Patient Advocate: Your Voice in Health Care

A durable power of attorney for health care, also known as a health care proxy or a patient advocate designation, is a document in which you appoint another person to make medical treatment and related personal care decisions for you.

A durable power of attorney for health care is legally binding in Michigan. To make this designation, you must be at least 18 years old, and you must understand you are giving another person power to make certain decisions for you if you become unable to make them. That person is called your patient advocate.

Your patient advocate can make decisions for you only when you become unable to participate in medical treatment decisions yourself. For example, you might have a temporary loss of ability to make or communicate if, for example, you had a stroke or were knocked unconscious in a car accident. Or you might suffer permanent loss through a degenerative condition, such as dementia.

The doctor responsible for your care and one other doctor or psychologist who examines you will make a determination whether you are able to make medical decisions. After examining you, a doctor and a mental health professional (physician, psychologist, registered nurse, or masters-level social worker) must each make the determination about mental health treatment. You may in the document choose the doctor and mental health professional you wish to make this determination.

What Your Patient Advocate Can Do
You can give a patient advocate power to make personal care decisions you normally make for yourself. For example, you can give your patient advocate power to consent to or refuse medical treatment for you; arrange for mental health treatment, home health care, or adult day care; or admit you to a hospital, nursing home, or home for the aged. You can also authorize your patient advocate to make a gift of your organs or body, to be effective upon your death. You can also give your patient advocate power to make decisions about mental health care and the authority to donate specific organs or your entire body upon your death.

You can give a patient advocate the right to withhold or withdraw treatment that would allow you to die, but you must express in a clear and convincing way that the patient advocate is authorized to make such decisions, and you must acknowledge these decisions could or would allow your death.

You can also express your wishes concerning other types of care you want during terminal illness. You could also express a desire not to be placed in a nursing home and a desire to die at home. Your patient advocate has a duty to try to follow your wishes.

Your patient advocate does not have general power to handle all your property and finances. If you wish another person to handle all your property and financial affairs if you become incapacitated, you could seek a lawyer's help to draft a durable power of attorney for finances or a living trust.

Excerpted from a State Bar of Michigan pamphlet, Advance Directives: Planning for Medical Care in the Event of Loss of Decision-Making Ability