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Five Wishes Document

Introduction, reprinted with permission by Aging With Dignity

Page One of Five Pages

Five Wishes makes it easier for you to let your doctor, family, and friends know how you want to be treated if you become seriously ill and cannot tell them. Five Wishes is a gift to your family members and friends so that they won't have to guess what you want. Five Wishes is easy to understand and simple to use.

Five Wishes has captured the hearts and minds of people in Florida from the day it was introduced. Hundreds of thousands of Floridians are using Five Wishes, including Florida's Governor, Supreme Court Chief Justice, and thousands of others.

Because Five Wishes was so successful in Florida, it was featured on the NBC Today Show. Aging with Dignity wanted to see if it could be used in other states. We consulted experts who reviewed the laws in all fifty states. We found out that Five Wishes could be written in a way that made it valid under the health care statutes in most states.

With the help of the American Bar Association Commission on Legal Problems of the Elderly, we came up with this new version of Five Wishes. They are confident that Five Wishes meets the legal requirements under the health decisions statues of 35 states and the District of Columbia.

Five Wishes States

If you live in the District of Columbia or one of the 35 states listed below, you can use Five Wishes and have the peace of mind to know that it meets your state's requirements under the law:

Unfortunately, if your state is not one of the 35 states listed above, Five Wishes does not meet the technical requirements in the statutes of your state, and some doctors in your state may be reluctant to honor Five Wishes. However, you can still use Five Wishes to put your wishes in writing. This will be a helpful guide to your care providers. Most doctors and health care professionals understand that they have a duty to listen to your wishes no matter how you express them.

Talk to your doctor during your next office visit. Give your doctor a copy of Five Wishes and ask to have a talk about it. Make sure you doctor understand your wishes and will honor them. Ask him or her to urge other doctors treating you to honor them.

You have a legal and moral right to decide what kind of medical treatment you want or don't want when you are seriously ill and your death is expected. You also have a right to choose a person to make health care decisions for you when you are no longer able to speak or think clearly. Five Wishes helps you exercise these rights. But remember, your doctor needs to know, and be willing to follow, your wishes.

Five Wishes is CONTINUED on Page Two

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