Comparing Advanced Directive Forms: Florida, Five Wishes, and POLST

a) Differences Between the Forms

Florida Advance Directive:

• Primarily focuses on medical decisions, such as life-sustaining treatments and organ donation.  
• Often more legally binding and specific in nature.
• May require more detailed instructions and designations of a healthcare surrogate.

Five Wishes:

• A more holistic approach, covering medical decisions, comfort care, and personal preferences.  
• Allows for more flexibility and personal expression.
• Can address spiritual and emotional needs in addition to medical directives.  

POLST (Physician Orders for Life-Sustaining Treatment):

• A specific medical order form designed for seriously ill or frail patients.  
• Focuses on immediate medical decisions, such as CPR, artificial ventilation, and tube feeding.
• Often used for patients with advanced illnesses or terminal conditions.  

b) Reasons for the Differences

The differences between these forms can be attributed to several factors:

• Legal and Regulatory Frameworks: State laws and regulations vary, influencing the specific content and legal implications of advance directives.  
• Cultural and Societal Factors: Different cultures and societies may have varying perspectives on end-of-life care, impacting the types of decisions individuals wish to make.  
• Evolving Understanding of End-of-Life Care: As medical practices and societal attitudes towards death and dying evolve, so too do the types of decisions that individuals may want to consider.

c) What is Accomplished by Newer Generation Advanced Directives

Newer generation advanced directives, like Five Wishes, offer several advantages:

• Comprehensive Coverage: They address a wider range of end-of-life concerns, including personal, emotional, and spiritual preferences.
• Person-Centered Approach: They prioritize the individual’s wishes and values, allowing for more personalized care.
• Clear Communication: They provide clear and concise instructions for healthcare providers, reducing the potential for misunderstandings.
• Reduced Decision-Making Burden: They can alleviate the burden on families and healthcare providers during difficult times.

d) Personal Preference for an Advance Directive

As a patient, I would prefer a comprehensive form like Five Wishes. It allows me to express my wishes regarding medical treatment, comfort care, and personal preferences, ensuring that my values are respected even if I am unable to communicate them myself. Additionally, its clear and concise format makes it easy for healthcare providers to understand and implement my wishes.