The year before he died, inspired by Californian sunshine and hallucinatory substances, Aldous Huxley wrote a counterpoint to Brave New World. His last novel, Island, describes a remote and idyllic civilisation of happiness, peace and harmony underpinned by a fusion of Buddhism, mind-altering drugs, free love, self-knowledge and other heady philosophies that were taking off in the early 60s.

For 21st-century tastes, Island is probably unpalatably sentimental and idealistic, but one episode has lingered in my mind. It is the story of a woman's death and her attempt, aided by her family, not to block out what is happening with painkillers, tubes and curtains, but to be fully aware of her life coming to an end.

It's not the quasi-religious experience that stayed with me, but the notion of looking death in the face and being prepared for. Because we are not. As religion has loosened its grip on us and hell has lost its terrors, so we have backed away from death to the point where many of us hardly believe it is going to happen.

So it is pretty nasty when it does. Probably it happens in hospital and there may be medical attempts to keep someone alive just that bit longer. This sort of death could not be more traumatic and we are worse prepared for it than for anything else in our lives.

It is hard all round. Doctors and nursing staff don't find it much easier than relatives to decide when it is time to stop keeping somebody alive. So we end up with acrimony and recriminations and unfathomable distress. It is unforgivable to write "Do Not Resuscitate" in a patient's notes without discussing it with them or their family, but it has happened because of the modern conspiracy of silence over death.

We have already had guidelines from the British Medical Association on withdrawing and withholding treatment from patients who are about to die, but doctors keep phoning the General Medical Council for advice, so it is about to consult on some of its own. They are unlikely to look very different.

There aren't any easy answers and I doubt whether a new set of rules will make anybody happier. Nor are advance directives the solution. It is fine to write a note saying "For God's sake pull the plug if I end up on a life-support machine", but the bravest have been known to change their mind at the last. Isn't there a case, then, for the un-medicalisation of death and for re-integrating it into our lives? Now that we don't see death all around us any more we badly need to talk about it long before it happens and keep on talking about it so that those closest to us know our minds.

Personally, I would go for a tropical island and hallucinogenic drugs, but failing that, I'd like to be tube-free, at home, with my family. But I reserve the right to change my mind.

It looks as though the new vaccinations have kicked meningitis C into touch, for which all parents will be truly grateful. Scientists are working on a vaccine for the other UK strain, meningitis B, and when they crack it, a disease that used to kill a few hundred children a year will have been conquered. It is more than unsettling, then, to hear that nearly 600 have already died in a meningitis epidemic in Burkina Faso in West Africa that broke out in January.

Burkina Faso is in the meningitis belt - a group of African countries, including Chad and Nigeria, which are struck by regular epidemics. In Burkina Faso they hit every three years and the one in 1997, killed 4,000.

The aid agencies have gone in, but Burkina Faso's epidemic has this time coincided with those in Ethiopia, Benin and Chad. There is a vaccine against the A strain, which causes these epidemics, but stocks are running out and health officials say 7.5m in Burkina Faso alone need to be vaccinated.

The populations of the meningitis belt need vaccinating before the regular epidemics hit, but a combination of African governments that cannot afford basic healthcare and do not want to admit to epidemics that might put off visitors, together with western countries who think Comic Relief day is probably doing their bit for African children means it just doesn't happen, and a disease our children enjoy protection from will just go on killing elsewhere.