Provided by the Probate & Estate Planning Section of the State Bar of Michigan

Patient Advocate Designation FAQs

What is a Patient Advocate Designation?

You have the legal right to make your own medical treatment decisions. But, suppose something happens that makes you unable to make your own medical treatment decisions? Who will speak to the doctors for you? You can choose a person to make these decisions for you by signing a legal document called a "patient advocate designation." This legal document gives the person you choose (the patient advocate) authority to make decisions for your care, custody, and medical treatment when you cannot.

What if I Don't Have a Patient Advocate Designation?

 If you become unable to make your own decisions and you don't have a patient advocate designation, the probate court may be asked to appoint a guardian to make decisions for your care, custody, and medical treatment.

What can be Included in a Patient Advocate Designation?

You can decide what care and medical treatment you want included in your patient advocate designation. You can also give your patient advocate permission to donate your organs or other body parts for transplant or research after you die.

How can I Make Sure My Patient Advocate Designation is Valid?

You and two other people (witnesses) must sign the patient advocate designation. You must be of sound mind and age 18 or older. The witnesses are agreeing that you appear to be of sound mind, that you are signing the document of your free will, and that you are not being pressured by others to sign the document.

A witness cannot be your spouse, parent, child, grandchild, sibling, or possible heir. A witness also cannot be a known beneficiary when the document is signed. Others who cannot sign are a physician, a patient advocate, or an employee of one of the following: a health insurance provider, a health facility that is treating you, a home for the aged where you live, or a community mental health services program or hospital that is providing you mental health services.

When can the Patient Advocate Act?

After you complete the patient advocate designation, your patient advocate must accept and agree to the terms. Your patient advocate can make decisions for you only 1) after signing an acceptance, 2) when you are unable to make your own medical treatment decisions, and 3) after your attending physician (or supervising physician if you have more than one physician) and another physician or a licensed psychologist determine that you are unable to make your own medical treatment decisions.

What are the Patient Advocate's Duties?

Your patient advocate must act in your best interest. Your patient advocate must take reasonable steps to follow your expressed desires, preferences, and instructions. This includes preferences you put in your patient advocate designation or that are obvious from your own medical treatment decisions. It is best to put your desires in writing but you don't have to.

Your patient advocate cannot condone, allow, permit, authorize, or approve your suicide or homicide. Your patient advocate cannot make a life-ending decision if you are pregnant.

Your patient advocate may withhold or withdraw treatment, allowing you to die, only if you clearly and convincingly authorized the patient advocate to make such a decision.

The patient advocate's powers cannot be delegated to another person without the patient's prior authorization.

A designation that names your spouse as your patient advocate is suspended during an action for separation or divorce and cancelled when the divorce is final.

Finally, a patient advocate cannot receive compensation but can be reimbursed for expenses.

What are the Responsibilities of Medical Professionals Regarding Patient Advocate Designations?

Medical professionals are required to use sound medical practice. They also are required to follow your patient advocate's instructions if they believe your patient advocate designation is valid and your patient advocate is following the law.