Blog post
Dying a ‘Good’ Death: The Evolving Perspectives Around Assisted Dying
8 June 2026
By Gurubaran Subramaniam
Nobel laureate Daniel Kahneman decided to undergo an assisted death in Switzerland aged 90 despite being relatively healthy.[i] His reasons were that it was ‘time to go’ as he had lived his life well and that ‘the miseries and indignities of the last years of life are superfluous’.
Kahneman’s example suggests contemporary discourse on assisted death is taking on a new frame. In the past, assisted death — a medical procedure where a lethal dose is administered to a patient, either by a medical professional or by the patient themselves — was predicated solely on one’s physical condition, such as unbearable suffering from a terminal or incurable illness. Today, assisted death is coming to be seen as a logical and calculated response to the highly uncertain and frightening journey of ageing.
The aversion to ageing
A growing number of relatively healthy individuals opt for assisted dying because they anticipate and dread the ills of ageing such as physical and mental deterioration, or widowhood. Indeed, medical practitioners have observed that it is not death itself that many seniors fear most, but the losses that precede it — loss of hearing, memory, loved ones, personality, and way of life.[ii] In 2024, for example, Jan Faber and Els van Leeningen, a happily married Dutch couple, underwent assisted dying as a couple (duo-euthanasia) despite neither being diagnosed with a terminal or uncurable condition that caused unbearable physical suffering. They decided to do so in light of Jan’s chronic back pain and after Els was diagnosed with early dementia.[iii] Els said, “the life we’ve lived, we’re getting old [for it].”[iv]
Having experienced the indignities of ageing, moreover, some seniors may also feel ‘existential exhaustion’. They feel as if they are ‘done with life’.[v] 75-year-old Gill Pharaoh, a retired palliative care nurse, underwent an assisted death in Switzerland in 2015 because she did not want to grow old.[vi] Before undergoing the procedure, she wrote on her blog:
I feel my life is complete and I am ready to die. My family are well and happy — their lives are full and busy. I can no longer walk the distances I used to enjoy so the happy hours spent exploring the streets of London are just a memory now. I simply do not want to follow this natural deterioration through to the last stage when I may be requiring a lot of help … I want people to remember me as I am now — a bit worn around the edges and not quite at my peak, but still recognizably me![vii]— Gill Pharaoh
Certain death, uncertain ageing
Well before being on cusp of ageing, some young adults consider assisted dying as a viable retirement strategy,[viii][ix] amid heightened interest in discussing and planning for death early on.[x] These young adults are often keen to gain financial independence and retire early (the FIRE movement) and have no heirs or dependents. Planning decades ahead to have an assisted death at a specific age removes uncertainty about whether they will have the money to lead the life they want to lead (including maintaining relationships) and afford eldercare. Freed from anxieties over the adequacy of retirement savings, people can financially plan for carefree and purposeful lives before their planned deaths, such as by splurging on expensive vacations, hobbies, and material possessions during their healthy years. These anxieties are intertwined with the desire to maintain independence and agency, and not wanting to be a burden to others into one’s senior years, leading to an assisted death being seen as a viable option.
Suicide tourism, medical ethics and costs of ageing populations
The emergence of assisted death as a logical response to the uncertainty and frightfulness of ageing poses opportunities and challenges for governments.
First, it could result in legal and regulatory loopholes, with deep ethical implications. Even among jurisdictions that have decriminalised or legalised assisted dying, legislative frameworks and eligibility criteria remain uneven. For instance, someone who has not been diagnosed with a terminal illness but is ‘done with life’ might be more likely to meet the criteria for assisted dying in Switzerland than in Canada. This could mean that those who are denied assisted dying in a particular jurisdiction could possibly do so in another. Countries such as Switzerland and Belgium have acquired a reputation for being ‘suicide tourism’ havens due to their liberal laws around assisted dying. According to reports, over 500 foreigners travel to Switzerland a year to undergo assisted dying procedures, in addition to around 1,700 Swiss citizens.[xi] The number of assisted suicides in Switzerland is projected to double by 2035.[xii] Such so-called suicide havens pose legal and moral dilemmas to other governments: should they follow suit?
Second, assisted death for reasons beyond unbearable physical suffering poses an ethical challenge to current paradigms around end-of-life care and the role of medical practitioners. The medical profession’s core duty has always been framed in terms of protecting and preserving life. Preventive medicine and palliative care place greater emphasis on quality of life and minimising pain and suffering, but do not challenge this tenet. If medical practitioners are involved in assisted dying — such as counselling individuals who request assisted deaths because they are ‘done with life’, prescribing drugs for the procedure, or certifying the death — it would run counter to their training and raise significant moral questions about their professional responsibility and purpose.
Third, while the primary objective of the destigmatisation and normalisation of assisted dying would be to allow for greater autonomy and dignity around ageing and dying, it could bring about some surprising policy implications. Governments of many developed economies are bracing for rapidly growing aged populations and single-member households, which would entail increased public expenditure on eldercare and social services. If people choose to undergo assisted deaths before they require care, fiscal pressures may ease. Land that otherwise would have been taken up for eldercare facilities such as assisted living and nursing homes could be freed up for other uses. To emphasise, these upsides would merely be the unintended consequences of enabling ageing and dying with autonomy and dignity, not the intent.
Let’s talk about ageing (and dying)
Many governments remain uncomfortable with taking the lead on conversations about assisted dying for various reasons, such as prevailing cultural norms, a belief that their societies are not ready for them, or concern that they might be perceived to be endorsing the practice. However, the growing interest in the procedure underscores the importance of having such conversations — to better understand evolving perspectives and motivations around living and dying with dignity and to ensure that key players in the end-of-life space are prepared for it. This is encapsulated in Atul Gawande’s argument in Being Mortal:
…our most cruel failure in how we treat the sick and the aged is the failure to recognise that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.[xiii]— Atul Gawande
Endnotes
1. https://www.nytimes.com/2025/04/14/opinion/daniel-kahneman-death-suicide.html
2. Gawande, Atul. 2014. Being Mortal. New York: Metropolitan Books
3. https://www.bbc.com/news/articles/c0jjq2vynq7o
4. Ibid.
6. https://www.cbsnews.com/news/retired-nurse-commits-suicide-to-avoid-growing-old/
7. Ibid.
8.https://www.reddit.com/r/Fire/comments/1rq7i6g/euthanasia_as_end_game/
9. https://riceball1.medium.com/my-retirement-strategy-is-euthanasia-839be1809bca
12. Ibid.
13. Gawande, Atul. 2014. Being Mortal. New York: Metropolitan Books
The views expressed in this blog are those of the authors and do not reflect the official position of Centre for Strategic Futures or any agency of the Government of Singapore.
[i] https://www.nytimes.com/2025/04/14/opinion/daniel-kahneman-death-suicide.html
[ii] Gawande, Atul. 2014. Being Mortal. New York: Metropolitan Books
[iii] https://www.bbc.com/news/articles/c0jjq2vynq7o
[iv] Ibid.
[v] https://theconversation.com/i-couldnt-care-less-if-i-saw-another-sunrise-what-older-people-who-are-tired-of-life-can-tell-us-about-the-assisted-dying-debate-209756
[vi] https://www.cbsnews.com/news/retired-nurse-commits-suicide-to-avoid-growing-old/
[vii] Ibid.
[viii] https://www.reddit.com/r/Fire/comments/1rq7i6g/euthanasia_as_end_game/
[ix] https://riceball1.medium.com/my-retirement-strategy-is-euthanasia-839be1809bca
[x] https://www.straitstimes.com/life/he-took-a-90-pay-cut-to-become-an-afterlife-agent-why-young-singaporeans-are-talking-about-death
[xi] https://www.swissinfo.ch/eng/assisted-suicide/switzerland-no-longer-wants-to-foot-the-bill-for-suicide-tourism/88896839
[xii] Ibid.
[xiii] Gawande, Atul. 2014. Being Mortal. New York: Metropolitan Books
Gurubaran Subramaniam is Lead Foresight Analyst at the Centre for Strategic Futures.
The views expressed in this blog are those of the authors and do not reflect the official position of Centre for Strategic Futures or any agency of the Government of Singapore.