04.10.2019 Centre universitaire romande de médecine légale, Switzerland Pillonel Alexandre;
Institut d’éthique appliquée Individual talk Réalités et enjeux du suicide assisté en Suisse. Eclairages à partir de deux études 17.09.2019 Université de Laval, Canada Castelli Dransart Dolores Angela;
14th International confrence on the social context of Death, Dying and Disposal Talk given at a conference Learning processes with a deadly outcome : the case of assisted suicide  07.09.2019 University of Bath, Great Britain and Northern Ireland Pillonel Alexandre;
Sociétà ticinese di psichiatria e psicoterapia Individual talk Dall’intenzione all’attuazione di un suicidio assistito  06.06.2019 Ospedale Civico Lugano, Switzerland Castelli Dransart Dolores Angela;
Symposium "Ethique et Travail social : nouvelles voies pour la pensée et pour l’action" Talk given at a conference Entre respect de l’autodétermination et protection de la personne : tensions éthiques vécues par des personnels socio-sanitaires confrontés en Suisse aux requêtes de suicide assisté de personne âgées institutionnalisées 05.03.2019 Université du Québec à Montréal, Canada Castelli Dransart Dolores Angela;
VIII Congreso Internacional Imagenes de la muerte Talk given at a conference Photographing dead body in the practice of medical examiners : a setting stage of the ‘neutral’ ? 30.10.2018 Universidad de Pachuca, Mexico Pillonel Alexandre;
VIII Congreso Internacional Imagenes de la muerte Talk given at a conference Images of terminality: anticipations of dying with assistance in Switzerland  29.10.2018 Universidad de Pachuca, Mexico Berthod Marc-Antoine;
International workshop Talk given at a conference An ambiguous process of medicalization. The role of medical examiners in the standardization of assisted suicide in Switzerland 14.09.2018 Université libre de Bruxelles, Belgium Pillonel Alexandre;
4ième Congrès international de la Société suisse de travail social Talk given at a conference L’actualisation du suicide assisté : une accélération de la dernière étape du parcours de vie? 12.09.2018 Haute école de travail social et de la santé Lausanne, Switzerland Pillonel Alexandre;
Institut de recherches cliniques de Montréal Individual talk Défis et enjeux pour les professionnel-le-s confronté-e-s à des demandes de suicide assisté en établissements pour personnes âgées 06.09.2018 Montréal, Canada Castelli Dransart Dolores Angela;
Journée d’activité du CRISE Talk given at a conference Le suicide assisté : variables influençant l’opinion des personnes âgées et des professionnel-les de la santé 30.08.2018 Cap St-Jacques Montréal, Canada Castelli Dransart Dolores Angela;
CDAS Conference ‘The politics of death’ Talk given at a conference The postmortem monitoring of legality: assisted dying and corpse removal 09.06.2018 University of Bath, Great Britain and Northern Ireland Berthod Marc-Antoine;
CDAS Conference ‘The politics of death’ Talk given at a conference The role of medical examiners in the standardization of assisted suicide in Switzerland. An expression of biopower ?  08.06.2018 University of Bath, Great Britain and Northern Ireland Pillonel Alexandre;


Self-organised

Title Date Place
Les réalités du suicide assisté 14.03.2018 Lausanne, Switzerland

Abstract

This project proposes an ethnographic inquiry into the practices through which assisted suicide in Switzerland is composed. Specifically the project focuses on the different kinds of knowledge and assessment, the varying forms of authority, the modes of valuation and the kinds of signification and meaning that are arranged during the process of assisted suicide and that shape the experience of those who participate in and facilitate it. Consequently, the aim is to observe as concretely as possible the social practices of a plurality of individuals concerned and solicited during the process of the request and realization of assisted suicide. We would also wish to take into consideration the events that immediately follow death, as well as to give an account of how each assisted suicide is narrated by those affected, in which ways and between which persons. This project is to be carried out in close collaboration with our field partners, active throughout Romandy, the Basel region and the Canton of Ticino. The ethnography is to be conducted by anthropologists Prof. Dr. Marc-Antoine Berthod and Dr. Anthony Stavrianakis and social worker and sociologist Prof. Dr. Dolores Angela Castelli Dransart. A research fellow will be employed at 100% for the duration of the project. The project aims to follow, observe and document a series of situations of assistance with suicide; these situations take place in a unique context, to the extent that assisted suicide in Switzerland requires the support of the medical corps, but does not demand the implication of doctors in its implementation. Access to these situations will be negotiated with the assistance of our field partners, in order to obtain the agreement of those who request assistance with suicide. Once such an accord has been reached with the person who requests assistance with suicide, and following our ethical protocol of voluntary participation, confidentiality and anonymity (when desired), the researchers will adapt to the temporality of the procedures in progress. To the extent that it is possible the researchers will engage, on several occasions, the maximum number of actors implicated in each situation: doctors, nurses, social workers, pharmacists, staff of right to die associations, persons who request assistance with suicide and their kin, the police, forensic medical teams, and the undertakers. The objective is to combine observations, informal exchange and in-depth interviews with these different actors to analyze the reality of a contemporary manner of dying and the different appreciations which traverse it. Moreover, it will be proposed that certain actors keep a “log book” - a quotidian chronicle - about their perceptions and their engagement in the process of assisted suicide, in order to enrich the data of the study. The originality of this project is the ethnographic focus on what is really occurring regarding this specific form of dying in Switzerland. It will give a scientifically and descriptively anchored added-value to a highly controversial issue, debated in many countries today, too often embedded in ideological and moral terms remote from the effective interplay of the actors involved in the process of assisted suicide. The ethnographic description will permit the analysis of two central phenomena: how a person’s request is accepted (or rejected) such that they can (or cannot) end their life; how different experiences and evaluations about the realization of an assisted suicide are lived and negotiated, through the entire process, as well as afterwards. Within such a two-part “problem of evaluation”-- (a) discernment of whose requests to be assisted can be accepted (under what conditions), as well as (b) reflection on the practice of such assistance--there is a fundamental question of authority and justification: on what authority, and then with what justification are evaluations and decisions in this practice based? To respond to these questions will facilitate shared reflection, with our field partners, on a series of crucial medical and ethical questions around forms of authority, including medical authority, as well as questions of how to ensure and enact autonomy and the interest of persons suffering from illnesses. By studying the process through which assessments and significations are formed in practices of assisted suicide, our ethnographic endeavor will provide a baseline of knowledge to facilitate a reflexive approach to social, ethical and political questions about assisted suicide.
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