Healthcare Directives – Ensuring That Your Wishes Regarding Your Medical Care Will be Followed

How can you assure that your wishes will be followed regarding your medical care if you should become temporarily or permanently unconscious or unable to communicate or make decisions as a result of disease, accident, or surgery? How can you assure that those wishes will be known by others if you are unable to communicate them? How can you avoid costly court proceedings that may unnecessarily delay or prevent your wishes from being carried out?

Michigan law allows you to appoint another individual called your “patient advocate” to make routine and life and death decisions concerning your care, custody, and medical treatment when you are unable to do so. Your patient advocate will have the power to act on your behalf only when you are unable to do so as determined by two physicians or one physician and a licensed psychologist. Your patient advocate has a duty to try to follow your wishes.

You may appoint a patient advocate by signing a valid “designation of patient advocate” document under Michigan law. Typically, people appoint a spouse, parent, child, or trusted friend as their patient advocate and also name a successor patient advocate to take the first appointed patient advocate’s place if he or she is unavailable or not able to act on your behalf for any reason.

Your patient advocate may have the power on your behalf to consent to or refuse medical treatment, to have access to your medical records under federal privacy laws, and to arrange for home or nursing home care. You can give your patient advocate the authority to withhold or withdraw life sustaining treatment, including a ventilator and food and water administered through tubes, as long as you express in a clear and convincing manner that your patient advocate has the authority to make those decisions and you specifically acknowledge that those decisions could or would allow you to die.

If you would want life sustaining treatment to cease under certain circumstances, you can express those desires in the designation form. You can also express any desires or restrictions regarding medical treatment that are in accordance with your religious beliefs. It is a good idea to make a copy of your patient advocate designation a part of your medical records.

Anyone who is 18 years of age and of sound mind may appoint a patient advocate and anyone who is 18 years old may be appointed. However, a patient advocate must accept his or her appointment in order for it to be effective. Therefore, it is important that you make sure that the person you would like to appoint is willing to take on the responsibility. It is also important that you clearly express your wishes by discussing them with your patient advocate and by expressing those wishes in writing on the designation form. You may revoke your patient advocate designation at any time with regard to medical treatment decisions.

Often, people also sign a document called a “living will”. A living will usually contains a general expression of desire that a person’s life not be unduly prolonged if they are terminally ill or persistently unconscious. Although not legally binding, a living will can provide written evidence of your wishes under those circumstances and may be especially important if there is no patient advocate available to act on your behalf.

The Michigan patient advocate law also has special provisions regarding mental health treatment. These provisions can make it easier for a person to receive necessary mental health care when he or she is incapable of making informed decisions due to his or her mental state.

The Michigan patient advocate statute has certain detailed and stringent requirements regarding witnesses and regarding provisions that must be included in the document. The estate planning professionals at Berry Moorman have been preparing designations of patient advocate as a part of every estate plan since these documents were authorized under Michigan law in 1990. We have kept abreast of changes and developments in that law and in federal law which impact your privacy and the authority of your patient advocate. Berry Moorman estate planning counsel have the knowledge, experience, and resources to ensure that your patient advocate designation will clearly express your wishes and will fully comply with the requirements of Michigan and federal law.