What's an Advance Directive and How Do I Make One?

If you want doctors to know what kind of medical care you want when you can’t tell them yourself, you need an advance directive.

There are three kinds:

  • Durable power of attorney for health care, also known as a patient advocate designation
  • Living wills specifying the type of medical care you want or don’t want
  • Do-not-resuscitate orders confirming that you don’t want to be revived should your breathing and heartbeat stop

You can have one of these, none or all; it’s up to you. Advance directives are never required.

If you’re ready to create an advance directive, the first thing you should do is talk to your doctor. He or she will help you understand the kinds of decisions you might need to make.

After that, you can follow these instructions for how to establish durable power of attorney for health care and a living will. To learn about do-not-resuscitate orders, visit michigan.gov.

Who can be a witness

Witnesses to advance directive documents must to be unbiased and at least 18 years old. Under Michigan law, a witness can’t be:

  • Your spouse
  • Your parent
  • Your child or grandchild
  • Your brother or sister
  • Someone who benefits under your will
  • Your patient advocate
  • Your doctor
  • Someone who works for your life insurance or health insurance companies
  • Someone who works for a health care facility where you receive treatment

This legal document authorizes a patient advocate to make decisions about medical treatments and where you get care.

It only applies to health care. Patient advocates can’t make decisions about your financial or legal affairs.

To establish durable power of attorney for health care, you must be:

  • At least 18 years old
  • Legally competent

You don't need a lawyer present. Just follow these steps. You don’t have to use our forms, either.

If you have questions, you may want to talk to an attorney who specializes in probate or elder law.

Step 1: Choose your patient advocate. The person should be someone you trust to make decisions about your health care.

Step 2: Ask your patient advocate to accept their rights and responsibilities by signing the Acceptance by Patient Advocate.

Step 3: Fill out the Durable Power of Attorney for Health Care form. You, your patient advocate and two witnesses need to sign it. Be sure to read about who can be a witness before signing.

Step 4: Give a copy of your durable power of attorney for health care to:

  • Your doctor, who’ll make it part of your medical records
  • Your patient advocate
  • Your lawyer
  • Anyone else who might need to know about your health care decisions—for example, a spouse, a nursing home or a hospital

You can mail the form to us at:

Blue Cross Blue Shield of Michigan
Mail Code 0400
600 E. Lafayette Blvd.
Detroit, MI 48226

Or fax it to 1-866-894-3101.

To change your durable power of attorney for health care, fill out a new form.

You can remove your patient advocate simply by making your wishes clearly known. They don’t have to be in writing. You can appoint another by repeating the steps above.

Durable power of attorney for health care is for deciding who you want to make medical decisions for you.

Living wills, also called patient’s or physician’s directives, clarify exactly what those decisions should be when you’re:

  • Terminally ill
  • Permanently unconscious
  • Conscious but will never again be able to make decisions about your care

Although Michigan hasn’t passed a law that makes living wills legal, state court decisions have considered them binding. At the least, they make your wishes known about important decisions.

Living wills can be as general or as specific as you want.

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