Living Will and Advance Health-Care Instruction Requirements in Michigan
At a glance
| Governing law and document | Michigan EPIC Part 5, MCL §§ 700.5506-.5515. Statutory architecture is a patient-advocate designation, not a standalone living-will act; designation may state patient's treatment desires and instructions for advocate (§ 700.5507(1)-(2)). No statutory short form |
|---|---|
| Who may make an instruction | Individual age 18+ and of sound mind; named advocate also must be an individual age 18+ (§ 700.5506(1)) |
| Oral, written, and signature form | Designation must be written, signed, dated, voluntary, and added to medical record before implementation (§ 700.5506(3)); no directed-signature route. Section 700.1202's audiovisual/e-signing procedure applies only to documents executed before July 1, 2021. Advocate follows desires given orally or written in designation (§ 700.5509(1)(b)), but oral desires do not replace written designation |
| Witness, notary, and disqualifications | Executed in presence of and signed by two witnesses; no notary alternative. Witness cannot be spouse, parent, child, grandchild, sibling, presumptive heir, known devisee, physician, advocate, or listed insurer/treating-facility/aged-home/mental-health employee, and signs only if patient appears sound and free of duress/fraud/undue influence (§ 700.5506(4)) |
| Covered conditions and trigger | No terminal, unconsciousness, dementia, or other diagnosis is required by EPIC; patient may state chosen conditions. Advocate authority begins only after attending physician plus another physician or licensed psychologist examine patient, determine inability to participate, write/chart finding, and review at least annually (§ 700.5508). Authority suspends if ability returns (§ 700.5509(2)) |
| Treatment, nutrition, hydration, and comfort | Designation may state desires and instructions about medical treatment broadly (§ 700.5507). EPIC supplies no separate nutrition/hydration or comfort-care checkbox. Advocate may allow death only with clear-and-convincing authorization and acknowledgment of consequence; may choose hospice. Any known current desire for specified life-extending care binds advocate (§§ 700.5509, .5511) |
| Pregnancy and other statutory limits | Designation cannot be used to withhold/withdraw treatment from pregnant patient if that would result in her death (§§ 700.5507(5)(3), 700.5509(1)(d)); this limits advocate decision, not execution validity. SB 33 would replace this current rule |
| Revocation, notice, and registry | Patient may revoke anytime, even unable to participate, in any communicative manner; nonwritten revocation witness describes/signs circumstances. Provider with notice charts revocation and notifies advocate; later inconsistent designation also revokes (§ 700.5510). No state advance-directive registry appears in current EPIC Part 5 |
| Provider duties, recognition, and effect | Provider is bound by sound medical practice and compliant advocate's instructions (§ 700.5511(3)); statute gives court dispute/removal route but no express conscience-transfer procedure. Current desire for life-extending care overrides prior desire (§ 700.5511(1)). EPIC Part 5 states no valid-where-executed safe harbor |
Michigan's statutory route for future treatment wishes is a patient-advocate designation under EPIC. It is not a standalone living-will act. The document appoints an advocate and may include the patient's own treatment desires and instructions for how the advocate must decide.
Requirements one by one
The designation is written, dated, and witnessed
Under MCL 700.5506, a person age 18 or older and of sound mind may appoint another adult. The designation must be written, signed, dated, voluntary, and placed in the applicable medical record before implementation.
Two witnesses must be present and sign. Neither may be the patient's spouse, parent, child, grandchild, sibling, presumptive heir, known devisee, physician, or advocate. The statute also excludes listed employees of the patient's life or health insurer, treating facility, home for the aged, and mental-health program or hospital. Each witness signs only if the patient appears of sound mind and free of duress, fraud, and undue influence.
The statute gives no notary substitute. Under § 700.1202(4), the Act limits its audiovisual/electronic procedure to documents executed before July 1, 2021, so it is not a current route. The Act also does not state that another person may sign for the patient. The advocate must separately receive the designation and sign the statutory acceptance before acting (§ 700.5507(4)-(5)).
The patient may state treatment desires without diagnosis categories
§ 700.5507 permits a statement of the patient's desires about medical treatment and instructions for the advocate. EPIC does not require terminal illness, permanent unconsciousness, dementia, or another specified diagnosis. The patient may define conditions and preferences in the document.
The advocate also must take reasonable steps to follow desires, instructions, or guidelines the patient gave while able, whether orally or in the written designation (§ 700.5509(1)(b)). Oral desires guide the advocate; they do not replace the written, witnessed designation.
Authority begins after a two-professional finding
The attending physician and another physician or licensed psychologist each examine the patient and determine inability to participate in medical-treatment decisions. They put the determination in writing, add it to the medical record, and review it at least annually under § 700.5508.
If the patient regains ability, advocate authority suspends for as long as that ability continues. It may restart after another statutory determination.
Allowing death requires clear-and-convincing authorization
The advocate may withhold or withdraw treatment in a way that allows death only if the patient clearly and convincingly authorized that decision and acknowledged that it could or would allow death. The advocate may choose hospice care.
EPIC does not supply separate artificial-nutrition, hydration, or comfort-care checkboxes. Those subjects can be addressed within the patient's treatment desires, subject to the clear-and-convincing end-of-life rule.
The patient's current desire to receive a specific life-extending treatment is binding on the advocate even if the patient cannot then participate or is not competent under § 700.5511(1).
Pregnancy currently limits the advocate's decision
The designation cannot be used to withhold or withdraw treatment from a pregnant patient if doing so would result in her death. The rule limits the advocate's treatment authority rather than invalidating execution of the designation.
Pending SB 33 would replace that restriction with a route for the patient to state which life-sustaining treatment should be provided or withheld if the patient is pregnant when the designation becomes effective. It passed the Senate but remains in the House Health Policy Committee.
Revocation may be communicated in any manner
Even after losing the ability to participate in medical decisions, the patient may revoke at any time in any manner communicating intent. If revocation is not written, a witness describes and signs the circumstances. A physician, professional, or facility with notice records it in the medical record and bedside chart and notifies the advocate.
A later designation revokes the earlier one expressly or by inconsistency. EPIC Part 5 establishes no state advance-directive registry.
Providers follow a compliant advocate within medical standards
Under § 700.5511(3), a provider is bound by sound medical practice and the instructions of an advocate who complies with §§ 700.5506-.5515. The statute provides a probate-court dispute and removal route, but no express conscience- refusal transfer process.
Part 5 also states no express valid-where-executed safe harbor for an out-of- state treatment directive or patient-advocate designation.
What trips people up
- Michigan does not require a terminal diagnosis. Conditions in a form are patient-selected language, not an EPIC condition list.
- The advocate's acceptance is a separate step. The named person signs the statutory acceptance before acting.
- Current requests for treatment control. A known present desire for specific life-extending care overrides an earlier desire.
- Pregnancy is a current authority restriction. SB 33 proposes a change, but it is not current law.
Common questions
Does Michigan require notarization?
No notary alternative appears in § 700.5506. The document uses two qualified witnesses.
Must the document name a terminal or unconscious condition?
No. EPIC allows the patient to state treatment desires but does not impose a diagnosis list. End-of-life authority instead turns on clear-and-convincing authorization and the incapacity finding.
Can I revoke after losing decision-making ability?
Yes. Section 700.5510 permits revocation in any communicative manner even when the patient cannot participate in treatment decisions.
Is there an interstate safe harbor?
EPIC Part 5 contains no express rule validating a designation merely because it was valid where executed.
Statutes and sources
- MCL §§ 700.5506-.5509 — execution, witnesses, treatment desires, advocate acceptance, incapacity findings, end-of-life authority, pregnancy, and suspension. Official § 700.5506, § 700.5507, § 700.5508, and § 700.5509 (accessed 2026-07-30).
- MCL §§ 700.5510-.5511 — revocation, current wishes, provider effect, and disputes. Official § 700.5510 and § 700.5511 (accessed 2026-07-30).
- MI SB 33 (2025-2026) — pending pregnancy-rule amendment. Official bill history (checked 2026-09-19).
Source links
Every statute quoted above, linked, with the date we checked it.
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