Durable Power of Attorney for Healthcare

P.A. 312 of 1990
H.B. 4016 of 1990 – Rep. David Hollister
Recodified by P.A. 386 of 1998
M.C.L. 700.5506-5512
Current Status
In December 1990, the Michigan Legislature approved a bill establishing a durable power of attorney for health care. Passage of the bill followed more than 14 years of debate over how the rights of incompetent patients should be protected. Disagreements existed in a variety of areas from dealing with an unconscious pregnant woman, to when patients could be deprived of food and water. Over time a process-oriented bill was crafted which provided safeguards against abuses. The law allows individuals to direct their medical care through an appointed patient advocate.The wisdom of this approach has become apparent as states which initially enacted only living will laws have found them to be inadequate.A durable power of attorney is the standard for a thorough advance directive. Incompetent patients now have available to them the best means of protecting their rights. By appointing an advocate, and being able to put their wishes in writing in the durable power document, patients can direct their care and still have the procedural safeguards to insure there right to life is not compromised. Right to Life of Michigan supported the concept of the durable power during many of the years of debate before the law was finally passed.

Description
A person 18 years of age or older who is of sound mind at the time a designation is made may designate in writing a person who is 18 years of age or older to exercise powers concerning care, custody, and medical treatment decisions for the person who made the designation. The law is an alternative to the living will as a health care directive.

Currently in Michigan, only documents executed pursuant to a 1990 Michigan law allow citizens to establish a legally recognized “advance directive.” The durable power of attorney for health care allows individuals to name another person to be their “patient advocate” in an instance when they are unable to make medical decisions. The law also allows individuals to specify in the document the types of treatments they wish to receive or refuse.

Background
Medical professionals acknowledge that the best way to respect patients’ personal autonomy is to give them all the facts about their condition and treatment options, then allow them to make decisions based on that information. This is the principle of “informed consent.” Living wills cut at the heart of “informed consent.” Because they are written in advance and usually in very broad terms, living wills take from patients the option of being treated based on the facts of their present condition. Instead, patients are treated based on general statements made in advance of any knowledge of their condition or possible advances in medical technology. Along with this disadvantage, living wills exclude family members from participating in treatment decisions for their loved ones. The potential for abuse in their application is also great. Living wills remove the human, compassionate element from a critically important decision-making process.

Right to Life of Michigan remains firmly opposed to granting legal recognition to living wills through legislative enactment.

History
Legislation to provide statutory recognition of living wills has been introduced and rejected in Michigan for two decades. The proposed laws would grant immunity to health professionals who carry out medical treatment decisions based on the advance written directives of the patient. Right to Life of Michigan remains firmly opposed to granting legal recognition to living wills through legislative enactment. The best interests of all patients will be better served by using the durable power of attorney process as allowed under Michigan law.