What Is the Five Wishes Advance Directive?

The Five Wishes Advance Directive is a form of living will developed by Jim Towney, an attorney who functioned as Mother Theresa’s legal counsel and worked side-by-side with her as she cared for the dying in Calcutta, India, from the 1950s until her retirement in 1995. Towney later founded Aging with Dignity, a nonprofit organization with roots in Catholicism, to continue working towards providing all humans with a dignified death. The Five Wishes living will is an outgrowth of that goal. It is the only formal living will to address end-of-life goals not just for medical treatment or lack thereof but in the personal, spiritual and emotional realms. It is the world’s most widely distributed living will and is now available in digital format, customized to meet the requirements of all 50 states. 

The Five Wishes advance directive contains five sections. The first, Wish One, designates your healthcare agent — the person you wish to make decisions for you if you cannot make them yourself. The form explains the role of a healthcare agent and gives some guidance about who to choose for the role. It then lists several decisions a healthcare agent typically can make for someone who cannot decide for themselves. 

The second section, Wish Two, includes instructions for the kind of medical care you would like to receive in several scenarios. It defines “life support” in concrete terms and provides a space to indicate if you want to change that definition due to your “personal or religious” beliefs. It goes on to outline three options from which you can choose:

• I want life support.
• I do not want life support, and if it has been started, I want it stopped.
• I want to have life support if my doctor thinks it will help. But I want my doctor to stop giving me life support treatment if it is not helping my condition or symptoms.
  

The form further clarifies these instructions by asking you to indicate your choices in several different scenarios, e.g., close to death, in an irreversible coma or permanent severe brain damage.

Wishes Three and Four in the document address pain management, comfort care and measures pertaining to quality of life. They contain some specific suggestions for things you might want as you approach death, such as whether or not to have clergy present, whether or not you wish to die at home, and who you may want to visit.

The last section, Wish Five, provides an opportunity for you to communicate your values, beliefs and final wishes to your loved ones by saying yes or no to several questions. It also allows you to write a personal message to loved ones and add any items the form doesn’t address. 

Sources
Aging with Dignity. https://agingwithdignity.org/