Default Health-Care Surrogate Priority in Michigan

At a glance

Requirements one by one

Care or setting covered

Michigan's Public Health Code § 333.5654(1) requires a physician treating a patient with reduced life expectancy from advanced illness to inform the patient, patient surrogate, or appointed advocate about recommended treatment and alternatives. Section 400.66h addresses surgical or medical treatment carried out under the Social Welfare Act. Neither provision supplies a statewide ranked list for every adult treatment decision.

Guardian or appointed agent

Under § 700.5508(1), a designated patient advocate's medical-decision authority begins after the required determination that the patient cannot participate. Section 700.5306(5) prevents a guardian from exercising the same medical or mental-health powers granted to that advocate unless the court modifies the guardianship on specified findings. A guardian's medical-consent powers under § 700.5314(c) must be granted by court order.

Family and partner order

Section 333.5653(1)(g) defines “patient surrogate” to include immediate family, next of kin, or a legal guardian when a condition prevents consent. Section 333.5655(b) recognizes that surrogate's role in decisions about treatment for reduced life expectancy from advanced illness. The definition gives no spouse, child, parent, or sibling ranking. In its narrower setting, § 400.66h calls for written consent from a nearest relative, legally appointed guardian, or person standing in loco parentis, without ranking those alternatives.

Decisions limited or excluded

For advanced illness, § 333.5655(b) describes decisions to receive, continue, discontinue, or refuse treatment. A court-appointed guardian's authority is limited by the order: § 700.5314(c) requires an express grant for inpatient hospitalization and directs a separate court process if the ward objects to or actively refuses mental-health treatment.

No surrogate or disputed authority

An interested person may petition for a guardian under § 700.5303(1). Under § 700.5306(1)–(2), the court needs separate clear-and-convincing findings of incapacity and necessity, then limits powers and duration to demonstrated need. These proceedings can supply a court-appointed decision maker where the current cited family provisions do not settle a contested choice.

What trips people up

The phrase “patient surrogate” in § 333.5653(1)(g) does not itself establish a statewide order among family members. The detailed order proposed in H.B. 4418 remains pending; its Senate substitute also requires companion legislation before it could take effect.

Common questions

Does a spouse automatically outrank an adult child under the cited current law? The advanced-illness definition in § 333.5653(1)(g) recognizes immediate family and next of kin without ranking them.

Can a guardian consent to inpatient hospitalization? Section 700.5314(c) requires the court to grant that power expressly in its order.

Can emergency first aid wait for the written consent described in the Social Welfare Act? Section 400.66h says its consent sentence does not prevent temporary first aid for an accident or sudden acute illness when consent cannot immediately be obtained.

Statutes and sources

• Mich. Comp. Laws §§ 333.5653–5655, 400.66h, 700.5303, 700.5306, 700.5314, and 700.5508. Verbatim official text, source links, and access dates appear in the source fields above.