Michigan: Health Care Power of Attorney Requirements

Michigan calls its health care power of attorney a patient advocate
designation. The signer is the patient, and the appointed decision-maker
is the patient advocate. The rules are in the Estates and Protected
Individuals Code, principally §§ 700.5506 through 700.5515.

Requirements one by one

The patient signs; the advocate separately accepts

Under § 700.5506(1), an adult who is of sound mind may appoint another adult. Section 700.5506(3)
requires a written, signed, dated, voluntary designation. Before it is
implemented, the document must be placed in the applicable medical record.

Naming the advocate is not the last signature step. Before acting, the proposed
advocate must receive a copy and sign an acceptance containing substantially the
statutory statements listed in § 700.5507(4)–(5).

Two witnesses are required; the statute has no notary alternative

Section 700.5506(4) says the designation must be "executed in the presence of
and signed by 2 witnesses." The execution section does not provide a
witnesses-or-notary choice.

Michigan briefly allowed two-way audiovisual witnessing for documents executed
from April 30, 2020 through June 30, 2021. The current § 700.1202 expressly
limits that procedure to that past window, so it is not a current remote-signing
route.

The witness-disqualification list is broad

Neither witness may be the patient's spouse, parent, child, grandchild, sibling,
presumptive heir, known devisee, physician, or patient advocate. Section
700.5506(4) also excludes the listed employees of the patient's life or health
insurer, treating facility, home for the aged, or mental-health program or
hospital. Each witness signs only if the patient appears of sound mind and free
of duress, fraud, and undue influence.

Two professionals make the medical-capacity finding

For medical decisions, § 700.5508(1) requires the attending physician and
another physician or licensed psychologist to examine the patient and determine
that the patient cannot participate in treatment decisions. They must put the
finding in writing, add it to the medical record, and review it at least once a
year. Mental-health decision-making uses the separate § 700.5515 procedure.

If the patient regains the ability to participate, the advocate's authority is
suspended. It can restart after a later qualifying determination
(§ 700.5509(2)).

End-of-life and mental-health powers need explicit language

The designation may authorize any of the listed care, custody, medical,
mental-health, and anatomical-gift powers that the patient could exercise
(§ 700.5507(1)). The advocate must take reasonable steps to follow the patient's
known desires and instructions (§ 700.5509(1)(b)).

Several decisions have a higher bar. The advocate may withhold or withdraw
treatment that would allow death only if the patient clearly and convincingly
authorized that decision and acknowledged its consequence. Forced medication or
inpatient mental-health treatment likewise requires clear-and-convincing
authorization. Current law also bars a decision to withdraw treatment from a
pregnant patient if that would cause the patient's death
(§ 700.5509(1)(d)–(e), (h)).

Revocation is broad, with a mental-health exception

Even after losing the ability to participate in medical decisions, the patient
may revoke in any manner that communicates the intent. If the revocation is not
written, a witness must describe and sign the circumstances in writing
(§ 700.5510(1)(d)). A later inconsistent designation also revokes the earlier
one.

For mental-health authority, the document may contain a limited waiver of the
right to revoke. Even then, § 700.5515(1) caps continued treatment after the
patient communicates revocation at 30 consecutive days.

A spouse-agent is suspended as soon as an action for separate maintenance,
annulment, or divorce is pending and is revoked when judgment enters, unless a
successor is named (§ 700.5510(1)(g)).

Part 5 has no express out-of-state safe harbor

The current official Part 5 index lists the patient-advocate provisions from
§ 700.5506 through § 700.5520, but none is an out-of-state-execution recognition
section. That is narrower than statutes that expressly validate any directive
valid where signed. Pending HB 4418 would expressly account for an out-of-state
equivalent when determining whether a default surrogate may act, but it has not
been enacted.

What trips people up

• The advocate must sign an acceptance. The patient's witnessed signature
  alone does not authorize the named person to begin acting (§ 700.5507(4)).
• A notary does not replace either witness. The current execution section
  specifies two witnesses and contains no notary alternative.
• The capacity finding is not a one-professional formality. Medical
  authority requires the attending physician plus another physician or licensed
  psychologist, with a written record and annual review.
• A divorce case matters before judgment. A spouse-agent's authority is
  suspended while the case is pending, not only after divorce is final.

Common questions

Can a Michigan patient advocate be paid?

Not for serving as advocate. The required acceptance says the advocate receives
no compensation, but may be reimbursed for actual and necessary expenses
(§ 700.5507(5)).

Can the advocate delegate decisions to someone else?

Only if the patient gave prior authorization. Section 700.5509(1)(g) otherwise
bars the advocate from delegating the granted powers.

Statutes and sources

• Mich. Comp. Laws § 700.5506. Who may sign; writing, date, voluntariness,
  medical-record placement, two witnesses, and witness disqualifications.
  Official text
  (accessed July 16, 2026).
• Mich. Comp. Laws §§ 700.5507–700.5509. Advocate acceptance, scope,
  capacity determination, authority, end-of-life and mental-health limits, and
  suspension on recovery.
  Official § 700.5507,
  § 700.5508,
  and § 700.5509
  (accessed July 16, 2026).
• Mich. Comp. Laws §§ 700.5510 and 700.5515. Revocation, spouse-agent
  suspension and termination, and the limited mental-health waiver.
  Official § 700.5510
  and § 700.5515
  (accessed July 16, 2026).
• EPIC Part 5 index. Complete current list of patient-advocate provisions;
  no express out-of-state recognition section.
  Official index
  (accessed July 16, 2026).
• MI SB 33 and HB 4418 (2025-2026). Pending pregnancy-rule and
  surrogate/out-of-state-equivalent proposals.
  Official SB 33 page
  and official HB 4418 page
  (checked July 16, 2026).