Local groups of Supporters of the Society for Old Age Rational Suicide (SOARS), in the UK, meet periodically to have a “Die-alogue” on their possible end-of-life care options. In particular, they focus on the importance of having up-to-date, very detailed advance decisions (formerly called “advance directives” or “living wills”) which state the type of medical care someone wishes to receive when that person becomes mentally incompetent (for example, due to a severe stroke or an advanced dementia) and is no longer able to communicate with their doctor(s).

Death was once a part of Life. People grew up seeing parents, spouses and friends die. It brought families, friends and neighbours together – to provide comfort and dignity to the dying, and those around them. Death used to be more of a social process rather than a medical one. Most people, even only fifty years ago, died at home. Death was normal, with people knowing what to expect. Unfortunately, since the 1960s, death has often become an institutional event rather than a personal experience. Today, in the UK, in spite of better at-home palliative care services, death is much more likely to take place in a hospital, a nursing home or in a hospice. We hide the dying away, turning death into something which is unknown, unseen, and therefore, much more frightening.

Today, as a society and a culture, many people, in the Western world, have become squeamish about death. We avoid the subject. Instead, we “battle” with serious illnesses, as if it is a fight we can always win if we just try hard enough. And, often, we fool ourselves, right up to the last day, that we are immortal, that death is something that happens to other people, but not to us.

Without having a morbid preoccupation with death, Die-alogue Groups discuss the subject in an open-minded way. The first group met in Brighton and Hove (a city on the south coast of England, where SOARS was founded in December 2009) in April 2013. Generally limited to a dozen individuals, each group meets three or four times a year. Topics discussed, in addition to advance decisions, range from the “ideal” funeral and natural or “green” burials to how elderly people can communicate with their families and friends on death without embarrassment. Hopefully, such discussions provide a painless and healthy corrective to the contemporary culture of death-denial.

No one, in a Die-alogue Group, is ever involved in assisting any suicide in the UK. But, if someone in a Group should qualify for a doctor-assisted suicide in Switzerland (where this possibility has been permitted for many years), and needs assistance in getting there, it is expected that others in the Group will be willing to help that person.

If further information is required about Die-alogue Groups, an e-mail should be sent to Michael Irwin, the Co-ordinator of SOARS: his e-mail address is michael@soars.org.uk.

The address of the SOARS website is www.soars.org.uk