Five Wishes

History

Five Wishes was originally introduced in 1996 as a Florida-only document, combining a living will and health care power of attorney in addition to addressing matters of comfort care and spirituality. With help from the American Bar Association's Commission on Law and Aging and leading medical experts, a national version of Five Wishes was introduced in 1998. It was originally distributed with support from a grant by the Robert Wood Johnson Foundation. With assistance from the United Health Foundation, Five Wishes is now available in 27 languages and in Braille. More than 18 million documents have been distributed by a network of over 35,000 partner organizations worldwide. An online version called Five Wishes Online was introduced in April 2011 allowing users to complete the document using an online interface or print out a blank version to complete by hand.

The Five Wishes

Wishes 1 and 2 are both legal documents. Once signed, they meet the legal requirements for an advance directive in the states listed below. Wishes 3, 4, and 5 are unique to Five Wishes, in that they address matters of comfort care, spirituality, forgiveness, and final wishes.

Wish 1: The Person I Want to Make Care Decisions for Me When I Can't

This section is an assignment of a health care agent (also called proxy, surrogate, representative, or health care power of attorney). This person makes medical decisions on your behalf if you are unable to speak for yourself.

Wish 2: The Kind of Medical Treatment I Want or Don't Want

This section is a living will—a definition of what life support treatment means to you, and when you would and would not want it.

Wish 3: How Comfortable I Want to Be

This section addresses matters of comfort care—what type of pain management you would like, personal grooming and bathing instructions, and whether you would like to know about options for hospice care, among others.

Wish 4: How I Want People to Treat Me

This section speaks to personal matters, such as whether you would like to be at home, whether you would like someone to pray at your bedside, among others.

Wish 5: What I Want My Loved Ones to Know

This section deals with matters of forgiveness, how you wish to be remembered, and final wishes regarding funeral or memorial plans.

Signing and witnessing requirements

The last portion of the document contains a section for signing the document and having it witnessed. Some states require notarization, and are so indicated in the document.

Legal requirements

According to analysis by the American Bar Association's Commission on Law and Aging, Five Wishes currently meets the legal requirements for an advance directive in the following 42 states and the District of Columbia. In the remaining 8 states, (Alabama, Indiana, Kansas, New Hampshire, Ohio, Oregon, Texas, and Utah) a statutory form is required, and one must attach the state document if one wishes to use the Five Wishes document as a guide.

Criticism

Barbara Coombs Lee of Compassion & Choices criticized the Five Wishes document for having religious undertones. In this blog she states that Five Wishes "creates internal conflict within the document" that could potentially result in "a confusing mess."