We don't like talking about death in Bermuda. We talk about 'passing' and the glory of 'going home', but not about dying. We talk about being 'laid to rest', not being buried.

One fellow columnist recently talked about someone being 'funeralised', which presumably translates into the funeral ceremony and interment of the body.

But as we age and face our own mortality in ever greater numbers, some good old-fashioned plain-speak is needed: death is the end of life, and dying is the process by which we get there.

And as modern medicine continues to find treatment for previously fatal disorders and diseases, we need to open a discussion on its impact on our quality of life as well as our quality of dying.

If anyone watched American television on Friday, 13th June, the programming was dedicated almost exclusively to the death of Tim Russert, host of the Sunday morning programme "Meet the Press".

Russert's death came as a shock, especially to his colleagues. He was a celebrity, and he collapsed and died in the studio of a major television network. His death was also a shock because he was 58 years old and at the top of his profession.

We are not supposed to die suddenly at 58. We are supposed to live into our eighties and nineties, thanks to good health care. And fortunately many of us are living well beyond our three score years and ten.

But there is a dark side to modern medicine. Together with current law, it is keeping people alive well beyond any realistic expectation of quality of life, whether treatment extends life for severely premature babies, sufferers of terminal diseases, or those in the final stages of extreme old age.

In some parts of the world, women of the family are still charged with caring for the dying and preparing their loved ones for burial or cremation. This is not the case in most of the Western world.

For us, death usually takes place behind the closed doors of a hospital, and preparation for burial is delegated to professional morticians and undertakers.

Over the last 100 years or so, we have learned to distance ourselves from the processes of dying and, ultimately, death.

Unfortunately, tragically and painfully in many instances, this has led to control of the dying process resting in the hands of law-makers, theologians and medical professionals who are bound to extend life at any cost.

A sudden death is a shock, and considered a tragedy when it comes 'before time'.

But what about the many thousands who suffer a long, extended, and very often painful dying process because the legal, religious and medical professions say they must?

Debbie Purdy is an Englishwoman suffering from advanced multiple sclerosis, a degenerative condition that often ends in death by choking.

She is seriously considering a lonely death in Holland where voluntary euthanasia (sometimes called assisted suicide) is legal.

Because her husband is of African descent, she worries that if he is with her at the time of her planned death, he will be made a scapegoat under British law where such action carries a sentence of up to 14 years.

She says" "The law is talking of abstracts. I am living the reality. All I want is to enjoy my life¿ and the dignity to control its end. Is that really so awful?"

We need to discuss the need for good palliative care in the community, hospital and hospice for all who need it, whether or not they are suffering from cancer.

We need to discuss the concepts of death with dignity, and the legal right to end one's life with the assistance of a healthcare professional when all hope of a quality of life and a pain-free death is ended.

We need to use medical knowledge wisely and not extend life at all costs.

The time has come to have an open discussion on death with dignity that may cause distress among the churches, the legal profession, the medical profession and others, but will bring great relief to those who are suffering now and in the future.

Marian Sherratt is Executive Director, Bermuda Council on Ageing. She writes on issues concerning our ageing population each month in The Royal Gazette. Send email responses to info@bdaca.org.