Mortality stops feeling abstract when the data says dying from heart failure or dementia often means years of pain, breathlessness and loss of control. We start there—naming the clinical truth—so agency has solid ground. From that reality, we trace a through line: autonomy in assisted dying, the harm of social erasure, the courage of meaning-making after loss, and the quiet power of self-transcendence when death draws near.

We talk about shifting the assisted dying debate from paternalistic language to clear talk of choice, freedom and responsibility. We widen the lens with Professor Patrick Vernon’s use of social death to show how structures can strip personhood long before the body fails, linking it to Windrush and to workplace policies that diminish culturally rooted grief like nine nights. Against that, black joy and Afrofuturism emerge as living strategies—imagination, celebration and creation as acts of repair that clinicians must recognise and support.

On the intimate front, Professor Emmy Van Deurzen maps how despair grows when trust in life collapses, and how Jaspers’ limit situations—struggle, death, chance, guilt—can become thresholds for transformation. Dr Robert Neimeyer then offers the practice: meaning-focused grief therapy that helps clients relearn their physical world (umwelt), reorganise their relational world (mitwelt) and reauthor a reflexive narrative that can hold the loss without breaking. We share a challenging case of reframing suicide in a way that reduces torment and restores agency, noting the ethical care this requires.

As we face death, many try to outrun fear by building the self; terminal illness makes that strategy untenable. The more reliable path is self-transcendence—loosening the ego’s grip through connection to nature, community, creativity, contemplation or the divine. We explore why love, presence and a sense of mystery often help more than technique, and why psilocybin-assisted psychotherapy shows striking promise for existential distress by catalysing profound connectedness in a single, well-supported session.

The thread tying it all together is simple and demanding: people tend to die as they have lived. Practise agency, meaning-making and transcendence now, not later. If this conversation resonates, subscribe, share it with a colleague, and leave a review to help more practitioners find these tools—and keep the learning going with the full conference recordings in our library.