Note to readers: This story discusses details of sickness and death and mentions suicide.
Kim Clune knows she is going to die soon of terminal breast cancer.
"There is no cure and it is all through my body," she said.
Clune is a photographer who lives in Haines, but since being diagnosed, she's spent some time in New York for treatment.
"The only thing we're doing now is not treating to save me, but treating to spare me from a hideous death," she said.
Her nurses and doctors have had frank discussions with her about what her last days could look like. She said they’ve told her it’s likely to be incredibly painful and she especially worries about what they say now is the most likely scenario, where tumors eventually push on her lower intestine.
"The contents of my bowels will be coming out of my mouth. That is a horrendous way to die," she said. "The level of pain that can be involved with this is so intense."
Clune does not want to die like that. She wants to die on her own terms, and she’s sharing her story in support of renewed efforts to allow medically assisted death in Alaska. A recently-launched organization, End-of-Life Options Alaska, is working to build support for the practice.
"These are not people who are choosing to die. That choice has been made for them," said Mary McDowell, a co-founder of the organization. "They are terminally ill."
Another way to die
Clune has thought a lot about her death during the often-excruciating journey of her cancer treatment. She said she loves Alaska and wishes she could die in Haines where she could be buried without being embalmed.
"I could have a lock of hair in a paper boat go down the river with my friends," she said.
But she doesn’t think she’ll live long enough for Alaska to change its laws — she's prioritizing being somewhere with a chance of a peaceful death.
Right now, 13 U.S. states and Washington. D.C. have laws allowing “medical aid in dying,” sometimes called “death with dignity.” The requirements are strict: generally, someone must have less than six months to live, be of sound mind, get two letters of support from physicians and they have to take the medication themselves. U.S. models are much stricter than those abroad, such as in Canada and Switzerland, which do not require a terminal diagnosis.
McDowell, with End-of-Life Options Alaska, spent more than 20 years as a hospice volunteer and she said what she saw there changed her understanding of death. She supports good end-of-life care, but she wants patients to have another option.
"Even the very best palliative care and hospice care does not always keep someone from terrible suffering," she said.
Past Alaska legislation
About a decade ago, two previous right-to-die bills were introduced in the Alaska Legislature but didn't pass. Opposing physicians and laypeople in Alaska worried some patients could be coerced into death, that the legislation would normalize suicide and that doctors could make mistakes in predicting how long people could live.
McDowell said she thinks Alaska’s earlier legislative attempts didn't include enough public outreach and that Americans are now more accepting of the practice. According to a 2025 poll, three-quarters of Alaskans support the right for terminally ill patients to end their life with medication. So, the organization is talking to people at health fairs and events to raise awareness and get input from Alaskans — with the goal to eventually advocate for a law legalizing the practice.
McDowell said the alternatives for Alaskans who are terminally ill and suffering aren't good. Some have moved to other states to be able to take life-ending medication and others have taken a more painful path.
"They will often take their own lives in a violent way," she said. "It's so sad because it's more traumatic for their loved ones and for them, and they usually die alone."
Alaska has one of the highest rates of suicide in the country and changing health can be a contributing factor.
Washington's end-of-life program
A violent death is in stark contrast with how Washington state physician Jessica Kaan said end-of-life medications work. The combination of medications includes sedatives and morphine, she said.
"It is 100% sure that the people who choose to take this medication and do so by the instructions that they're given are going to die a peaceful death," she said.
Kaan is medical director at End of Life Washington, an organization that provides education and support for terminally ill patients, including surrounding medical aid in dying. The practice has been legal in the state since 2009. About 500 people died in Washington by taking the medication in 2024.
Kaan said she's heard pushback from some in the medical community, especially from older doctors. But, she said, the practice has become more and more accepted over the last decade.
"Sometimes all it takes is being in a situation where all of a sudden (they) or their loved ones are suffering tremendously, and they suddenly understand why it might be important," she said.
'This isn't the end'
Kim Clune previously lived in New York, and she’s now back there to get treatment. She plans to be there when she gets close to death because the state recently passed a law to allow medical aid in dying. She doesn't know if she will end up taking life-ending medication, but she wants to have the option if her pain and suffering become intolerable.
"I'm not afraid to die," Clune said. "That's one thing I learned through cancer is that there are times where I felt like I left my body when things were so bad, that I know something else exists out there. I don't know what it is, and I don't pretend to tell anybody else what to think, but I know for me, this isn't the end."
She hopes to have at least one more summer back in Alaska before she dies, but doesn't know if she'll survive until then.
