Is Five Wishes a Good Advance Directive?

The Five Wishes advance directive is an extremely popular choice among people who wish to document their choices for end-of-life care. Proponents claim that it simplifies complex issues around life-sustaining treatments and goals of care and provides an easy-to-follow format for documenting what an individual wants done for them as they near the end of their life. However, some believe it addresses too many possible scenarios, contains a degree of ambiguity that can be confusing, and incorporates a religious view of end of life that not all agree with.  

Overall, the Five Wishes living will gets high marks for its focus on values as well as medical care. Most statutory advance directives for healthcare or living wills focus on two main areas:

• Identifying who will make decisions for you should you become incapacitated and unable to make them yourself
• Identifying what medical care and supportive interventions you do or do not want implemented should you become incapacitated and critically ill.

The Five Wishes document takes these instructions further, and allows the person making the declaration to identify which life-sustaining interventions they would like to have implemented in a number of specific scenarios. It also addresses comfort measures such as pain management and personal hygiene; spiritual considerations such as whether to involve a chaplain or pastor in one’s end-of-life care, and communications with loved ones around last wishes, values and beliefs.  It also includes a section covering how you wish to be remembered and your choice for final disposition of your body after death. 

Despite its popularity, however, many attorneys state that the Five Wishes advance directive for healthcare is probably best used as a guide for having important conversations about your end-of-life wishes rather than serving as your formal living will. If you wish to use it to enhance your existing directive, you can complete it along with your state’s statutory form and share copies with  your healthcare agent, healthcare team and other important people in your life.

Sources

“Five Wishes” Sounds Good, But Legally Dangerous.” Law Professor Blogs Network. https://lawprofessors.typepad.com/trusts_estates_prof/2009/06/in-be-careful-what-you-wish-for-analyzing-the-five-wishes-advance-directive-97-ill-b-j-242-2009-ray-j-koenig-iii-p.html#:~:text=The%20Five%20Wishes%20document%20uses,not%20serve%20as%20his%20agent.