Defense Date

4-9-2025

Graduation Date

Summer 8-8-2025

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Psychology

School

McAnulty College and Graduate School of Liberal Arts

Committee Chair

Derek Hook

Committee Member

Elizabeth Fein

Committee Member

Mark Goldblatt

Keywords

assisted dying, assisted suicide, medical assistance in dying, Lacanian discourse analysis, LDA, Lacanian psychoanalysis, ideal ego, Ego ideal, master signifier, the big Other

Abstract

More and more people worldwide are requesting euthanasia, physician-assisted suicide (PAS), or medical assistance in dying (MAiD). Arguments in favor of expanding access to MAiD tend to prioritize the rational, competent, autonomous subject who has the right to make decisions about their body, including their death. Some have argued that this perspective – common in biomedical and bioethical literature – tends to neglect the fact that requests for assisted dying involve a relational structure: a relationship between the subject who requests an assisted death and the Other to whom this request is addressed. After reviewing relevant psychoanalytic approaches to suicide and assisted dying, this study examines the relational structure of MAiD from a Lacanian theoretical perspective, focusing on the case of non-terminal in Canada. The overarching question motivating this study is: What is the position of the o/Other addressed in MAiD? From this perspective, the relational structure of assisted dying is tracked across three Lacanian registers: first, as a (real) relation of the subject to his/her body, including the illnesses for which they seek an assisted death; second, as a dyadic (imaginary) relation between the subject and the others to whom they address their request; and third, as a (symbolic) relation between the subject and the big Other, instantiated by the laws, policies, and institutions governing assisted dying practice.

To track the position of the o/Other addressed in MAiD, the author conducted semi-structured psychoanalytic interviews with six individuals with non-terminal illness considering applying for MAiD. Lacanian discourse analysis (LDA) was deployed as the methodology to analyze data collected. LDA is an evolving methodological tradition characterized by diverse methods, but is unified by its definition of the human subject as split into conscious and unconscious processes, and hence replete with ambivalence and contradiction. Data analysis was divided into two main chapters. In the first, the author outlines the relational origins of subject-formation according to Lacanian psychoanalysis and discusses the central position of the Other in mediating the relationship between the subject to the body and its drives. The author examines two participant transcripts in which an actualpathological position was assumed, characterized by the Other failing to provide adequate knowledge of and symbolization of the drives. This chapter includes a discussion of the structural lack in the symbolic (the Other) with respect to the real of the drives (object a), and explores MAiD as a master’s discourse that functions to cover over medicine’s lack vis-à-vis the real. In the second chapter, the author discusses identificatory processes operative for participants who request MAiD. A Lacanian theory of identification and alienation is described. Key Lacanian concepts are then operationalized (ideal ego, Ego ideal, superego, and master signifier) and analyzed with reference to two participant transcripts. This study concludes that with respect to MAiD, the Other appears to function in at least two ways: First, as a promise to solve the problem of the body and its drives; and second, as a promise to solve the problem of alienation in the Other’s signifiers. In both functions, MAiD, as a total identification with the master’s discourse, may preclude the subject from encountering his/her own desire/lack; alternatively, the process of applying for MAiD may initiate the subject’s interrogation of their alienation in the Other’s discourse and a movement toward separation.

Language

English

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