Advanced Directive

Advanced Directives are written instructions you make about your health care and treatment, usually in the event that you are incapacitated such that you cannot meaningfully participate in those decisions yourself. Advanced Directives come in different forms.

"Living Will Declarations" are a form of Advanced Directive which is self-executing. In other words, the writing, itself, directs the caregivers and presumably, they look only to that writing.

"Health Care Durable Powers of Attorney" are an agency document which appoints and authorizes another person to make decisions on your behalf--again, usually in the event of incapacity.

In Michigan, the latter Durable Power of Attorney is recognized by our legislature. Denominated "Health Care Designation of Patient Advocate," this Michigan statutory document requires specific language. Additionally, Michigan requires a determination by 2 licensed medical professionals that you are unable to participate in your own decision making -- and a written "Acceptance of Designation" by your designated representative.

At this time Michigan does not recognize a Living Will Declaration either statutorily or by court ruling (though this does not mean that a court would not use it as evidence of your intent).

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Health Care "Designation of Patient Advocate"

The Michigan Durable Power of Attorney Statute provides for the creation of a Durable Power of Attorney for Health Care or Medical Decision Making. This is essentially a specialized Durable Power of Attorney (see Durable Power of Attorney) which is generally limited to issues of Medical Care and Treatment. The statute designates these powers as "Health Care Designations of Patient Advocate."

These may be alternatively known as Medical Power of Attorney, or Health Care Power of Attorney.

Unlike other powers of attorney, by Michigan Statute, the Designation of Patient Advocate is only effective upon a finding by two physicians (or other qualified medical professional), in writing that the patient is unable to meaningfully participate in their own care and treatment decisions.

By Michigan Statute, a Patient Advocate must sign a written "Acceptance of Designation" which includes certain statutory provision.

The Designation of Patient Advocate, in addition to providing for general care and treatment decision making, may also provide for end-of-life decision making and can authorize the Patient Advocate to sign a Michigan "Do-Not-Rescuscitate" order (DNR) on behalf of the patient.

These documents should not be confused with "Living Will Declarations" which are not currently recognized in Michigan, but may contain similar language with similar end results. The primary difference is that the Patient Advocate Designation gives an agent the decision-making power, while the Living Will is a direct instruction to the medical community.

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