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Click here to read the April 21, 2002 Wall Street Journal article

The Wall Street Journal Sunday
Living wills: reader tips
Encore Column

By: Glenn Ruffenach
July 11, 2004]

Should you get a living will? The readers weigh in.Our recent column debating the merits of living wills generated a number of letters and questions, many of them asking for more information about how to craft a living will and how to ensure that the document is available when needed.

Again, a living will is a written statement about the types of medical care you want (or don’t want) if you become incapacitated. A reader in New York asked simply if there is a good “rule of thumb” for writing such a document. One of the best templates is called Five Wishes, which was created by Aging With Dignity (online at, a nonprofit group based in Tallahassee, Fla., that provides information and tools to draft health directives.

Five Wishes is a living will, a 12-page document that prompts individuals to consider five questions and issues: who your health-care agent should be (the person to make decisions if you’re unable to do so); what kind of medical treatment you want in various situations; how comfortable you wish to be (addressing issues like pain medication); how you want people to treat you (would you prefer to die at home?) and what you want your loved ones to know (where you wish to be buried, for instance).

Since the document’s introduction nationwide in 1998, about four million copies have been distributed, says Paul Malley, president of Aging With Dignity. About 600 companies currently offer Five Wishes as a benefit to employees.

Perhaps most important, the document encourages users to discuss issues that go beyond medical care, Mr. Malley says, such as spiritual needs and family duties during a serious illness. “So often, a living will just asks about life-support treatment,” he says. “An ‘X’ in a box is just not enough.”

Five Wishes costs $5 (bulk orders cost less) and can be ordered at Aging With Dignity’s Web site or by calling 888-594-7437.

In our original column, we noted that one of the biggest problems with living wills is that people fill them out and forget about them. They end up in the bottom of a drawer and can’t be found when needed. A reader in Texas called our attention to a simple remedy.

U.S. Living Will Registry (, based in Westfield, N.J., will store an electronic version of your health-care directive and provide copies as needed, 24 hours a day, to health-care providers anywhere in the country. There’s no charge for the service. (The operation is funded by health-care providers.) Started in 1996, the operation has about 15,000 participants.

More recently, a group called has joined forces with Aging With Dignity to provide electronic storage of individuals’ versions of Five Wishes. The service currently costs $2 a year (the $5 price tag on Five Wishes itself includes the first year of storage).

David O’Neal, president of Health care Directive Partners in Waipahu, Hawaii, which operates, says he is working with Blue Cross/Blue Shield plans across the country to market the storage service to companies and their employees.

Finally, J. Marshall, a reader in California, cautioned that a living will is far from foolproof. When her mother was dying in a hospital, Ms. Marshall was asked by a doctor if she wished to consider life-support measures. When she responded that her mother’s living will ruled out such steps, the doctor said: “Yes, I know — but you can override it.”

“I was furious,” Ms. Marshall recalled. “My mother’s living will wasn’t worth the paper it was written on. I think your readers would be interested to know that.”

Mr. Malley at Aging With Dignity notes that the ability to supersede a medical directive varies from state to state. That’s why it’s critical, he says, to name a health-care agent who is familiar with your wishes. “Don’t just fill out a document,” he says, “with ‘treatment’ or ‘no treatment.'”