Guides · State guides · Michigan

Medical Power of Attorney in Michigan: The Patient Advocate Designation and Its Witness Rules

Michigan's medical power of attorney is a patient advocate designation. It needs two qualified witnesses, and the advocate must sign an acceptance. Here is how it works, from MCL 700.5506.

By naveen · Updated October 13, 2026 · How we research our guides

A medical power of attorney in Michigan is created by a patient advocate designation. Under MCL 700.5506, a person 18 or older and of sound mind can name another adult to make decisions about "care, custody, and medical or mental health treatment." It must be in writing, signed, dated, executed voluntarily, and signed in the presence of two witnesses. Before anyone uses it, the patient advocate must sign an acceptance.

What is a patient advocate designation in Michigan?

It's the document that names your parent's patient advocate: "an individual who is named in a patient advocate designation to exercise powers concerning care, custody, and medical or mental health treatment decisions." The Michigan Legislature's guide to advance directives explains that "a designation of patient advocate is the term used for a durable power of attorney for health care."

The designation can also include your parent's instructions about how decisions should be made, a statement of their wishes on care and treatment, and authority to make an anatomical gift. It must include a statement that the authority "is exercisable only when the patient is unable to participate in medical or mental health treatment decisions."

It's separate from a financial power of attorney, which follows Michigan's 2024 power of attorney law; see our Michigan power of attorney guide.

Does Michigan recognize living wills?

Not as binding documents. The Michigan Legislature's guide, Planning for Your Peace of Mind, says, "Living wills are not recognized in Michigan statute." The state Office of Retirement Services adds that although a living will isn't legally binding, "it lays the groundwork for the types of decisions you've made and gives direction to your loved ones about your wishes."

The patient advocate designation is the document Michigan's statute provides for, and your parent's written instructions can go in it (MCL 700.5507). For the general picture, see power of attorney vs. advance directive.

How do you sign a patient advocate designation in Michigan?

Your parent signs it in the presence of two qualified witnesses. Under MCL 700.5506, it must be:

• in writing;
• signed;
• dated;
• executed voluntarily;
• "executed in the presence of and signed by 2 witnesses."

The statute requires two witnesses and doesn't offer a notary as an alternative. A witness may sign only if your parent "appears to be of sound mind and under no duress, fraud, or undue influence." Before it's implemented, the designation must also be made part of your parent's medical record with the attending physician or the facility where they're located.

Who can't be a witness in Michigan?

Close family, heirs, your parent's doctor and certain staff can't witness. Under MCL 700.5506(4), a witness can't be your parent's:

• spouse, parent, child, grandchild or sibling;
• presumptive heir or known devisee;
• physician or patient advocate;
• employee of their life or health insurance provider;
• employee of a health facility treating them, a home for the aged where they live, or a community mental health services program or hospital providing mental health services to them.

That rules out close family. Friends, neighbors or colleagues who aren't heirs are possible witnesses.

What does the patient advocate sign?

Under MCL 700.5507, "Before acting as a patient advocate, the proposed patient advocate must sign an acceptance of the patient advocate designation." The acceptance must include statements such as that the designation isn't effective unless your parent can't participate in decisions, that the advocate "shall act in accordance with the standards of care applicable to fiduciaries," and that the advocate can't be paid, though expenses can be reimbursed.

The Michigan Legislature's guide notes that the acceptance "does not have to be done at the time you sign the document." A successor advocate needs a copy before acting.

When does the patient advocate start making decisions?

Only when your parent can't participate. Under MCL 700.5508, "The patient's attending physician and another physician or licensed psychologist shall determine upon examination of the patient whether the patient is unable to participate in medical treatment decisions," put it in writing, add it to the medical record and review it at least annually. If there's a dispute, a court must hold a hearing within 7 days of receiving a petition and decide within 7 days after it.

The designation is suspended if your parent regains the ability to participate. For mental health treatment decisions, a physician and a mental health practitioner must both certify in writing that your parent can't give informed consent.

What can't the patient advocate decide?

The advocate can't end life-sustaining treatment without your parent's clear and convincing authorization, and can't delegate without permission. The limits are in MCL 700.5509:

• The advocate can decide to withhold or withdraw treatment that would allow your parent to die "only if the patient has expressed in a clear and convincing manner that the patient advocate is authorized to make such a decision."
• The advocate must take reasonable steps to follow your parent's desires and instructions, given orally or in writing.
• The advocate can't delegate their powers without your parent's prior authorization.
• The advocate can choose hospice care.

And under MCL 700.5511, your parent's current desire to receive specific life-extending treatment is binding on the advocate, whatever your parent's condition. If your parent wants the advocate to have authority over end-of-life decisions, the designation needs to say so clearly.

What happens if your parent has no patient advocate?

Michigan's patient advocate law, MCL 700.5506 to 700.5520, doesn't set a general family priority list in the sections we read. The court process for appointing a decision-maker is guardianship. Before anyone files, the court must give them written information on alternatives, including a patient advocate designation (MCL 700.5303), and a court that knows of a designation "shall not grant a guardian any of the same powers that are held by the patient advocate" (MCL 700.5306).

As of October 13, 2026, a bill to create a family priority list, House Bill 4418, had passed the Michigan House and was pending in the Senate; it isn't law. See our Michigan guardianship guide for what the court route involves.

How do you revoke a patient advocate designation?

Under MCL 700.5510, "even if the patient is unable to participate in medical treatment decisions, a patient may revoke a patient advocate designation at any time and in any manner by which he or she is able to communicate an intent to revoke." If the revocation isn't in writing, the person who witnesses it must describe it in writing, sign it and notify the advocate if possible.

Divorce matters too. If your parent named their spouse, the designation is suspended while a divorce, annulment or separate maintenance action is pending, and revoked when the judgment is entered, unless a successor advocate was named. The Michigan Legislature's guide says "it is best to do it in writing and to provide a copy of the revocation to your physician, mental health professional or health care facility."

What questions are worth asking before your parent signs?

• Who would your parent trust as patient advocate, and who should be the successor?
• Does the designation state clearly whether the advocate can make end-of-life decisions?
• Which two adults can witness without falling into any excluded group?
• Will the advocate sign the acceptance now, so there's no delay later?
• Has a copy gone into your parent's medical record?

Frequently asked questions

Does a medical power of attorney need to be notarized in Michigan?

No. A Michigan patient advocate designation must be signed in the presence of two witnesses under MCL 700.5506, and the statute doesn't offer a notary as an alternative. The witnesses can't be your parent's close family, heirs, doctor, patient advocate, or certain insurance or care staff.

Can a family member witness a patient advocate designation in Michigan?

No. MCL 700.5506 bars your parent's spouse, parent, child, grandchild, sibling, presumptive heir and known devisee from witnessing. A family member can still be named as the patient advocate, but the two witnesses need to come from outside those groups, such as friends or neighbors who aren't heirs.

Where can I get a Michigan patient advocate form?

The Michigan Legislature publishes a sample Designation of Patient Advocate form in its guide Planning for Your Peace of Mind, and says "This is a suggested form only." Michigan law doesn't require a specific form. Whatever form your parent uses, it needs two qualified witnesses and the advocate's signed acceptance.

Does a Michigan patient advocate designation cover finances?

No. It covers care, custody and medical or mental health treatment decisions. Money and property need a separate financial power of attorney under Michigan's Uniform Power of Attorney Act, which uses a notary or two witnesses and has its own statutory form. Your parent can sign both.

Can the patient advocate stop life-sustaining treatment?

Only if your parent authorized it clearly. Under MCL 700.5509, the advocate can decide to withhold or withdraw treatment that would allow your parent to die only if your parent expressed in a clear and convincing manner that the advocate may make that decision, acknowledging it could allow their death.

Can my parent change their mind after signing?

Yes. Under MCL 700.5510, your parent can revoke a patient advocate designation at any time and in any way they can communicate the intent, even if they can't otherwise participate in treatment decisions. A spoken revocation should be written down and signed by the person who witnessed it.

Getting started

A patient advocate designation only helps if it's signed while your parent can sign it, with two qualified witnesses and a signed acceptance. The plan this site builds asks four questions, including which state your parents live in, and puts the steps that matter most for your family in order. It's free and takes about 90 seconds.

Build your plan

Sources

• MCL 700.5506, Patient advocate designation: who can make one, signing and witnesses.
• MCL 700.5507, Acceptance: the patient advocate's acceptance.
• MCL 700.5508, When authority begins: the two-professional determination.
• MCL 700.5509, Limits on the advocate: the clear and convincing rule.
• MCL 700.5510, Revocation: how to revoke and the divorce rule.
• Michigan Legislature, Planning for Your Peace of Mind: the Legislature's guide to patient advocate designations, with a suggested form (revised 7/2017).
• Michigan Office of Retirement Services, Power of attorney and advance directive resources: the state agency's note on living wills.
• Michigan Legislature, House Bill 4418 (2025): the pending patient surrogate bill.

More on what this tool does and doesn't do, or browse everything we've written.