How would you like to die? Some would like to pass on while hearing a favorite piece of music, with certain friends or family surrounding them. Some would rather be alone or asleep, while others would prefer to be awake as it happens. And some have never really thought about it.

But I bet you have an answer to another question: How don't you want to die? Everyone I know has an opinion about that. Nobody I've ever talked to wants to experience excessive pain, and most say they don't want to be attached to machines to help them breathe or eat.

George and Shirley Brickenden felt the same.

"We witnessed, many years ago, someone we loved very much, a family member, who lived for several years and turned from being a magnificent human being into somebody you couldn’t recognize, that lay in bed and made noises," Mrs. Brickenden told the Globe and Mail. "We thought then, 'Well, I don’t care what happens when we get to zero. When we know it’s the end, we’re not going to do that.'"

And so the Brickendens didn't. They died holding each other's hands in a Toronto nursing home, on a day of their choosing, after a goodbye week that included a party with loved ones, a final date night at their favorite restaurant, and time with each of their children independently and together. They had time to see their grandchildren, who flew in from Switzerland, Vietnam and elsewhere to say their goodbyes. The couple toasted a life well-lived together with champagne and a last supper of hors d'oeuvres including salmon, lobster and filet mignon. It's kind of like they were able to enjoy their own memorial service before they died.

The Brickendens' passing was quiet, and designed to be as easy and painless as possible. It's certainly the kind I'd like to have, considering the many ugly and painful deaths I've seen in my own family and heard about via family friends. I won't go into the specifics but I'm sure I don't need to; most families have their own horror stories.

Choosing doctor-assisted death

A couple silhouetted in the evening light, holding hands and walking together End of life decisions aren't easy, no matter how old you are. (Photo: Antonio Guillem/Shutterstock)

Avoiding needlessly horrible deaths for people who aren't going to live much longer is why in Canada (and Belgium, the Netherlands, Luxembourg, Colombia, Switzerland and seven U.S. states), people can apply for doctor-assisted deaths. Each country or state has its own rules.

Since the new rule was passed in June 2016 in Canada, two independent doctors must find that the person applying for the assisted death has health issues that make their passing "reasonably forseeable." The law also requires that people be of sound mind and experience intolerable suffering and irreversible decline before legal permission to assist with death is given to the doctors. In the Brickendens' case, doctors found just that, with each half of the couple dealing with severe heart problems and Mrs. Brickenden in severe pain from rheumatoid arthritis.

But there are people who have a problem with this. There are the concerns, especially when considering a couple, that one may coerce the other into dying, though the Brickendens were consulted separately by four doctors, so there are ways to avoid that issue. Still, the Brickendens are the first couple in Canada able to die together. Another couple who wanted to do the same was forced to plan their deaths four days apart so the doctors could be clear there was no coercion at play.

Others who argue that physician-assisted death shouldn't be allowed are concerned it could be used for eugenics purposes, but there are such strict rules in place to prevent any kind of unexamined death to take place. Except for those in Switzerland, most of the laws surrounding the practice are new and are designed to prevent abuse. According to the CBC, "Statistics show that most patients who choose [Medical Assistance for Dying (MAiD)] are older, well-educated, independent and terminally ill. A 2016 survey in the Journal of the American Medical Association revealed that 70 percent of MAiD cases involved individuals with cancer."

Finally, some say that because certain religious texts suggest choosing death is wrong, that it shouldn't be allowed. In secular countries though, it doesn't seem fair that one person's religious beliefs should impact another person's choice to end his own suffering and pain.

The Brickendens passed together while listening to a playlist of Mozart, Bach and Scottish folk songs that one of their children assembled for them. Mr. Brickenden's last words were, "I love you all," to his children who surrounded him.

Starre Vartan ( @ecochickie ) covers conscious consumption, health and science as she travels the world exploring new cultures and ideas.

Elderly Canadian couple's last act raises questions about how we die
George and Shirley Brickenden clinked their champagne glasses, said goodbye to family — and with a doctor's help, died together in Toronto.