Michigan Living Will Requirements

Michigan has never enacted a living-will statute. A stand-alone written statement of treatment wishes, with no agent named, has no independent legal force here. The only legally binding advance health care document is the Patient Advocate Designation (MCL 700.5506 to 700.5515), which requires naming an agent and only optionally carries a statement of treatment wishes inside it.

Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to inform patients in writing of their right under Michigan law to make an advance directive, including documenting whether the patient has executed a Patient Advocate Designation.

The Patient Advocate Designation is Michigan's only legally binding advance health care document. It must be in writing, signed by an adult of sound mind, dated, executed voluntarily, and witnessed by two qualifying adult witnesses. Michigan does not offer a notary-instead-of-witnesses alternative for this document, unlike some other states.

You must name a patient advocate for any treatment-wishes statement to be legally binding in Michigan; there is no way to execute a binding document that states only your wishes without an agent. The proposed patient advocate must sign a written acceptance containing ten specific statutory statements before the designation can be implemented, including standards for withholding or withdrawing life-sustaining treatment and the advocate's fiduciary duty.

Your patient advocate may make mental health treatment decisions on your behalf only after a physician and a mental health practitioner both certify in writing, after examining you, that you cannot give informed consent to mental health treatment. You may waive your right to revoke this specific authority, but revocation still takes effect within 30 days of you communicating an intent to revoke.

Michigan's Revised Uniform Anatomical Gift Act lets you authorize organ and tissue donation, and a patient advocate designation may separately authorize your patient advocate to make an anatomical gift on your behalf.

You may revoke your Patient Advocate Designation at any time and in any manner sufficient to communicate your intent to revoke. This is a statutory right, not something your document itself needs to spell out. The designation also ends automatically on your death (except for anatomical-gift authority), if your patient advocate resigns without a named successor, by court order, or, if you named your spouse as advocate, upon a judgment of divorce, annulment, or separate maintenance unless you named a successor advocate.

Michigan's printed statute still bars a patient advocate from withholding or withdrawing treatment that would cause a pregnant patient's death. On April 16, 2024, the Michigan Court of Claims ruled in Koskenoja v. Whitmer that this clause is unconstitutional and ordered it struck from the statutes, with the state's own officials agreeing it is unenforceable. A bill to formally repeal the clause passed the Michigan Senate but had not yet been signed into law.

Because Michigan provides no official government form, your Patient Advocate Designation should specifically address your preferences for mechanical ventilation, artificial nutrition and hydration, dialysis, antibiotics, and pain management in your own words.

Federal HIPAA regulations govern how your patient advocate can be authorized to access your protected health information once your Patient Advocate Designation is in effect.

A witness cannot be your spouse, parent, child, grandchild, sibling, presumptive heir, or known devisee at the time of witnessing, your physician, your named patient advocate, or an employee of a life or health insurance provider for you, a health facility treating you, a home for the aged where you reside, or a community mental health services program or hospital providing you mental health services.

Notarizing your Patient Advocate Designation is not legally required and does not substitute for the two-witness requirement. Unlike some other states, Michigan's statute provides no notary-instead-of-witnesses execution path for this specific document; two qualifying witnesses are required regardless of notarization.

Your Patient Advocate Designation can specify your preferences for palliative care and comfort measures if curative treatment is no longer desired or effective.

The First Amendment protects the free exercise of religion generally but does not itself require health care providers to follow any particular preference stated in your designation.

If a Michigan probate court is aware you executed a valid Patient Advocate Designation before being found incapacitated, the court cannot give a guardian the same care, custody, or medical and mental health treatment powers your patient advocate already holds, unless the court finds your designation was not validly executed or that your patient advocate is not complying with the law or acting in your best interests. A validly executed designation is therefore a practical way to avoid, not just supplement, a full court guardianship over your medical decisions.

Michigan's Do-Not-Resuscitate Procedure Act lets a qualified patient execute a DNR order that emergency personnel must honor outside a health care facility, separate from and in addition to a Patient Advocate Designation.

Give copies of your completed Patient Advocate Designation to your patient advocate, successor advocate, physician, and close family so it can be located and honored when needed.

Unlike several other states, Michigan's Patient Advocate Designation statute contains no express clause recognizing an advance health care directive that was validly executed under another state's law. Michigan's Patient Advocate Designation is also specifically excluded from the general out-of-state reciprocity rule that Michigan's Uniform Power of Attorney Act provides for other kinds of powers of attorney. If you move to Michigan with an out-of-state living will or health care power of attorney, do not assume it is automatically valid here; executing a new Patient Advocate Designation under Michigan law is the safer path.