Advance Directives for Health Care
What is an Advance Directive for Health Care?
An advance directive for health care is something you write giving instructions for your medical care in case you cannot speak for yourself. You can write what kind of treatment you want if you are sick, and how long you want to get care. You do not need an advance directive to get medical care, and you can cancel it at any time.
In Michigan, there are two kinds of advance directives for healthcare: a designation of patient advocate (DPA) and a psychiatric advance directive (PAD). Both are also known as a durable power of attorney for healthcare.
Other states have different names for their advance directives and different laws. Those advance directives may or may not be valid in Michigan.
What is a Designation of Patient Advocate (DPA)?
This is something you write that describes the kind of health care you want.In a DPA, you give another person the power to speak for you if you cannot speak for yourself. This person is your Patient Advocate. If two (2) medical people think you cannot make medical decisions yourself, your Patient Advocate can tell the doctor what you would want.
You can have more than one Patient Advocate. The other one would be in case your first Patient Advocate cannot act for you.
You can cancel your DPA at any time. All you need to do is say you cancel it. It's best to put something in writing, so there is no confusion, but it is not required. If you gave copies to anyone, let them know that you canceled it.
What is aPsychiatric Advance Directive (PAD)?
People with mental health issues sometimes go into crisis. Ifyou do, you often lose the right to make decisions about yourown treatment. If you are in court and might be committed, the law says the court must try to make an order for treatment as close as possible to your wishes.
A PAD is much like a DPA, except that it is for mental health treatment. You appoint someone else to make decisions for you about your mental health treatment if you lose the ability to do so. In a PAD,you can write what medications you want to take, where you want treatment, or if you want a certain kind of treatment. Some people even give their Patient Advocate the right to put them into a hospital for up to 30 days. If two doctors decide that you cannot make decisions for yourself, then your Patient Advocatecan agree to or refuse treatment for you.
You can cancel your PADthe same way you would cancel a DPA, with one difference.If you gave your Patient Advocate the right to put you in the hospital for up to 30 days, you can still cancel your PAD, but it will take 30 days. Even if you are on a court order for treatment, you can still cancel it.
How do you create a Designation of Patient Advocate or Psychiatric Advance Directive?
There is no special form. The law just requires:
1. You must be at least 18 and "of sound mind" to write one. A person with a guardian cannot write an advance directive.
2. There must be a written document with information about what powers you give your Patient Advocate.
3. It must have your signature and date.
4. It must have the signatures of two (2) witnesses who are not providers or family.
5. The people you want to be your Patient Advocate(s)must agree in writing to do this.
Make plenty of copies. Give them to your Patient Advocate(s), your doctors and keep a few for yourself.
If you want, you can also store it with Michigan's registry. You can call
1-800-482-4881 to get more information, or go online to If you change your directive later, you will need to remember to change it at this registry too.
For more information and forms you can use, go to:
Michigan's Advance Directive Registry
Michigan Legal Aid
National Hospice and Palliative Care Organization
Michigan Department of Community Health (Psychiatric Advance Directives only)
National Resource Center on Psychiatric Advance Directives
reviewed 3/2015
1