Boycotting Five Wishes: Denying Dignity
Why I’m No Longer Using Five Wishes in My Work
As a death doula, my role is to support individuals and families in navigating the deeply personal journey of end-of-life care with dignity, respect, and autonomy. For years, I recommended Five Wishes as a tool for advance care planning, believing it provided a compassionate and accessible way for people to document their end-of-life preferences.
However, I can no longer support or recommend Five Wishes. Their recent statements and policies regarding transgender individuals, Voluntarily Stopping Eating and Drinking (VSED), and Medical Aid in Dying (MAID) make it clear that they do not fully respect personal autonomy and inclusive care. End-of-life planning should center on the individual’s needs and wishes—not be dictated by restrictive or exclusionary beliefs.
If you, like me, value autonomy, bodily integrity, and inclusive care, I encourage you to reconsider using Five Wishes and explore better, more affirming alternatives.
What is Five Wishes?
Five Wishes is an advance care planning tool that has been widely used across the U.S. It provides a framework for individuals to outline their medical, personal, emotional, and spiritual preferences for end-of-life care. It has often been praised for its accessibility and ease of use, helping to facilitate important conversations about death and dying.
For many years, I recommended Five Wishes because it simplified the advance care planning process, allowing individuals to express their wishes clearly. It was a widely accepted document that provided guidance beyond medical decisions, including emotional and spiritual considerations. I believed it could help individuals and families feel more prepared and empowered in end-of-life planning.
Their Stance on Transgender Individuals and End-of-Life Autonomy
Recently, Five Wishes has taken a troubling and frankly exclusionary stance that fails to respect the dignity of transgender individuals. Ensuring that a person’s identity is honored in both life and death is a fundamental right, yet Five Wishes does not guarantee this respect in their documents. Transgender individuals already face enough barriers in healthcare—no one should have to worry that their advance directives will be ignored or invalidated because of their gender identity. Just the thought is heartbreaking.
Additionally, Five Wishes has expressed opposition to MAID and VSED, both of which are legally recognized end-of-life options in many places. While these choices are not for everyone, they are essential options for those who meet the legal and ethical criteria. By opposing them, Five Wishes reinforces stigma rather than supporting individuals in making the decisions that are best for them. As a death doula, I believe in honoring all choices at the end of life, including the right to MAID and VSED where legally permitted.
More Inclusive and Affirming Alternatives
You do not need Five Wishes to create a comprehensive advance care plan. I can help you develop a personalized, legally valid plan that reflects your values, priorities, and unique needs—without compromise. Here’s how I can support you:
Personalized Advance Care Planning Sessions – I work with individuals and families to create clear, legally recognized advance directives that ensure your wishes are honored.
Guidance on State-Specific Forms – I can help you navigate the legal requirements in your state so your documents are valid and enforceable.
End-of-Life Decision Coaching – Whether you need support in articulating your preferences, discussing them with loved ones, or ensuring they align with your values, I’m here to guide you.
If you have questions or need support, I’m here to help. Let’s create a plan that truly reflects you.