Five Wishes is a United States advance directive created by the non-profit organization Aging with Dignity. It has been described as the "living will with a heart and soul". [1]
Five Wishes is a United States advance directive created by the non-profit organization Aging with Dignity. It has been described as the "living will with a heart and soul". [1]
Five Wishes was originally introduced in 1996 as a Florida-only document, [2] 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. [3] 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 28 languages and in Braille. [4] More than 40 million documents [5] have been distributed by a network of over 40,000 partner organizations worldwide. [6] 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. An updated version, renamed Five Wishes Digital, debuted in 2022, including options for all 50 states, and fully digital signing and witnessing options. [7]
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.
The last portion of the document contains a section for signing the document and having it witnessed. The document indicates which states require notarization.
According to analysis by the American Bar Association's Commission on Law and Aging, [8] Five Wishes currently meets the legal requirements for an advance directive in 46 states and the District of Columbia. [9] In the remaining 4 states (Kansas, New Hampshire, Ohio, Texas), a statutory form is required, and one must attach the state document if one wishes to use the Five Wishes document as a guide.
Five Wishes has been translated from English into 30 other languages: [10] Albanian; Arabic; Armenian; Bengali; Chinese Traditional; Chinese Simplified; Croatian; Farsi; French; German; Gujarati; Haitian Creole; Hebrew; Hindi; Hmong; Ilocano; Italian; Japanese; Khmer; Korean; Nepali; Polish; Portuguese; Punjabi; Russian; Somali; Spanish; Tagalog; Urdu; Vietnamese.
A power of attorney (POA) or letter of attorney is a written authorization to represent or act on another's behalf in private affairs, business, or some other legal matter. The person authorizing the other to act is the principal, grantor, or donor. The one authorized to act is the agent, attorney, or in some common law jurisdictions, the attorney-in-fact.
An advance healthcare directive, also known as living will, personal directive, advance directive, medical directive or advance decision, is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. In the U.S. it has a legal status in itself, whereas in some countries it is legally persuasive without being a legal document.
A do-not-resuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on the jurisdiction, indicating that a person should not receive cardiopulmonary resuscitation (CPR) if that person's heart stops beating. Sometimes these decisions and the relevant documents also encompass decisions around other critical or life-prolonging medical interventions. The legal status and processes surrounding DNR orders vary in different polities. Most commonly, the order is placed by a physician based on a combination of medical judgement and patient involvement.
The Uniform Rights of the Terminally Ill Act, was recommended as a Uniform Act in the United States. The Uniform Rights of the Terminally Ill Act subsequently was passed by many states. The Uniform Rights of the Terminally Ill Act was replaced as a recommended Uniform act by the Uniform Health-Care Decision-making Act in 1993. The law allows a person to declare a living will specifying that, if the situation arises, he or she does not wish to be kept alive through life support if terminally ill or in a coma. The patient may also obtain a health care power of attorney. This power of attorney appoints an agent to make medical decision for the patient in case the patient becomes incompetent.
The right to die is a concept based on the opinion that human beings are entitled to end their life or undergo voluntary euthanasia. Possession of this right is often understood that a person with a terminal illness, incurable pain, or without the will to continue living, should be allowed to end their own life, use assisted suicide, or to decline life-prolonging treatment. The question of who, if anyone, may be empowered to make this decision is often the subject of debate.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.
Estate planning is the process of anticipating and arranging for the management and disposal of a person's estate during the person's life in preparation for a person's future incapacity or death. The planning includes the bequest of assets to heirs, loved ones, and/or charity, and may include minimizing gift, estate, and generation-skipping transfer taxes. Estate planning includes planning for incapacity, reducing or eliminating uncertainties over the administration of a probate, and maximizing the value of the estate by reducing taxes and other expenses. The ultimate goal of estate planning can only be determined by the specific goals of the estate owner, and may be as simple or complex as the owner's wishes and needs directs. Guardians are often designated for minor children and beneficiaries with incapacity.
A legal guardian is a person who has been appointed by a court or otherwise has the legal authority to make decisions relevant to the personal and property interests of another person who is deemed incompetent, called a ward. For example, a legal guardian might be granted the authority to make decisions regarding a ward's housing or medical care or manage the ward's finances. Guardianship is most appropriate when an alleged ward is functionally incapacitated, meaning they have a lagging skill critical to performing certain tasks, such as making important life decisions. Guardianship intends to serve as a safeguard to protect the ward.
Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990), was a landmark decision of the Supreme Court of the United States involving a young adult incompetent. The first "right to die" case ever heard by the Court, Cruzan was argued on December 6, 1989, and decided on June 25, 1990. In a 5–4 decision, the Court affirmed the earlier ruling of the Supreme Court of Missouri and ruled in favor of the State of Missouri, finding it was acceptable to require "clear and convincing evidence" of a patient's wishes for removal of life support. A significant outcome of the case was the creation of advance health directives.
The Vial of Life, also known as Vial of L.I.F.E. is a program that allows individuals to have their complete medical information ready in their home for emergency personnel to reference during an emergency. The program is used to provide the patient's medical information when a patient is not able to speak or remember this information. Vial of Life programs are commonly used by senior citizens and promoted by senior center organizations, fire departments, and other community organizations.
In the field of medicine, a healthcare proxy is a document with which a patient appoints an agent to legally make healthcare decisions on behalf of the patient, when the patient is incapable of making and executing the healthcare decisions stipulated in the proxy. Once the healthcare proxy is effective, the agent continues making healthcare decisions as long as the primary individual is legally competent to decide. Moreover, in legal-administrative functions, the healthcare proxy is a legal instrument akin to a "springing" healthcare power of attorney. The proxy must declare the healthcare agent who will gain durable power attorney. This document also notifies of the authority given from the principal to the agent and states the limitations of this authority.
End-of-life care (EOLC) refers to health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.
Aging with Dignity is a national non-profit organization based in Tallahassee, Florida. The stated mission of Aging with Dignity is to "honor the God-given human dignity of the most vulnerable among us". The primary focus of Aging with Dignity is to improve end-of-life care by encouraging people to make medical decisions in advance of a serious illness.
Euthanasia became legal in New Zealand when the End of Life Choice Act 2019 took full effect on 7 November 2021. It is illegal to "aid and abet suicide" under Section 179 of the New Zealand Crimes Act 1961. The clauses of this act make it an offence to "incite, procure or counsel" and "aid and abet" someone else to commit suicide, regardless of whether a suicide attempt is made or not. Section 179 covers both coercion to undertake assisted suicide and true suicide, such as that caused by bullying. This will not change under the End of Life Choices Act 2019, which has provisions on coercion of terminally ill people.
The proposed America's Affordable Health Choices Act of 2009 was an unsuccessful bill introduced in the U.S. House of Representatives on July 14, 2009. The bill was introduced during the first session of the 111th Congress as part of an effort of the Democratic Party leadership to enact health care reform. The bill was not approved by the House, but was superseded by a similar bill, the proposed Affordable Health Care for America Act, which was passed by the House in November 2009, by a margin of 220-215 votes but later abandoned.
Euthanasia in Canada in its legal voluntary form is called Medical Assistance in Dying (MAiD) and it first became legal along with assisted suicide in June 2016 for those whose death was reasonably foreseeable. In March 2021, the law was further amended by Bill C-7 which to include those suffering from a grievous and irremediable condition whose death was not reasonably foreseeable. According to the Fourth Annual Report on MAID, there were 13,241 MAID deaths reported in Canada in 2022.
A surrogate decision maker, also known as a health care proxy or as agents, is an advocate for incompetent patients. If a patient is unable to make decisions for themselves about personal care, a surrogate agent must make decisions for them. If there is a durable power of attorney for health care, the agent appointed by that document is authorized to make health care decisions within the scope of authority granted by the document. If people have court-appointed guardians with authority to make health care decisions, the guardian is the authorized surrogate.
In 2001, in the case Conservatorship of Wendland, also known as Wendland v. Wendland, and the Robert Wendland case, the Supreme Court of California unanimously ruled that Rose Wendland, the wife of Robert Wendland, in the absence of a durable power of attorney for health care (DPAHC), did not have the authority to withhold artificial nutrition and hydration in her husband's behalf. The Court recognized that patients unable to make a decision for themselves should receive special protection according to the right to life and right to privacy provided by the California constitution.
POLST is an approach to improving end-of-life care in the United States, encouraging providers to speak with the severely ill and create specific medical orders to be honored by health care workers during a medical crisis. POLST began in Oregon in 1991 and currently exists in 46 states; some of the 46 states have the program in development. The POLST document is a standardized, portable, brightly colored single page medical order that documents a conversation between a provider and an individual with a serious illness or frailty towards the end of life. A POLST form allows emergency medical services to provide treatment that the individual prefers before possibly transporting to an emergency facility.
Advance care planning is a process that enables individuals with decisional mental capacity to make plans about their future health care. Advance care plans provide direction to healthcare professionals when a person is not in a position to make and/or communicate their own healthcare choices. Advance care planning is applicable to adults at all stages of life. Participation in advance care planning has been shown to reduce stress and anxiety for patients and their families, and lead to improvements in end of life care. Older adults are more directly concerned as they may experience a situation where advance care planning can be useful. However, a minority use them. A research conducted in Switzerland with people aged 71 to 80 showed that better knowledge on advance care planning dispositions could improve the perception older people have of them. Communication on dispositions should take into account individual knowledge levels and address commonly enunciated barriers that seem to diminish with increased knowledge.