It has already been said, “We will die in the system we create.” The statement raises a larger question: What do we mean by death? Death can be spiritual through excommunication, economic through expulsion from work, social through eviction from a community, psychological through exclusion and loss of sanity, or physical through extinction. Birth and death often result from forces beyond an individual’s control. Yet death can also become intentional. People facing profound spiritual, economic, social, psychological, or physical crises may feel driven to choose death, while other people or the systems they create may decide it for them.
Health care professionals work at the intersection of these crises and their consequences. Professional norms, ethics, laws, and moral duties permit them to discuss possible death but sharply constrain actions that could cause it. Today, human institutions bear ultimate responsibility. In the future, however, artificial intelligence (AI) systems may be asked to interpret a person’s circumstances, assess whether a choice is voluntary or coerced, and determine what should happen next.
Generative AI chatbots and conversational assistants built on large language models could be used to frame and evaluate cases involving spiritual, economic, social, psychological, or physical crises. Eventually, advocates may argue that these systems can decide whether a person’s chosen or coerced path toward death is justified and how to make that death as peaceful as possible. Such delegation would not eliminate moral responsibility. It would transfer or obscure it.
The questions become most concrete in practices such as assisted suicide, active euthanasia, and capital punishment, wherever they are legal. Could AI be asked to select a method? Could robots establish vascular access, administer a lethal medication protocol, and monitor the heart until activity ceases, all without direct human intervention? Technical automation might reduce visible human involvement, but it would also distance people from the consequences of decisions made in their name.
These questions are not only about what AI could do. They are about whether humans should allow AI to interpret suffering, consent, coercion, and death. A machine may process information consistently, but the norms, laws, and values guiding its decisions would still come from people.
Death is unavoidable. The challenge is to make dying as peaceful and humane as possible without allowing technology to remove human judgment and accountability from decisions about life and death. In an AI-driven world, the risk is not only that machines may execute human choices. It is that they may quietly evict humans from responsibility for those choices.
Deepak Gupta is an anesthesiologist.
