Vista, Calif. — Roseana Spangler-Sims, 72, passed away peacefully on Sunday, August 31, after choosing to end her life through California’s Medical Aid in Dying (MAID) law, following an 18-month battle with stage 4 pancreatic cancer.
Nearly a year and a half ago, Roseana was diagnosed with the aggressive disease and endured months of chemotherapy and radiation treatments in the hope of healing. But in June, after an MRI revealed that the cancer had continued to spread, she made the decision to stop treatment and instead choose her own ending.
“I’m ready to go,” Roseana told People magazine as she chronicled her final days. “I’m more at peace than I’ve ever been.”
California is one of 11 states in the U.S. where MAID is legal. For Roseana, the choice was not just about ending pain but about controlling the way she left the world—surrounded by love, peace, and meaning.
On August 18, she left her single-room apartment in Vista and traveled to a rental home near Palomar Mountain. There, she spent her final weeks with her son, Shawn Cisneros, his wife, Cindy, and Cindy’s twin sister, Sandi, who had flown in from Florida. Together, they retraced her favorite hiking routes, looked through family photos, and even held a “living wake” with more than a dozen friends and relatives.
On her final day, Roseana ate a light breakfast of papaya and mango. By late morning, her death doula, Melissa McClave, and a psilocybin facilitator joined the family to help create a ritual of peace and connection. The facilitator led a smudging ceremony with sage and administered a microdose of psilocybin mushrooms — meant not for recreation, but as a spiritual practice closer in nature to last rites.
At 5 p.m., Roseana took anti-nausea medication. An hour later, she mixed her prescribed MAID solution — a carefully measured blend of sedatives and narcotics — into two ounces of white grape juice. Lying outdoors in a hospital bed, surrounded by family, she drank the medication and peacefully passed away.
True to her lifelong values of giving back, Roseana donated her body to the University of California, San Diego, for scientific research.
Roseana’s story, shared in her own words, reflects the deeply personal decision to use MAID. She hoped her openness would help others better understand the process and the peace it can bring.
She is remembered as a resilient, loving mother, a woman of courage, and an advocate for living — and dying — with dignity.
