Advance directive frequently asked questions
What is an Advance Directive?
Advance directives are documents that state how you want medical decisions made if you lose the ability to make them for yourself. The documents include the Patient’s Advance Directive, which explains what kind of care the patient wants, the Acceptance by Patient Advocate form, which names the person who will assure your care and the Durable Power of Attorney for Health Care, which authorizes that person to speak for you. Michigan only recognizes advance directives that include a Durable Power of Attorney for Health Care.
What is a Durable Power of Attorney for Health Care?
A Durable Power of Attorney for Health Care is a legally binding document in which you appoint an advocate to make medical decisions for you if you become unable to make them for yourself.
What is a living will?
A living will is a document that identifies which medical treatments you would want — and which you would refuse — if you became terminally ill. Living wills are not authorized by Michigan law.
Must I have an Advance Directive?
No. Advance Directives are strictly voluntary. It's against the law for health care providers or insurance companies to require them as a condition of treatment or coverage.
Who can establish a Durable Power of Attorney for Health Care?
Anyone at least 18 years old and legally competent can establish a Durable Power of Attorney for Health Care.
How does it work?
You select someone you trust, who is at least 18 years old, to be your patient advocate. Then you fill out the form in the presence of two witnesses and you and the witnesses sign it. Under Michigan law, a doctor does not have to honor your Durable Power of Attorney for Health Care form unless two witnesses sign it.
Your advocate starts to make decisions on your behalf only when your attending doctor and another doctor or a licensed psychologist determine you are no longer able to make decisions for yourself. Your advocate has the authority to work with your doctors to make the same decisions you would make if you could, as documented in your Durable Power of Attorney for Health Care form.
Who can witness my Durable Power of Attorney for Health Care form?
Your witnesses must be at least 18 years old. Under Michigan law, witnesses cannot be your spouse, parent, child, grandchild, brother or sister, someone who benefits under your will, your patient advocate, your doctor, someone employed by your life or health insurance company, someone employed at a health care facility where you receive treatment, or someone employed by the home for the aged where you live.
What is the Acceptance by Patient Advocate form?
The person you appoint as your advocate must acknowledge his or her rights and responsibilities by signing the Acceptance by Patient Advocate form (861K PDF). If your advocate does not sign the form, your Durable Power of Attorney for Health Care may not be honored. It's a good idea to make this form and the Durable Power of Attorney for Health Care (197K PDF) form part of your medical record at the same time.
Do I need an attorney to establish a Durable Power of Attorney for Health Care?
No, you only need to fill out the form, sign it and have two witnesses sign it. If you have questions, you may want to consult your family attorney or an attorney who specializes in probate law or elder law.
Should I use the form provided?
Only if you wish. Other versions of the form are available through hospitals and attorneys. The form provided is intended for use in Michigan only. Other states have different Advance Directives.
I know my advocate can ensure that I receive every available treatment or end life-sustaining medical treatments if I give him or her written permission. What other kinds of decisions can my advocate make?
With your written permission, your advocate can make decisions about routine care like eating and taking medications. Your advocate can also decide whether you receive care in a nursing home, an assisted living apartment or from home health aides in your own home.
Can I authorize my advocate to withhold or end artificial nutrition and hydration?
Yes, because they are considered life-sustaining treatments. If you want your advocate to withhold these treatments, you must document your wishes and acknowledge that you understand withholding these treatments could allow you to die.
Can I authorize my advocate to make sure I receive all available treatments?
Yes. The Patient's Advance Directive includes a checklist where you can indicate which treatments you want and which you refuse. You can also document additional instructions on a separate sheet of paper and attach it to the form.
Can I designate someone to manage my financial affairs in a Durable Power of Attorney for Health Care?
No. The person you designate in a Durable Power of Attorney for Health Care can only make health care decisions. If you want to appoint someone to handle your financial or legal affairs, you should consult an attorney.
How does Blue Care Network file my Durable Power of Attorney for Health Care for future use?
When you first visit your primary care physician, you will be asked if you have an Advance Directive. If you do, give a copy to your doctor so it can be placed with your medical records. This is a good time to discuss your Advance Directive with your doctor and to ask questions. Also, give a copy to your patient advocate and alternate advocate, as well as to family members or anyone else who might be affected by your decision to appoint a patient advocate.
I am already a Blue Care Network member. How do I file my Advance Directive with my medical records?
You can file an Advance Directive with your primary care physician at any time. Simply take a copy of your Advance Directive with you on your next visit to your doctor. Tell your doctor you want to add your Advance Directive to your medical record. If you had one on file previously, ask your doctor to destroy it.
Can I change my Durable Power of Attorney for Health Care?
Yes. You can revoke it at any time and in any way you are able to communicate your wishes. You can also appoint a different patient advocate or change your wishes regarding medical care by completing and signing a new Durable Power of Attorney for Health Care form.
Is there a procedure to make sure my advocate is acting according to my wishes?
If you believe your advocate is not acting according to your wishes, you can file a petition with the probate court in the county where you live.
How can I get more information about Advance Directives?
You can discuss your Advance Directive and your wishes with your primary care physician. You can also contact us.
page modified 05/04/2008