Death & Dying Questionnaire     

1. If you could choose the date of your death, at what age would you decide to die (please state an exact number of years)? Why?

2. What time of day or night would you wish to die (please state the exact hour)? Why?

3. How do you want to die (please be specific, including the setting)? Why?

4. Would you rather die lucidly in agonizing pain, or would you rather die in a painless morphine stupor? Why? 

5. How do you want your remains to be dealt with: traditional burial (inhumation), burial at sea, Viking ship burial (not to be confused with burial at sea), tree pod burial, sky burial (excarnation), space burial, entombment in a mausoleum, cremation, mummification, cannibalization, taxidermy, plastination*, cryonic preservation, alkaline hydrolysis (liquefaction), being turned into compost, or converting your corpse into a lab-grown diamond? Why?

*Plastination is a technique developed by Gunther von Hagens in 1977 to preserve organs and whole bodies for public display.

6. Are you an organ donor? Why or why not?

7. Who do you think has an easier time dealing with death, the religious person or the non-religious person? Why?

8. Must all living things die? Why or why not?

9. When does human life begin?

10. Is the death of a child worse than the death of an adult? Why or why not?

11. Is it important to contemplate death? Why or why not? 

12. How often do you think about death? A) Never B) Once in a while C) Fairly often D) All the time 

13. Does the thought of death cause you anxiety? Why or why not?

14. Have you ever wished for someone’s death? If so, why?

15. Is suicide ever acceptable? Why or why not? 

16. Have you ever contemplated suicide? If so, what were the circumstances?

17. If you were to commit suicide, what method would you choose to end your life: noose, gunshot, overdose, poison, jumping from a high precipice, drowning, hypothermia, slashed wrists, seppuku (hara-kiri), starvation, car exhaust (carbon monoxide poisoning), vehicular collision, railway collision, self-immolation, electrocution, suicide pod or some other type of euthanasia device? Why?

18. Is euthanasia ever acceptable? Why or why not? 

19. Is the death penalty ever acceptable? Why or why not?

20. Do you fear eternal damnation? Why or why not?

21. Do you fear non-being? Why or why not?

22. Do you fear being forgotten? Why or why not?

23. Do you fear your life will be irrelevant? Why or why not?

24. Do you believe in near-death experiences? Why or why not? 

25. Do you believe in out-of-body experiences? Why or why not?

26. Do you believe in ghosts? Why or why not?

27. Do you believe that all mental processes can be explained in terms of physical processes? Why or why not?

28. If upon death you could enter into any type of afterlife you wish, what type of afterlife would you wish for? Please provide a detailed description.

29. How often do you question the validity of your beliefs concerning death and the afterlife (or denial thereof)? A) Never B) Once in a while C) Fairly often D) All the time

30. What is the worst thing about death?

31. What can death teach us?

32. “The person who no longer fears death ceases to be a slave.” What does this statement mean? Do you agree with this statement? Why or why not?

33. Do you believe that your mental disposition affects your physical health? Why or why not?

34. If you were told that you only have ten months left to live, would you change the way you live your life? What if you were told that you only have ten years left to live? Would you change the way you live your life then?

35. If you died right now, what would be your biggest regret in life?

36. Name one thing you would like to do or see before you die. 

37. Do you believe the universe itself will someday come to an end? Why or why not? Suppose all the stars eventually burn out and the universe does in fact come to an end, how does this scenario make you feel? 

38. How should the elderly and those who are nearing death be taken care of? Related question: How do you want to be cared for when you are elderly or nearing death?

39. In the past, how have you dealt with grief over the loss of someone you cared for? Do you wish that you would have expressed or dealt with your grief differently?  

40. How do you think people will remember you? What will your friends think of you after you’re gone? What will your detractors think of you after you’re gone?

41. What would you want inscribed on your tombstone?

42. Take a moment to write your own obituary.

43. Would dying for a valiant cause make the prospect of your death any easier?

44. Would knowing you accomplished something truly momentous or historically significant make the prospect of your death any easier?

45. Have you written your will and testament? Why or why not? 

46. Do you have life insurance? Why or why not?

47. How have you prepared for your retirement?

48. How would you like to spend your retirement years?

49. Do you believe science will eventually devise a way for humans to potentially live forever? Why or why not?

50. Do you believe science should strive to greatly increase the human lifespan? Why or why not?

51. Do you want to live forever? Why or why not?

52. Do you believe life has inherent meaning? If your answer is “yes”, please state what the meaning of life is. If your answer is “no”, please state why not.