My father died of brain cancer. But in his final minutes, it was the mucus in his throat which he could no longer swallow that asphyxiated him. My great aunt’s dementia killed her by inducing a seizure in which she choked on her own vomit. Freshwater drowning amounts to a heart attack as your red blood cells burst and release lethal doses of potassium. Urinary incontinence affects about a third of home hospice patients, especially women, dementia and stroke patients: the elderly wet themselves as they prepare to die. So forgive me for my scepticism that death has dignity. But let us examine this empirically: can death be peaceful? Can we choose to make it have dignity?

When trying to remove my personal biases from my research, I found some optimistic human stories. There was someone on Reddit whose son complained of a headache for a few minutes, reported his pain going away, and slipped into a coma. But it felt like for every optimistic story, ten were traumatic.

Human death

What is death anyway? It is the inevitable end of life, the basis of biology. Most of us have a deep instinct to cling to our fragile mortality. Legally, it is the irreversible cessation of either brain or cardiovascular function. That means you can be dead with a beating heart; your heart can pump blood autonomously for a while. Often, death starts with progressive organ failure, finally resulting in a lack of circulation to the brain, thus ending our consciousness.

“But it felt like for every optimistic story, ten were traumatic”

In humans, lung and heart diseases account for well over 40% of deaths; other leading causes include diarrheal diseases, HIV/AIDS, malaria, and cancer. Lung diseases are often associated with chronic chest pain. Diarrhoea kills because it dehydrates you. Late stage HIV/AIDS involves fatigue, memory loss, and susceptibility to a host of other infections with various side effects. Malaria symptoms range from fatigue and joint pain to nausea and coughing. Cancers, while varied, make the sufferer waste away.

These points do not invalidate the possibility of peaceful death, but most causes of human death are low on dignity, particularly in the final stages, when death has become inevitable. While modern medicine has miraculously improved survival in most of these diseases, the experience for those who are not cured remains grim.

Animal deaths

Looking to the natural world for a point of comparison not influenced by modern medicine, the leading cause of death (55%) in small animals is predation: hardly an enviable end. The next greatest cause of death, accounting for 17% of mortality, is “harvest”: a euphemism for being killed by humans for human consumption. Methods by which humans kill animals vary immensely between cultures.

Under UK law animals must be stunned before being killed, although exceptions are made on religious grounds for halal and kosher meat production. Stunning aims to reduce the pain experienced by the animal, and methods include a metal bolt to the brain, precise brain electrocution, and lethal gases. We can’t ask any animal how it feels, let alone a dead one, so it is difficult to really evaluate how peaceful any of this is. According to the RSPCA, stunning at least reduces the time taken for the animal to die, and reduces how much shackling is required to keep the animal still in order to slit its throat.

Evidently, the slaughtering of livestock can be more or less peaceful, but the slaughterhouse environment is inevitably distressing. Human slaughterhouse workers are up to four times more likely to suffer from clinical depression than population averages. It is not hard to imagine that any animal with any degree of sentience would be similarly distressed by the sights, sounds, and smells of their kin dying.

“Personally, I marvel that this mercy is reserved for pets and denied to humans in this country”

Humans are kinder to our pets. When putting down a dog, a comfortable environment is created, sometimes even at home, unlike the horrors of a slaughterhouse. A high dose of general anaesthesia-type drug is administered directly to a vein. It is quick, and the pet loses consciousness before their organs start to shut down, unlike many sufferers of terminal illness. They may defecate and urinate as their muscular control disappears, but they are unaware of this, unlike our hospice patients. This alone sounds peaceful. Far better than suffocation or dehydration or predation. Personally, I marvel that this mercy is reserved for pets and denied to humans in this country.

Having examined death, and questioned it, and dissected it, I can picture how I want to go. It is autumn 2084. At the start of the summer, I received a diagnosis. Something deadly, but where symptoms can be managed by painkillers, and where my mind remains intact. I spend the summer seeing my loved ones and sitting in the shade of an oak tree reading my old diaries and marvelling at how far I have come. When the leaves start to brown, I know it is time. I start to retire to my room more, looking out at the tree through a bay window. For three days I say goodbye to family, personally giving each member a small gift and unsolicited life advice. On the third day, my final visitor is a doctor. General anaesthetic, a lethal injection, and I leave this world forever.