Medical power of attorney in Michigan: how it works, how to sign
The short answer
In Michigan, a medical power of attorney is called a patient advocate designation. You sign it before two witnesses, and no notary is needed. Relatives and heirs can't witness. Michigan has no law ranking family to decide if you name nobody, so without one, a court may need to appoint a guardian.
The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?
In Michigan, the honest answer is: nobody automatically. This page explains why, and how a short document fixes it. It is part of our guides to estate planning by state. For the basics of the role, see what a medical power of attorney is.
What is a medical power of attorney called in Michigan?
Michigan calls it a "patient advocate designation." The person you name is your "patient advocate" (MCL 700.5506).
Any adult of sound mind can sign one and name another adult. It is the same idea as a health care power of attorney in other states, with a few Michigan rules worth knowing.
Who decides if I haven't named anyone?
This is the most important thing on this page. Michigan has no general law that ranks family members or friends to make medical decisions for an adult who can't, when there is no patient advocate and no guardian.
Most states have a default list: spouse first, then adult children, then parents, and so on. Michigan does not. The only related wording is a definition in the state's Dignified Death Act, which mentions immediate family, next of kin or a legal guardian. It sets no order, and it doesn't mention close friends at all (MCL 333.5653).
A bill to create a default list, House Bill 4418, passed the Michigan House in 2025 and is waiting in the Senate. It is not law (HB 4418 bill status).
So where nobody has clear authority, the practical route is a court-appointed guardian. That means a petition, a hearing and a judge choosing who serves.
| Your situation in Michigan | Who can make medical decisions |
|---|---|
| You signed a patient advocate designation, and it is in effect | Your patient advocate |
| A court has appointed a guardian with medical authority | The guardian |
| Neither of the above | Nobody is ranked by law; hospitals look to family case by case, and a court may need to appoint a guardian |
| The person who knows you best is a close friend | No standing under any statutory list; they can act only if you name them |
Why naming someone matters even more in Michigan
In a state with a default list, your sister or your adult son would at least have a place in line. In Michigan, there is no line.
That leaves room for confusion at the worst moment. Two relatives may disagree. A doctor may not know whom to ask. A dear friend who drives you to every appointment has no legal standing at all.
A patient advocate designation answers all of that in advance. You choose. You can name a friend, a niece, a neighbor or a professional, and a backup behind them. Our post on who decides for you walks through the question, and medical decisions without a power of attorney compares how other states handle it.
How do I sign a patient advocate designation?
Michigan's rules are in MCL 700.5506. The document must be:
- In writing, signed and dated by you, freely.
- Signed in front of two witnesses, who also sign.
No notary is needed. Michigan has no required form, so any writing that meets these rules works.
That is different from Michigan's financial power of attorney, which works best notarized. Our Michigan power of attorney guide covers that document.
Who can't be my witness?
Michigan's list is long, and it rules out the people you might ask first (MCL 700.5506). A witness can't be your:
- Spouse, parent, child, grandchild or sibling
- Presumptive heir, or anyone named in your will
- Physician, or the person you name as patient advocate
- An employee of your life or health insurer
- An employee of a health facility treating you, the home for the aged where you live, or a community mental health program or hospital serving you
The easiest path is two friends or neighbors who aren't related to you and aren't in your will. Some people ask two staff members at their lawyer's office or bank.
What has to happen before it works?
Two more steps, and both are easy to overlook (MCL 700.5507).
- Your patient advocate signs an acceptance. The statute sets out statements they must agree to before acting.
- It goes into your medical record. Give a copy to your doctor and your hospital.
The document takes effect only when your attending physician and another physician or a licensed psychologist decide, in writing, that you can't take part in treatment decisions (MCL 700.5508).
Do I need a living will too?
Michigan has no separate living will law. Instead, you put your wishes inside the patient advocate designation. It may include your wishes on care, custody and medical treatment, and instructions on how your patient advocate should decide (MCL 700.5507).
One rule deserves care. Your patient advocate can decline or stop treatment that would allow you to die only if you said so "in a clear and convincing manner." If that is your wish, write it plainly. Our post on treatment preferences helps you think through what to write, and health care power of attorney vs living will explains how the two ideas fit.
How do I choose my patient advocate?
A short checklist:
- They know what you want, because you've told them.
- They can stay calm in a hospital hallway and ask questions.
- They live close enough, or can travel when needed.
- You've named a backup in case they can't.
Here is a typical case, a composite. Joan is 73, widowed, and lives in Ann Arbor. Her only brother lives in Florida. Her friend Ellen knows her doctors and her wishes. Joan names Ellen as patient advocate and her brother as backup, and two neighbors witness.
Our post on how to choose a medical power of attorney has more questions to ask. Some people would like a professional standing by. A Kinly membership includes a medical power of attorney written for your state, and Trella Trust Company can be named in the role, first or as backup to someone you choose.
For what happens to your home and savings later, see our Michigan probate guide.
Common questions
Does a Michigan patient advocate designation need to be notarized?
No. It needs two qualified witnesses who watch you sign and then sign themselves. A notary is not required.
Who makes medical decisions in Michigan if there is no patient advocate?
Michigan has no law ranking family or friends in that situation. Hospitals work with family case by case, and if nobody has authority, a court may need to appoint a guardian. Naming a patient advocate avoids this.
Can my daughter witness my patient advocate designation?
No. Michigan bars your spouse, parents, children, grandchildren, siblings, heirs and anyone named in your will from witnessing. Ask two unrelated friends or neighbors.
Can a close friend make medical decisions for me in Michigan?
Only if you name them as your patient advocate. Without that document, a friend has no legal standing in Michigan.
Does Michigan have a living will?
Not as a separate document. You write your treatment wishes inside your patient advocate designation, signed the same way.
Sources
- MCL 700.5506: Patient advocate designation (Michigan Legislature)
- MCL 700.5507: Patient advocate designation; contents and acceptance (Michigan Legislature)
- MCL 700.5508: Determination of inability to participate (Michigan Legislature)
- MCL 333.5653: Michigan Dignified Death Act definitions (Michigan Legislature)
- House Bill 4418 of 2025, bill status (Michigan Legislature)
This page is general information, not legal or financial advice. Laws vary by state.