Last year, 245 people ended their lives using Oregon's Death With Dignity Act. Bruce Yelle wasn't one of them.
For years, the retired construction worker from Florence had worked to expand the law, which allows terminally ill people to request medication to end their life.
When Yelle was diagnosed with pancreatic cancer last summer, he asked for -- and received -- his own set of the deadly pills. But in the end, Yelle decided not to take them. His wife, Kathy Yelle, said he never explained why he made that choice.
He leaves behind a community of people eager to carry on with his efforts to expand access to the law.
A tough call
When Bruce Yelle was diagnosed with Parkinson’s Disease nearly a decade ago, his greatest fear was that his mind would go before his body. People with the disease can live for years even after their mental capacities deteriorate.
So, Yelle looked into the Death With Dignity law. He wasn’t ready to go, mind you. But he wanted to know his options.
The answer was disappointing. To qualify, two doctors would have to sign a paper saying Bruce had less than six months to live. That’s a tough call to make for a Parkinson’s patient.
"Doctors are often reluctant to make a six month diagnosis, because people can live with those diseases for years and years and years," said Bruce's wife, Kathy Yelle. "And unfortunately, they can also suffer for years and years and years."
Bruce figured people should be allowed to request the medication if they had up to a year to live. That way they’d be more likely to have a sound mind when they were allowed to make that choice.
And so Bruce became an advocate. He wrote letters to the editor. He testified at the state capitol. He was a regular speaker on the retirement home circuit.
"Bruce was passionate," said his friend, Chris Buffalo. "I mean, this guy called everybody in the state."
Buffalo is a local lumber salesman. The two met at the Florence chapter of the Toastmasters Club. "There’s like eight of us,” said Buffalo.
One evening, Yelle spoke to the club about his ambition to change Oregon’s Death With Dignity law to allow more people to qualify. It struck a chord with Buffalo.
"I said, ‘Bruce that speech moved me. I want to help. I want to continue your voice when you pass away,'” said Buffalo.
That came sooner than anyone expected.
A new diagnosis
Last summer, Bruce was diagnosed with an aggressive form of pancreatic cancer. If there was one silver lining, said Kathy, it was that Bruce no longer had to worry about qualifying for the law.
"Oh, he immediately applied for Death With Dignity," she said.
But when the pills came, they sat in a cupboard, collecting dust.
Weeks, then months, went by. At one point, Bruce even set a date: He would end his life on the first day of December.
“And so we were kind of prepared for that," said Kathy. "Then lo and behold, a couple weeks later, he said ‘No, I’ve decided I’m not going to do that. I’m going to die peacefully in my sleep.’”
But that isn’t how it happened.
"I personally feel that if Bruce had been aware of how his ending would go, he would have spoken up and taken the drugs," said Kathy.
The last few days were rough. Bruce was an ex-football player: big and tall. Drugs that normally calm people as they approach death had a limited effect on him.
Around 7 p.m. on Christmas Eve, Bruce Yelle passed away.
Kathy said Bruce never did tell her why he decided not to use the Death With Dignity act, after spending the last few years of his life trying to make it more accessible. But she took comfort in knowing that it was a decision that he made of his own free will.
"He still, all along the way, up until the very end, had the ability to make that choice," she said. "And that really is what the fight is about: individual choice and determination."
The work continues
No bills have been introduced so far during the 2021 Oregon legislative session that would change the Death With Dignity law, but lobbying efforts are underway nonetheless.
Dr. Charles Blanke, a Professor of Medicine at OHSU's Knight Cancer Institute, thinks the most politically feasible expansion of the law would involve the very thing Bruce fought so adamently for: expanding the horizon in which doctors can issue end-of-life prescriptions. Eligible patients would be those deemed to have less than 12 months to live, instead of the current six months.
"I think a lot of physicians would suggest that we're very good at predicting death within a year," he said. "It's not going to open the door to a flood of patients."
Blanke has written more prescriptions for Death With Dignity medications than any other Oregon doctor. He got to know Bruce Yelle when the two of them would sometimes testify on behalf of the same bill at the Oregon Capitol.
"What really stuck with me was the frustration, and even in light of that frustration, his perseverance." he said. "He just kept trying. And I do think he spoke on behalf of many other patients."
Bruce’s friend from Toastmasters, Chris Buffalo, is determined to keep up the fight, too. The speech Yelle gave one evening still resonates in Buffalo's mind.
"Sometimes you're just moved by something," he said. "It takes you in a direction in life you'd never thought you'd go but you're going because you're not quite sure why but you know damn well it's important."
The thing is, if Bruce Yelle was the definition of a grass roots advocate, then Chris Buffalo is the seed that’s just starting to germinate. He’s never testified to lawmakers before and freely admits he only has a vague sense of the legislative process.
But for Bruce, he’s willing to learn.
