Some argue that it is about shortening life. Others say it shortens death. The debate is complex; deeply personal, yet raises ethical, legal, and spiritual questions.

Assisted dying debates are currently gaining increased attention in Malta and the UK.  Now we cannot overlook the issue, especially amid the ongoing persistent campaign on national media persuading us to have thoughtful conversations around the idea of ending life as a personal choice.

Aside from ethical and medical notions, assisted dying debates reveal deeper cultural shifts; the belief that just as we shape our lives, we should have a say in how to end it. In a world that values personal freedom, the choice of when, and how to let go may be seen not as giving up, but as an ultimate act of self-determination.

It is on this point, that I would like to anchor my thoughts. Whilst aware of the theological and ethical underpinnings of this debate, I will be focusing specifically on two related sociological arguments: the growing range of choices we now have throughout our lives, including, potentially, at the end of life itself, and the evolving sense of obligation that we and others can potentially experience within an increasingly individualised society.

From a sociological perspective the issue of assisted dying invites critical examination of how societies construct, manage, and make meaning of death. In my lectures on the Sociology of Emotions, I discuss the sociology of death and grief, which offers valuable insights relevant to this discussion. Sociologically speaking, death is not seen merely as a biological event but as a socially constructed experience which changes with time. Societies determine what constitutes a "good death," what rituals accompany dying, and who has the authority to decide the terms of life's end.

Assisted dying challenges traditional understandings of death as something to be passively endured, introducing the idea that death can be chosen, planned, and controlled. To live well means to live on our own terms. So it follows that many now believe dying well should carry the same agency. However, this individualistic view can come into conflict with religious beliefs, cultural norms, and familial expectations, all of which influence how death is perceived and managed socially.

One major concern in this argument is that such an increasingly individualised society can place subtle yet profound pressures on those at the end of life to make the choice. As autonomy is elevated above all, we must ask: Will people begin to feel that their mere existence is a burden? That their care, their fragility, their slowness, is too much for others to bear? Dignity in dying must never be confused with silent pressures to let go.

This can propel a culture of obligation for instant fixes. The sense of obligation to not be a burden on others often arises from empathy, pride, and a desire for independence. It reflects an awareness of the emotional, financial, or physical weight our needs can place on those around us. For many, this obligation is a powerful guide in daily life, driving them to solve problems on their own, avoid asking for help, or suppress personal struggles.

Death, once a familial and community-centred process, has become increasingly medicalised. Hospitals, hospices, and legal systems now govern the dying process. Assisted dying intensifies this, placing death even more squarely within institutional frameworks. Does it mean that doctors would be tasked to recommend ending life under certain conditions? How does this shift the role of healthcare professionals in palliative care? How empathetic should the end-of-life process be in honouring life itself rather than focusing on death?

I return to music, as I often do; My all-time solace. This time with Adele, who in a sombre ballad, captures the sense of nostalgia of life slipping by in "Million Years Ago." Her lyrics echo the ache of reflection on life and honouring our worth in it:

"I wish I could live a little more,
Look up to the sky, not just the floor.
I feel like my life is flashing by.....

..Life was a party to be thrown, but that was a million years ago."

At the difficult and inevitable end of life, thoughts of loved ones, cherished memories, and the meaning of one's journey may come to the forefront. This is undoubtedly a difficult topic, one where every case tells its own deeply personal story.

From a sociological standpoint, assisted dying is deeply embedded in our changing cultural norms, and collective values. This debate puts at centre stage the uncomfortable questions about what it means to die well, who controls that process, and how much autonomy we truly have in the face of death. The experience of losing a loved one can oscillate between the desperate wish for more time and the painful desire to end suffering in the name of dignity. Taking a definitive stance is rarely straightforward. It should not be straightforward. There are too many factors at stake.

As debates continue, we require sociological understandings on the broader implications of how we live, and die, as a society. Amid the complexity, one truth stands firm: the essential need for high-quality palliative care that supports both those nearing the end of life and the families who walk that path with them.

Prof. Valerie Visanich is an Associate Professor in Sociology