Tripartite: a Special Conceptual Metaphor

The tripartite is a conceptual metaphor utilizing the concepts of critical tourism studies to elucidate suicidal tourism behaviour. The processes between the interconnecting points are the vectors influencing persons with MDD’s suicidal touristic behaviour. In the context of suicide tourism, the authentic self is a process of negotiating the totality of a ‘hopeless, incurable’ objectively-analyzed state in using the doctor to quantify their misery. The process depends on the gamut of a latent signifier, that is, a dormant mode of being that is dependent on the coded-approval in signifying the doctor’s will as affirming themselves, (the applicant,) as the object of their self-resentment. The transferential agency is the displacing of one’s own actions to be self-determinable in the eyes of another. Wherein the doctor’s will usually succumb before the patient’s will to die wears out. The ‘hopeless’ prognosis then transfers self-reliance, self-determination, and self-capacity to a singular mode of self-management in preparing for an ‘undeveloped’ life. Therein, the aim is to show that the phenomena of suicide tourism can be further expounded upon by existing tourist practices. It is not considered a conventional act of suicide tourism, the essay however does consider Godelieva de Troyer’s decision part of the phenomena that is turning into a practice.The case study will be referred to as highlighting possible ambiguities when it comes to accepting euthanasia applicants under the pretence of MDD. The essay will try to make sense of de Troyer’s decision and how it may be related to phenomenology studies. The results are to show that the applicant’s mood may be further assessed in a touristic perspective as a means of elucidating their desire. However before the connection can be made, it has to be noted a delineation between euthanasia and suicide tourism distinguishing features.

In order to properly assess suicide tourism, in the context of persons with MDD applying for euthanasia similar to de Troyer, a distinction should be made from what differentiates it from euthanasia tourism. Suicide tourism involves a suicidal individual travelling within regional/residential sites to end their lives in synchronistic fashion. The phenomena is not new, but the sites are defined by the phenomena of travelers to a particular destination to end one’s life. Euthanasia tourism describes a irremediably or terminally-ill individual traveling out of region to non-residential places which lawfully sanction assisted suicide in asserting his/her right for a dignified death. The circumvential practice centralizes around the fact the individual cannot lawfully be assisted. The study’s research points to the conflation of suicide and euthanasia tourism, both in the lexicon and discursive practice. Beginning with the former, the lexicon had drastically changed between 2007-09. “Suicide Tourism in Manhattan, New York City, 1990-2004” discussed how “little research has studied “suicide tourism,” the phenomenon of out of town accompanied by suicide” (Gross et al. 2007, 755). A follow-up periodical by the Journal of the Royal Society for the Promotion of Health (2008) stated that the Gross et al. articles “[were] the first known report” (5) documenting the phenomena of suicide tourism . In 2009, the epistemology of suicide tourism transcribes around the lexicon of medical discourse. Due to growing debate over changing legal policies and regulations prohibiting assisted suicide, individuals seeking euthanasia were traveling out of region to circumvent prosecution. The medical discourse of bioethics promulgated the semiotics of suicide tourism as involving travel by a suicidal individual from one jurisdiction to another, in which s/he will (or is expected to) be assisted in their suicide.The argument shifted from places of suicide to spaces permitting suicide. The medical ascription of suicide tourism has effectively replaced the ‘prior’ phenomena of individuals traveling to commit non-residential suicide. Gauthier’s et al. (2015) study, “Suicide tourism: a pilot study on the Swiss phenomenon,” substantiates the lexicon shift by stating the “phenomenon of suicide tourism has been growing over the years and is still increasing unabated”—yet this in the context of euthanasia, and not non-residential travel to commit suicide without assistance (616). Precisely, the non-residential suicide by one’s hand stipulating the critical tourism studies definition of suicide tourism, has been overlaid by the medical discourse of bioethics in repurposing the definition of suicide tourism as euthanasia seekers circumventing legal prosecution.

What the paper desires to draw attention to is not only the possibility of the phenomena of suicide/euthanasia conflating lexicon, but the transitioning of the discursive practice itself. The Gauthier study (2015) describes the Swiss phenomena of the increasing number of traveling euthanasia applicants. While the majority of applicants are suffering from terminal illness, there is a percentage of mental health applicants accepted as “medically diagnosed hopeless or incurable illnesses” (Dignitas). Before suicide tourism was semiotically warped into the lexicon of medical discourse and epistemology concerning right to die, the Gross et al. study (2007) stressed that “whereas prevention efforts have been aimed at certain sites that are often used for suicide (i.e., suicide fences at the Eiffel Tower and Empire State Building), we know very little about the reasons for the concentration of suicides in specific locations, nor about the characteristics of people who commit suicide in particular destination places” (756). Again, medical discourse dismisses the phenomenological aspects of the consciousness in terms of how the body and subject is oriented to/by discursive images, symbols, and significations. The prominence of suicide tourism localities are sites made popular in the general population. These sites are emblematic of cultural narratives and that the person committing suicide forfeits their life to it, sacrificing their life for a signifier greater than his/her own. Non-residential suicide is a mediated suicide. The site itself is symbolic to the person as a totem of all their regrets in life. It is a metaphysical death by society. This form of mediated tourism, the flux of imagery pertains to how the Dignitas pro-euthanasia website reinforces the ‘aid of dying’ imagery circulating the representation of a voyeuristic touristic experience. For persons with MDD this would be to authenticate the self in death, the imagery of flowery meadows, the ‘good’ end, presented as the Dignitas website banner, obfuscates the fact the applicant will be ending their lives in a Dignitas apartment. Similar to a tourist that books a vacation and is satisfied only with staying at the resort. There are no pictures of Zurich on the website. There are no alternatives for the applicant to explore the land which they wish to end their life in. Could applicant ‘s not be granted a temporary stay based on compassionate grounds? The moment away from ‘host-life’ and the phenomenological breath of sensory intakes, the new sights and sounds,may they not jostle their proportionate thinking?

Certain reinforcements put in place complicate the phenomenological circle of (self)representation. The applicant ‘s prehistory is funneled between border international nexuses (from home to guest doctor) and their authenticity in exercising ‘competent’ self-will, is dependent on the site itself: “rather, the tourist is an active audience who ‘searches out the meaning, drawing on the “bricolage” of meaning systems (Levi-Strauss 1966) which comprise the cultural baggage one takes to any situation’” (Jenkins 2003, 314-15). In the case study of Godelieva de Troyer, it is not unreasonable to suggest places like Dignitas are synonymous with the phenomenons happening at prominent tourist destinations. Persons with MDD are in a perpetual process of self-destruction: “[a]ccording to Casteur, a second concluded that she could still be helped; the psychiatrist observed that when Godelieva discussed her grandchildren she became emotional and expressed doubts about her decision to die” (Aviv 2015). After hearing of her plight, Dr. W. Distelmans granted de Troyer’s wish. Here is the absence of pleasure normally sought in death, de Troyer’s prior indecisiveness is indicative of suicidal ideations rather than euthanasia forethought. Suicides pertaining to family relation cannot bear thought of a pain they might have caused their significant others, and is spurred on by being unable to improve because of some hopeless ‘deficit’. The trouble with persons with MDD is that they consider the outcome of their death as it being tied in relation to another person or thing. De Troyer desired not to call her grandchildren because it would break the (non)authenticity of the grant from the Doctor in competence and autonomy. Thus, two main observations are noted: (i) persons with clinical depression are in a medically ‘grey,’ and legally-binding area; (ii) a need to address the gap between the medical and social science disciplinary models. The phenomena of suicide tourism is seen in both a semiotic, lexical shift, and a paradigmatic shift in applicant ‘s discursive practice which has led to the conflation of euthanasia practice with suicidal touristic ideation.

The effort of Godelieva was to express her authentic self, in relation to the cathect impulses of the trip, (death, hopelessness,) in semiotic relation to the doctor in process of transferring agency . De Troyer had been asked endless if she wanted to call her grandchildren, which is the same as asking a depressive patient if they want to be happy. Of course they do, but its phenomenologically numbing when one does not have the language to recuperate such losses. What could she have said to them? Here, palliative care (family support) should have been an option in trying to reconnect de Troyer with her son and grandchildren. The person with MDD is seeking the authentic approval of a dismal quality of life. It is dissimilar to applicants seeking euthanasia which have a feeling of euphoria, a right to a ‘happy’ death, than persons with MDD who are void of that euphoric basis in seeking an end to an unhappy life. Dignitas has become a referential point for persons of MDD to commit death by society in having someone affirm the irrationality of their decision. The phenomena of suicide tourism to places symbolic of societal qualities, (the Empire State Building, the Eiffel Tower,) has started to sporadically channel or shift into the power grids and emblematic presence of Dignitas. It represents a collusion of the tourist ‘s death drive which gazes at Dignitas in immense pleasure for accepting their wish, so much so they forgo commenting on the dedication, will, and determination sought in approving one’s death, how it may be translated into safeguarding one’s life.