'Five Wishes': Now and at the Hour of Death

TALLAHASSEE, Fla.—It's easy to make a “living will,” stipulating when you will die.

But what about stipulating how you will die?

In today's euthanasia-prone culture, respect can be the hardest thing for the dying to find, said Jim Towey, executive director of the privately funded, nonprofit Commission on Aging with Dignity.

“People say, ‘Gosh, we put our animals to sleep when they're very sick. Why can't we do that for people?’” Towey explained.

“When you start taking human life it affects the disabled, the poor. It gives the message, ‘Do the decent thing and get out of the way. Stop being a burden.’ Our premise is that life is a gift from God, and there's no such thing as a life that's a burden.”

Two years ago, Aging with Dignity introduced “The Five Wishes,” a living will that gives control to end-of-life care by considering more than just legal and medical questions. It also addresses a person's desires in the areas of comfort, companionship and relationships.

“The strength of this document is that it is very clear and easy to understand. It is not written in medical or legal language,” said Father John West, a moral theologian and ethicist, and rector of St. John's Center for Youth and the Family in Washington, D.C.

For example, under Wish No. 3, “How Comfortable I Want to Be,” people are asked to consider such alternatives as, “I wish to have my favorite music played when possible until my time of death,” and “I want my lips and mouth kept moist to stop dryness.”

An Education in Calcutta

Towey was introduced to end-of-life realities through Mother Teresa of Calcutta.

“In 1985, I was working as legislative director for Senator Mark Hatfield,” said Towey. “He knew Mother, so on my way back from a business trip, I spent one day in Calcutta. After Mass, Mother asked me if I'd seen her House for the Dying.

“I went that afternoon, and the sister who greeted me handed me some cotton and a bottle of solution and told me to go clean a man who had scabies. I was trapped. If I had known I'd have to work that day, I don't think I'd have gone. But what I found was the Lord waiting for me in that bed.”

That experience led Towey to work with the dying in Calcutta; Tijuana, Mexico; and Washington, D.C. A lawyer, he has also been the U.S. legal counsel for the Missionaries of Charity for 12 years.

Towey is an expert on social services for the elderly for another reason. From 1993 through 1995, he was secretary of Florida's 40,000-employee Department of Health and Rehabilitative Services.

“I was acutely aware of how the disabled and elderly were not valued, and how we push them to the margins of society,” said Towey. “I've volunteered in First World hospitals, and seen end-of-life care there. It struck me that the way Mother Teresa cared for the dying in Calcutta was a lot more humane and dignified than what you see in the First World. People are dying alone. They're hurting, they're miserable, and it doesn't have to be that way.”

“Most Americans are scared to death of dying,” said Annette Kane, executive director of the National Council for Catholic Women, citing a study commissioned by the Robert Woods Johnson Foundation (the country's largest philanthropy devoted to health and health care).

“Women tend to lead the conversation in families on these things,” Kane continued, “and the Five Wishes set up the opportunity to get the dialogue going.”

“It was a wonderful tool for opening the conversation with my family,” said Tallahassee resident Kristin Manos. “My grandmother was very sick, and she had a living will, but it wasn't as extensive or caring as the Five Wishes. Using the Five Wishes, my parents, my grandparents, my husband and I were able to talk about everything before my grandmother died.

“My husband and I have filled out the Five Wishes ourselves, and I've given it to my parents and my grandfather.”

The Five Wishes have been distributed to more than 625,000 households all over the country, and 350 hospitals have ordered it. It is supported by Florida Gov. Jeb Bush, and has been distributed to more than 5,000 Florida state employees. It is valid in 33 states and usable in all 50, by filling it out and attaching it to required state forms.

“We haven't paid a penny in advertising,” said Towey. “We only have six full-time employees in Tallahassee and one in Miami. I marvel at what the Lord is doing, that he can shine through something as small as this.”

My Wish For:

1. The person I want to make care decisions for me when I can't.

2. The kind of medical treatment I want or don't want.

3. How comfortable I want to be.

4. How I want people to treat me.

5. What I want my loved ones to know.

Dana Mildebrath is based in Seminole, Florida.