Ralph McFadden shared his story in January of 2024.
In the late 1980s, after spending nearly two decades working as a pastor and denominational executive, I started working with the gay community intimately affected by the AIDS epidemic, first as a volunteer with AIDS Pastoral Care Network in Chicago, then as a hospital and hospice chaplain.
Starting in 1990, I recall poignantly being with young gay men dying from HIV — sometimes with their partners, and sometimes with or without their parents by their side. Sometimes, the parents would not acknowledge that their son was gay and dying from HIV, and sometimes they would hold a memorial service for their son back in their hometown and tell people he had died of cancer. For those young men whose parents were unwilling to honor their memory truthfully, I held memorial services for their partners and friends and among their community at gay-friendly congregations.
Recognizing the damaging injustice of homophobia was important in my claiming my own identity as a gay man. Holding a space of authenticity, honoring how these men identified, and the truth about what took their lives and how rampant HIV was at the time was personally important. These individuals, just like anyone else, deserved the integrity of being honored wholly.
As a chaplain, not only did I visit with hundreds of people who were dying and their loved ones, but I was by the bedside of many at the time of their deaths. I have celebrated with dozens of families and friends in memorial services. One of the most memorable was with the wife and children of a man in his fifties: at the timberline on Mt Evans, scattering his ashes, while a bagpiper played “Amazing Grace” on the same hillside.
At 90 years old, living with cancer (but thankfully in remission because of a very experienced and competent hematologist) and because of the years with hospice, and certainly because of the more recent deaths of family and friends, I cannot avoid — nor do I want to — considering the end of my life.
I have written a rather detailed will that includes my children, not-for-profit agencies and my partner, Keo, of 25 years. I have given careful consideration and have had detailed discussions with Keo and my adult children about how I want my life to end: no protracted and long, drawn-out attempts to save my life. If my cancer progresses to stage two or three, contact home hospice care. If unable to verbalize my thoughts and possibly in a paralyzed or incapacitated state, I ask for no further treatment.
Keo and my children know, understand and have promised to enforce my wishes to the best of their abilities. I have signed an agreement with a local funeral organization that allows them to go ahead with cremation in the event that my family cannot be reached. I have made it clear that I prefer cremation — and have named two possible locations for the remains: my congregation’s memorial garden and, of course, the hillside at the timberline of Mt. Evans. My pastor — and my partner and my adult children — will have access to a file folder that “suggests” possible memorial service ideas. I have a relative that has written in his will and remarks for his memorial, “Do not sing ___ ,” and he names a tune that he had heard countless times at memorial services. I have no such demands but appreciate the thought that he has given to his specifications.
My experiences within hospice were instrumental in understanding how people die and what it means to support someone going through this transition we all eventually must endure. I found that there are options — including medical aid in dying — that empower a patient and that a painful end doesn’t have to go on and on and on. People deserve options. Lawmakers should not prohibit their constituents from making whatever decision is right for them. It takes courage to die the way you want rather than die the way people think you ought to. For me, that’s dignity.
