Hospice nurse Julie McFadden has spent years caring for people in their final days, watching the body change as strength fades and priorities sharpen. After witnessing thousands of deaths through her work, she says there are a few choices she simply will not make anymore. McFadden, who also talks openly about end of life care on her YouTube channel, believes these decisions are less about fear and more about protecting everyday quality of life. She is also the author of the book Nothing to Fear Demystifying Death to Live More Fully.
The first rule is avoiding alcohol as a regular habit, even when it is framed as harmless or “moderate.” McFadden pushes back on the idea that daily drinking is automatically safe, pointing to what she calls clear clinical evidence that everyday alcohol use takes a toll. She has shared that she once considered herself a high functioning alcoholic and that she has been sober for years, which shapes how directly she speaks about the topic. In her view, both frequent drinking and occasional heavy sessions can set people up for serious consequences.
What makes her stance so firm is the pattern she has seen repeatedly in patients. She emphasizes how hard the liver works and how quickly life can unravel when it begins to fail. She has cared for people who died from alcohol related complications, including cirrhosis, and she describes those outcomes as deeply painful to witness. She also notes that the body can recover when drinking stops or is dramatically reduced, which is part of why she frames this as a preventable road to suffering.
Her second rule is steering clear of smoking and vaping, even though vaping is often marketed as the safer alternative. McFadden argues that inhaling nicotine and chemicals does not just affect the lungs, it can also damage the cardiovascular system. She warns that even people who avoid a major lung diagnosis can still end up dealing with circulation issues and serious heart problems over time. From her perspective, watching someone struggle for air is one of the hardest realities of end stage illness, and it is not something she takes lightly.
The third rule surprises some people because it is not about a substance at all. Based on her experience in a trauma intensive care setting, McFadden says she avoids riding motorcycles and similar vehicles like quads where the rider is exposed and a fall can be catastrophic. She stresses that she has seen many severe injuries and deaths connected to these accidents, even when helmets are involved. For her, the risk simply outweighs the thrill.
What do you think about these three rules, and which one feels most challenging to follow in real life? Share your thoughts in the comments.
