‘This is Cancer in The End’ by Amanda Villegas

In a series of photographs, Amanda Villegas documents the final month in the life of her husband, Chris Davis, as he dies from bladder cancer. The photographs are raw and arresting. They show the signs of medical intervention on Chris’s emaciated body. They accentuate the tubes, the wires, and the stitches that mark his body and his obvious pain as he lies dying. The series includes photographs that display the grief of his friends and family as they bear witness to the end of Chris’s life. In her commentary on the series, Amanda states that it was her intention to show the ‘harsh reality of terminal illness’ to highlight the need for ‘more compassionate end-of-life laws.’ The photographs were first shared via Google Drive in 2019, then appeared in the news media in 2021, and were finally published as an essay in Photographic Journal in 2023.

California’s End of Life Option Act was enacted in June 2016. The law allowed adult residents of California to obtain a prescription for drugs that would end their lives if they had a terminal illness and had six months or less to live. The drugs had to be self-ingested, and the patient was required to make two verbal requests for the prescription that were at least 15 days apart. After Chris’ death in 2019, Amanda began working with Compassion and Choices, a non-profit organization, to advocate for changes to the law that would have allowed him to receive medical aid in dying. Chris wanted to received medical aid in dying but was unable to do so because the hospice where he was treated provided misinformation about the legality and procedural requirements of the process. In the end, he died before the 15-day waiting period had elapsed. In 2022, California’s law was changed to reduce the mandatory waiting period between verbal requests to 48 hours. The 2022 amendments made two additional changes to make it easier for patients to access medical aid in dying. First, the law requires healthcare facilities to post their policies related to medical aid in dying on their websites. Second, the law requires healthcare providers to document and date requests for medical aid in dying so that the requests are visible to other providers if the patient transfers their care. Amanda’s photographs regularly appeared in media articles reporting on the amendments to the law.

* Addendum on 11 August 2026:

From the 54 photos shared in 2019, Villegas made different selections to construct a narrative of the last days in the life of her husband. Her first selection, with 18 images, appeared in a 2020 webinar organized by Compassion & Choices, where Villegas presented the slideshow ‘This Is Cancer: Chris Davis’s final days in home hospice’. While introducing Villegas, C&C president Kim Callinan underscored the importance of the humanities to help us ‘see the patient’s experience and the grieving process for the family’. She warned that Villegas’s photographs ‘are extremely moving but also very graphic’, and emphasized their social-justice aspiration – ‘to shine a light on the injustices that exist and that need to be addressed’. While displaying a photo of Chris Davis (the one that illustrates this entry), Villegas declared the subjective-and-objective nature of her work: ‘This is my interpretation and my documentation of Chris’s final days at home’. She highlighted the importance of the camera as the one thing she had control of, even though – as she acknowledged – ‘capturing this was the most difficult thing I’ve ever done, aside from being his caregiver’. Villegas felt she ‘had to document this’, because she ‘had never seen this imagery in the media… never seen anyone suffer like this’; so she wanted people to ‘see the harsh reality as brutal as it is and as painful as it is’ (see related entry on the film Sonhar com Leões, which dares viewers not to look away). Villegas clarified that Chris not only consented to being photographed, but also wanted the photos to help others. The choice of black-and-white felt appropriate to Villegas, ‘as some of the colours were very grotesque, of bodily fluids exiting the body’, and she ‘wanted to give him a bit of privacy in that’.

In a 2025 review, Dina Rathke asserts that ‘Villegas uses her photo essay as a tool for ethical awareness and empathy’, arguing that the absence of colour helps the audience concentrate on the content of the images, which are presented chronologically. As the disease worsens, the viewer who chooses to keep looking feels more and more the powerlessness of Chris’s family. In her 2003 essay Regarding the pain of others, critic Susan Sontag wrote lines about war photography that seem applicable to the suffering documented by Villegas: ‘there is shame as well as shock in looking at the close-up of a real horror. Perhaps the only people with the right to look at images of suffering of this extreme order are those who could do something to alleviate it’. Even though photographs may instigate powerful emotions, Sontag reminds us that ‘the question is what to do with the feelings that have been communicated’. As ‘compassion is an unstable emotion’, Sontag argues ‘it needs to be translated into action, or it withers’. This urgency to employ shocking photos to effect legal change somehow matches the urgency of cases like Chris’s, whose unspeakable suffering made any waiting periods look cruel and absurd. In 2020, about 8 months after Chris’s death, both Callinan and Villegas testified before the California State Assembly, urging – and helping persuade – them to change the law; thus, the 15-day waiting period was eventually reduced to 48h. If the initial 15-day buffer was conceived as protection for people who may change their mind, Villegas’s photos and testimony shed light on the unintended consequences of that decision – and on the difficult balancing act of that seemingly arbitrary period of time: to minimize suffering, safeguard against abuse, and allow for unrushed decisions.