The discursive context of medical aid in dying: A paradox of control?

Individual agency is central to late modern and neoliberal concepts of the self and notions of a good death. Assisted dying can be understood as a reflection of these ideas in that control over death resides with the individual. The aim of this article is to explore individual agency and control and employ concepts of biopower and freedom to illustrate the paradoxes inherent within assisted dying. Assisted dying is currently of wide interest due to legislative change. At the time of research, the New Zealand Parliament was passing the End of Life Choice Act, yet there had been no research with people approaching the end of life about assisted dying. Through the media we recruited and interviewed 14 people approaching the end of life who would have considered choosing assisted dying if it were available to them. Interviews were analyzed using an immersion/crystallization thematic analysis. Assisted dying appealed to participants because it offered control. This article examines the discursive context of control as well as the participants’ perception of control to offer insights into how paradoxically, a medical regime of assisted dying reinforces health professionals as in control of the circumstances of dying. We argue that although legalized medical assisted dying is highly regulated and monitored, thus limiting freedom, the option of assisted dying also increases freedom for the dying person. Within this paradox of control, there is still scope for choice and an ethical making of the self, although limited by the biopolitical regime, that equates to a degree of freedom for participants.