Living Will

Request a Five Wishes living will.

At MedStar Good Samaritan Hospital, we truly value the rights of our patients and their families. As we strive to create ideal health care experiences, we've adopted the Five Wishes program to help you.

What is Five Wishes?

Five Wishes is the first living will that talks about your personal, emotional and spiritual needs as well as your medical wishes. It lets you choose the person you want to make healthcare decisions for you if you are not able to make them for yourself. It was written with the help of The American Bar Association's Commission on the Legal Problems of the Elderly, and the nation's leading experts in end-of-life care. It's also easy to use. All you have to do is check a box, or write a few sentences. Five Wishes is now available in 20 languages.

How Five Wishes Can Help You and Your Family

  • It lets you talk with your family, friends and doctor about how you want to be treated if you become seriously ill.
  • Your family members will not have to guess what you want. It protects them if you become seriously ill, because they won't have to make hard choices without knowing your wishes.
  • You can know what your mom, dad, spouse or friend wants through a Five Wishes living will. You can be there for them when they need you most. You will understand what they really want.

How Five Wishes Began

For 12 years, a man named Jim Towey worked closely with Mother Teresa and, for one year, lived in a hospice she ran in Washington, DC. Inspired by this first-hand experience, Mr. Towey sought a way for patients and their families to plan ahead and to cope with serious illness. The result is Five Wishes. Called the first "living will with a heart", it has been featured on CNN, NBC's Today Show and in Time and Money magazines.

Who Should Use Five Wishes

Five Wishes is for anyone 18 or older, married, single, parents, adult children and friends.

Five Wishes States

If you live in Maryland [or one of the states listed below], you can use Five Wishes and have the peace of mind to know that it substantially meets your state's requirements under the law. If your state is not listed here, Five Wishes does not meet the technical requirements in the statutes of your state.









Rhode Island




South Carolina




South Dakota



New Jersey




New Mexico




New York


District of Columbia


North Carolina




North Dakota

West Virginia





How Do I Change To Five Wishes?

You may already have a living will or a durable power of attorney for healthcare. If you want to use Five Wishes instead, all you need to do is fill out and sign a new Five Wishes as directed. As soon as you sign it, it takes away an advance directive you had before. To make sure the right form is used, please do the following:

  • Destroy all copies of your old living will or durable power of attorney for healthcare. Or you can write "revoked" in large letters across the copy you have. Tell your lawyer if he or she helped prepare those old forms for you. AND ...
  • Tell your healthcare agent, family members and doctor that you have filled out the new Five Wishes. Make sure they personally know about your new wishes as well.

Visit to request a Five Wishes living will and for more information.