How to Fill Out a Michigan Health Care Proxy (Patient Advocate Designation)

To fill out a Michigan Patient Advocate Designation, you name an adult you trust to make medical decisions for you if you cannot, spell out what authority they have (including specific language if you want them to be able to withhold life-sustaining treatment), and sign the document in front of two qualified witnesses who also sign. The form is governed by Michigan’s Estates and Protected Individuals Code starting at MCL 700.5506, and a free fill-in template is published in the Michigan Legislature’s Peace of Mind booklet.¹ The State Bar of Michigan also keeps a probate page with background and resources.²

Choose Your Advocate and at Least One Backup

You can create a designation if you are a Michigan resident, at least 18 years old, and of sound mind. The person you name as your patient advocate must also be at least 18.³ The statute does not require any particular relationship. A spouse, adult child, close friend, or anyone else whose judgment you trust will qualify.

Name a successor, and ideally more than one. A successor steps in if your first choice is unable to serve, declines, resigns, or is removed.⁴ If your sole advocate is unreachable during an emergency and no backup is listed, the designation does nothing at the moment you need it.

Write down each person’s full legal name, address, and phone number. Add cell numbers and email where you have them, because hospitals need to reach these people fast.

Write Out the Authority You Want to Give

Under MCL 700.5507, you can authorize your advocate to exercise any combination of powers over your care, custody, and medical or mental health treatment that you could exercise yourself.⁴ Within that broad frame, several items need actual drafting choices from you.

Life-Sustaining Treatment

If you want your advocate to be able to withhold or withdraw treatment that could result in your death, the statute requires clear and convincing language saying so, plus your acknowledgment that such a decision could or would allow your death.⁵ A vague reference will not do it. If the form does not already contain this language, you need to add it in your own words and sign it. Leave it out and your advocate will not have that authority, no matter what you told them in conversation.

Instructions on How Decisions Should Be Made

You can include instructions guiding your advocate’s choices. Examples include prioritizing comfort care over aggressive intervention, or honoring specific religious beliefs about blood products or particular procedures. These instructions give your advocate something concrete to point to when a doctor or family member pushes a different direction.

Organ and Tissue Donation

The designation can include your wishes about anatomical gifts. If you include this authority, you can also address how to handle any conflict between the directive’s terms and the medical steps needed to keep organs viable for donation.³

Limits

You can restrict what your advocate may do: for example, prohibiting certain surgeries, experimental medications, or admission to particular facilities. Specific limits reduce guesswork in a crisis. Write them in plain language and keep them narrow enough that your advocate can still function.

One Limit You Cannot Override

A patient advocate designation cannot be used to withhold or withdraw treatment from a pregnant patient if doing so would result in the patient’s death.⁴ Nothing you write in the form changes that.

Sign It the Way Michigan Requires

Execution rules are strict. Miss one and the entire document is void. The designation must be in writing, signed by you, dated, and executed voluntarily in the presence of two witnesses who also sign.³ Both witnesses must be physically present when you sign. Their signatures confirm you appeared to be of sound mind and were not acting under duress, fraud, or undue influence.

Michigan disqualifies the following people from witnessing your signature:

Your designated patient advocate or any successor advocate
Your spouse, parent, child, grandchild, or sibling
A presumptive heir or anyone known to be a beneficiary under your will at the time of witnessing
Your physician
An employee of a health facility treating you, a home for the aged where you reside, or a community mental health program or hospital providing you mental health services
An employee of your life or health insurance provider

The list exists to shut out conflicts of interest. In practice, coworkers, neighbors, or friends who are not related to you and have no stake in your care or estate are the easiest witnesses to find.³

Notarization is not required. Two qualified witnesses are enough. Some people notarize anyway because it can smooth acceptance at hospitals, especially out of state. Use wet-ink signatures rather than electronic ones; the statute requires the designation to be “in writing” and “signed,” and healthcare directives are generally excluded from the federal ESIGN Act and the Uniform Electronic Transactions Act’s scope.

Get Copies Where They Need to Be

A signed designation in your desk drawer does nothing. Before it can be implemented, a copy must become part of your medical record with your attending physician, the mental health professional treating you, or the facility where you are located.³ Give copies to your primary care doctor, specialists you see regularly, and to the advocate and every successor. A copy must be provided to any successor before they act.⁴ Keep the original somewhere your advocate can actually reach, such as a fireproof home safe or a clearly labeled file. A bank safe-deposit box that no one can open on a weekend is the wrong place.

When the Advocate’s Authority Actually Turns On

Your advocate has no power while you can still participate in your own medical decisions. The designation activates only after your attending physician and one additional physician or licensed psychologist examine you and determine in writing that you are unable to participate in treatment decisions. That written determination goes in your medical record and must be reviewed at least once a year.⁶ If your religious beliefs prohibit a medical examination, state in the designation how incapacity should be determined instead.

Before stepping in, your advocate must sign a written acceptance of the appointment. The acceptance contains required acknowledgments: that their authority exists only while you are incapacitated, that they cannot exercise any power you could not have exercised yourself, and that they understand the pregnancy limitation.⁴ Walk your advocate through the acceptance when you give them their copy, so there is no delay later.

If you regain the ability to make your own decisions, the advocate’s power is suspended automatically. It can reactivate only through a new two-clinician determination.⁷

Changing or Revoking the Designation Later

You can revoke your designation at any time and in any manner that communicates your intent to revoke it.⁸ That includes tearing up the document, writing a new one (which replaces the old), or telling your doctor you are revoking it. The flexibility is deliberate.

If you revoke, pull or replace the old copies everywhere you distributed them: your doctor’s office, hospitals, the former advocate, and any family members who had copies. A stale designation floating around in a medical record causes confusion in an emergency. Creating a new designation is the cleanest path, because it revokes the old one and puts a replacement in effect at the same time.

If You Spend Time in Another State

A Michigan Patient Advocate Designation may not be automatically honored in other states. Some states recognize out-of-state advance directives, some accept them only when they substantially comply with local law, and some have no clear rule. If you split time between states, complete a valid advance directive for each state where you regularly receive care. Carry your Michigan designation when you travel; many hospitals will accept it in an emergency even without a reciprocity statute.

1
Michigan Legislature. Peace of Mind – A Guide to Medical and Legal Decisions
2
State Bar of Michigan. Probate Information: Patient Advocate Designation
3
Michigan Legislature. Michigan Compiled Laws 700.5506 – Designation of Patient Advocate
4
Michigan Legislature. Michigan Compiled Laws 700.5507 – Patient Advocate Designation; Statement; Acceptance
5
Michigan Legislature. Michigan Compiled Laws 700.5507 – Patient Advocate Designation; Statement; Acceptance
6
Michigan Legislature. Michigan Compiled Laws 700.5508 – Patient Advocate Designation; Exercisable Authority
7
Michigan Legislature. Michigan Compiled Laws 700.5509 – Patient Advocate Designation; Suspension
8
Michigan Legislature. Michigan Compiled Laws 700.5510 – Patient Advocate Designation; Revocation