Michigan does not use a health care power of attorney. It uses a Designation of Patient Advocate, governed by MCL 700.5506, and it has a requirement no neighbouring state shares: your patient advocate must sign a separate acceptance before exercising any authority. A perfectly executed designation with no signed acceptance gives your advocate nothing.
The acceptance is the step people miss
MCL 700.5507 requires the patient advocate to sign an acceptance before acting. Until that happens, the designation is a piece of paper naming someone who cannot do anything.
Ask the person you intend to name before you sign, and get their acceptance signed at the same sitting if you can. Keep it attached to the designation.
Two witnesses, and no notary alternative
MCL 700.5506 requires the designation to be executed in the presence of and signed by two witnesses. Unlike Michigan's financial power of attorney — which does offer a notary route — there is no notary substitute here. A notarized designation with no witnesses is not properly executed.
The disqualification list is long: not your spouse, parent, child, grandchild, sibling, presumptive heir, or a known devisee at the time of witnessing; not your physician or your patient advocate; and not an employee of a life or health insurance provider for you, of a health facility treating you, of a home for the aged where you live, or of a community mental health services program or hospital providing mental health services to you.
Life-sustaining treatment takes two statements
This is the part that most often fails. Under MCL 700.5507, a patient advocate may make a decision to withhold or withdraw treatment that would allow you to die only if you have expressed, in a clear and convincing manner, both of two things.
- That your patient advocate is authorized to make that decision; and
- That you acknowledge such a decision could or would allow your death.
Mental health treatment is separate
Michigan treats mental health treatment as its own authority, and the designation has to say so expressly for your advocate to have it. Your advocate also cannot admit or commit you to a facility for mental illness, developmental disability, or substance dependency on an inpatient basis, and cannot consent to psychosurgery or electroconvulsive treatment.
Frequently Asked Questions
Why does my patient advocate have to sign something?
MCL 700.5507 requires it. The acceptance is what makes the designation operative — without it, your advocate has no authority no matter how properly the designation was executed.
Can I use a notary instead of witnesses?
No. Michigan requires two witnesses for a patient advocate designation. The notary alternative exists for Michigan's financial power of attorney, not this document.
Why are there two life-sustaining lines instead of one?
MCL 700.5507 requires both the authorization and a separate acknowledgment that the decision could or would allow your death. One without the other is not enough.
When can my patient advocate start acting?
Only after your attending physician and one other physician — or a licensed psychologist, where mental health treatment is concerned — determine you cannot participate in those decisions.