The experience of dignity in the context of medical assistance in dying: A phenomenological and hermeneutic study

Medical assistance in dying has become a significant topic of debate in Western societies, where legalization is expanding. A key feature of this debate is the appeal to dignity, invoked by both proponents and opponents. Two dominant conceptions of dignity emerge from the literature: ontological dignity and dignity based on autonomy. Public discourse often draws on these frameworks. This study aims to move beyond this binary by exploring dignity through the lived experiences of individuals who choose medical assistance in dying. Using a phenomenological-hermeneutic approach, interviews were conducted with six patients considering medical assistance in dying and six bereaved individuals. Five key themes emerged: 1) dignity-autonomy, 2) dignity-identity, 3) dignity without and with others, 4) suffering and doubt, 5) embodied and contextualized experience. While autonomy initially appears central, further analysis, informed by Ricoeur's philosophical concepts, highlights a relational dimension that refines a purely autonomy-centered understanding of dignity.