Have You Made Your Five Wishes Known? Now is the Time to Think About Later

The 1st Annual Healthcare Ethics Symposium (AHES) will be held May 9-11 from 7:30 a.m. to 4:30 p.m. in the Laurel Clark Memorial Auditorium at Walter Reed National Military Medical Center (WRNMMC).

The symposium, sponsored by the Walter Reed Bethesda-Bioethics Committee with the assistance of the Department of Pastoral Care, is part of an ongoing effort at WRNMMC to educate patients and staff on the role ethics play in health care.

"The focus of the AHES is to professionally address critical issues in health care ethics," said Amy O'Connor, assistant department chief of Healthcare Resolutions at WRNMMC. "The symposium will address relevant, ethical dilemmas that today's military and Department of Defense health care professionals and providers encounter in their day-to-day practice, and will offer a framework and approach for understanding and resolving these critical ethical issues."

In conjunction with the symposium, the Bioethics Committee, WRNMMC's Internal Medicine Clinic and Social Work Department sponsored a class focused on the "Five Wishes" initiative on April 19. The class, which may be offered on a monthly basis, is designed to help people make what could be difficult end-of-life decisions concerning an advanced directive, O'Connor explained.

"An advanced directive allows people to make end-of-life decisions while they're still healthy," O'Connor said. "The directive will explain the health care they wish to receive in the event they are incapacitated and unable to make those decisions later. Using the Five Wishes information, family members and loved ones will be able to speak on their behalf."

One of the instructors of the Five Wishes class, Paul Cauchon, provider champion for the outpatient advance directive initiative and a staff physician assistant at WRNMMC, developed the slogan, "Now is the time to think about later." He said this emphasizes the importance of filling out the Five Wishes form sooner rather than later.

"Ideally, the Five Wishes forms should be filled out prior to the need for them and regardless of the age or health status of the individual," said Anne Hall, one of WRNMMC's social workers. "The goal is to prevent a crisis, disagreement or turmoil amongst family members."

No one knows when an accident will occur or a sudden health condition will arise, said Kathleen Baxley, deputy chief of WRNMMC's social work department. "It's easier to make these decisions when you don't eminently 'need' to and you can always change your mind about your decisions later." O'Connor said it is often difficult to think in terms of a loved one dying, but it's better to know their wishes in case they're unable to convey them later. She added that Sergeant Archie, one the hospital dogs, will be wearing a button asking patients if they've signed the Five Wishes paper.

Both O'Connor and Baxley agreed that filling out the Five Wishes form is an excellent way to start the challenging end-of-life conversation with family members and loved ones. They said they have properly "field tested" the tool by filling out forms for themselves.

For more information or to register for the 1st Annual Healthcare Ethics Symposium May 9-11, call Amy O'Connor at (301) 319-4447, or e-mail an.o'connormed.navy.mil. For information about the Five Wishes program or to register for a future class, call Anne Hall at (301) 295-6360 or Paul Cauchon at (301) 319-8750.