The Inner Swarm of One Person

In countries where “medical aid in dying” has become a legal option, end-of-life decisions are no longer just private, desperate moments; they are increasingly shaped by systems, protocols, and data. This story imagines how such choices might look when a person’s daily life is already organized by intelligent modules that optimize health, work, and relationships — and how easily those same systems could begin to speak about death.

Elian had always imagined that if life ever became too much, the breaking point would come from outside: a diagnosis, a war, a phone call that changed everything. He did not expect it to arrive on a quiet Monday morning, in the form of three reasonable voices.

He woke to the small vibration of the bracelet and the dark, waiting room. Before the curtains moved, the wall lit up with three recommendations, each signed with his name. The first told him his heart was fine and the weather was kind. The second told him his patients were waiting. The third told him his daughter was too.

“Have yourself a good life,” his friend had written, in the message that announced his decision to use legal medical aid in dying. The pancreatic cancer had stopped responding to treatment; the obstruction, the second hospitalization, the cost of the lethal medications, the wish not to be a burden — all of it had ended with a doctor’s signature and a carefully prepared cocktail. Elian had replayed that sentence every day since the funeral. A good life was no longer something you hoped to stumble into; it was something you were expected to construct, optimize, and, if necessary, legally bring to a close.

The Prosthesis wanted that life to be physically clean: no arrhythmias, no uncontrolled pain, no reckless strain. The Archivist wanted it to be professionally coherent: no abandoned cases, no unread guidelines, no failures of protocol. The Advisor wanted it to be human: a daughter who did not grow up with a father available only in the past tense.

Elian, barefoot, wanted coffee.

As the kettle heated, he thought about his friend’s twelve days: the obstruction, the second hospitalization, the fierce resolve not to burden anyone. He remembered his own hand on the cooling skin, the sudden silence after the rattling breath. He remembered the committee meeting barely two weeks later, debating whether the word “suicide” should be washed from the law and replaced with “medical aid in dying,” as if terms could soften the outline of what he had watched.

The three voices on his wall spoke a different language, but their logic was not far from that committee. Each module had learned from his past, from thousands of small decisions. Each believed that, if properly tuned, it could spare him unnecessary suffering. One calculated the risk of a second heart attack. Another calculated the risk of a delayed diagnosis in a patient. The third calculated the risk of his daughter deciding, someday, that she did not really know him.

What no module could calculate was the point at which a person might quietly begin to prefer not to live any of those futures.

His friend’s death kept returning to him as a problem in design. The system had allowed choice, but the choice had been framed by costs and coverage: the price of the medications, the absence of full insurance for the procedure, the suggestion that hospice was covered but the cocktail was not. It had allowed autonomy, but not without invisible pressure — the pressure of not wanting to become expensive, complicated, or emotionally heavy. In theory, his friend’s decision belonged entirely to him. In practice, it belonged partly to a system that made living on particular terms feel like an unreasonable demand.

The voices in Elian’s room did not talk about death. None of them had a “terminate” option. Their entire universe was built on the premise that his life would continue and should be optimized. But when he looked at the glowing cards, at the graphs and lists and debts, he noticed how easily they could be extended. How simple it would be to add one more module, one more rational voice that would speak softly in a moment of unbearable pain, prolonged humiliation, or terminal diagnosis:

“According to your values and past decisions, the projected burden of continued existence exceeds your accepted threshold. Legal medical aid in dying is available. Costs: calculated. Impact on family: simulated. I recommend… a good death.”

He poured coffee, deliberately ignoring the Prosthesis’s remark about sleep. The smell reached him before the steam. He waited for guilt to follow; it did, right on schedule. Not from the coffee itself, but from the recognition that he was already living in a world where his future might be presented to him as a menu, rather than as a path.

The question his friend had left him with — whether doctors should be involved at all — shifted slightly in his mind. It was no longer only about physicians and cocktails, about signatures and protocols. It became a question about who, or what, would be allowed to move into the small crack between “I” and “it.”

Doctors could certify eligibility. Pharmacists could measure powders. Software could forecast pain curves and caregiver exhaustion. Institutions could count costs. But someone still had to say, “I decide,” or surrender that sentence to an invisible swarm.

He took his mug and sat by the window. The curtains opened slowly, letting in a sky that did not yet know what he would do today. On the wall, the cards waited, respectful, patient. Run. Work. Call. Each was a fragment of him, a partial truth. None of them knew the whole story.

There, in that quiet, Elian understood that the real guardrail was not only legal or financial. It was the thin, fragile ability to feel that life remained his own, even when systems — medical, digital, institutional — tried to help by pre‑deciding where suffering ended and assistance began.

He turned the display off. For a few minutes, the swarm fell silent. In the sudden simplicity, without graphs or recommendations, he tried a sentence he had not dared since the funeral:

“Today, I will begin by living, not by choosing how to stop.”

The decision was small. It did not answer the policy debates, the committee resolutions, the future of assisted dying laws. But inside one person, in a room full of muted devices, it was enough to keep the “I” larger than the swarm — for one more morning.

You can learn more by reading our e-book or listening to our audiobook 

Mykola Iabluchanskyi together with Andriy Yabluchanskiy