In many Western countries, public debate about assisted dying centres on the idea of “choice” – the right of individuals to decide when and how they die. Switzerland has become a focal point in these discussions because its laws allow assisted suicide under certain conditions, including for non-residents. As a result, a growing number of people from countries where assisted dying is illegal travel there to seek help in ending their lives – a practice sometimes referred to as “suicide tourism.” 

Despite frequent media coverage and political debate, very little is known about the inner lives of the individuals who make this journey. Carrigan’s research shifts the focus from laws and policies to the personal stories behind the decisions. 

Looking beyond “choice” 

Rather than treating assisted dying as a simple matter of individual freedom or autonomy, Carrigan examines how people understand their decision within the context of their entire life story. Over seven years, Carrigan conducted in-depth interviews with individuals planning to travel to Switzerland for an assisted death. She explored their past experiences, present realities and fears about the future. 

Her findings challenge the common assumption that choosing assisted death is purely a rational decision made in isolation. Instead, she shows that it often emerges gradually, shaped by illness, loss of independence, changing relationships and shifts in identity. 

Choice, Carrigan says, is not a single moment. It is part of an unfolding life narrative which continues to evolve until the end. 

“Biographical contraction” and “Biographical closure” 

Carrigan introduces two new concepts to help explain this process. 

“Biographical contraction” describes the feeling many participants expressed that their world was shrinking. As illness progressed, they experienced physical limitations, social isolation and a growing sense that they could no longer live as the person they once were. Life felt increasingly confined – not only physically, but emotionally and socially. 

“Biographical closure” refers to the meaningful steps people take when preparing for death. Participants described putting their affairs in order, repairing or strengthening relationships, and reflecting on the meaning of their lives. These actions were not simply practical arrangements; they were ways of completing their life story on their own terms. 

Together, these concepts suggest that a wish to hasten death is often tied to a desire to preserve identity and coherence in one’s life narrative. 

Implications for end-of-life care 

Carrigan’s research highlights the isolation and uncertainty that many people face when considering assisted dying abroad. Because the option is illegal in their home countries, individuals often navigate the process quietly, with limited support. 

Carrigan calls for greater attention to personal biography in end-of-life care. She suggests that healthcare professionals and policymakers should look beyond legal criteria and abstract debates about autonomy and instead engage more deeply with the lived histories and experiences of patients. 

‘By listening closely to individual stories, society can better understand what unbearable suffering means – not only in physical terms, but as a disruption to identity, dignity and connection.’