What Type Of Advance Directive Is The Better Fit For Me?

As an estate planning law firm, preparing advance directives is a regular part of the services we provide. However, we often run into confusion among clients as to what an advance directive is, and how it differs from a “living will,” a term with which many people are familiar. But the “advance directive vs. living will” debate is an unnecessary one, especially in Michigan.

An advance directive is a written document in which you can specify the types of medical care you do (or do not want) in the future, as well as designate a person you want to make medical decisions on your behalf if you become unable to make those decisions for yourself. “Advance directive” or “advance medical directive” is an umbrella term for a number of documents that fit that description, such as a patient advocate designation (PAD), a “Do Not Resuscitate” (DNR) declaration, or a living will.

Do I Need a Living Will in Michigan?

Based on the description above, you can see that the choice is not between an advance directive and a living will, because a living will is a type of advance directive. A better question is, do you need a living will?

A living will is an advance directive that tells your doctors, care providers, family members and others what type of medical care you want in the event that you become terminally ill or permanently unconscious. It is designed to take effect only after a doctor has determined you will not recover or regain consciousness and that you will not be able to communicate decisions regarding your care. You could be specific regarding types of procedures, like intubation or CPR, that you do or don’t want. Or you could be more general, stating that doctors should do everything possible to prolong your life, or should withhold treatment except for comfort care if there is no chance of recovery.

It sounds like an important document to have in place, doesn’t it? However, there is something of which you should be aware: Michigan is one of the very few states in which living wills are not legally binding. That’s right: no matter how specific your living will might be, under current Michigan law, your doctor and family are not required to abide by it.

So what should you do to ensure that your wishes about end-of-life medical care are not only known, but honored? The answer is straightforward: make use of other types of advance directives that are legally binding in Michigan.

Making Your Wishes Known with Advance Directives

The goal of advance health directives is to make sure that your wishes for your medical care are known and respected. Fortunately, you do not need a living will to achieve that goal. By putting in place other advance directives, you can communicate your preferences in a way that will be recognized by Michigan law.

The goal of advance health directives is to make sure that your wishes for your medical care are known and respected. Fortunately, you do not need a living will to achieve that goal. By putting in place other advance directives, you can communicate your preferences in a way that will be recognized by Michigan law.

One type of advance directive every Michigan resident should have is a patient advocate designation (PAD), also known as a healthcare power of attorney. A PAD enables you to designate a person—your patient advocate— to make medical decisions on your behalf if you are unable to do so. The inability to make medical decisions may be temporary, such as because you were knocked unconscious in an accident. Or it may be permanent, as in the case of dementia or a debilitating stroke.

You can give your patient advocate the authority to make whatever health care decisions you would make for yourself, including whether to submit to mental health treatment, have a particular surgery, or donate organs in the event of your death. It goes without saying that your patient advocate should be someone you would trust (literally) with your life. For most people, a spouse or other close family member is an ideal patient advocate.

There may be situations in which you would want to decline medical treatment, and a family member might find it difficult to do so on your behalf, especially if declining treatment would mean your death. For instance, if you were gravely ill in the hospital and went into cardiac arrest, your family member might authorize medical providers to “do everything possible” to save you. That would probably include cardiopulmonary resuscitation (CPR), which could restart your heart. However, CPR can also be painful and might not offer you additional quality of life.

If there are situations in which you would not want extraordinary measures used to save your life, you can relieve your loved ones of the burden of making that decision with a Do Not Resuscitate (DNR) declaration. A DNR can be placed in your medical file at your doctor’s office and at the hospital; your patient advocate should have a copy as well. A DNR instructs your medical providers that you do not want specific measures taken to save your life in certain circumstances.

Advance Directive vs. Living Will: Make Your Estate Plan Solid

By working with your estate planning attorney to identify and articulate your wishes for your medical care, including end-of-life care, you can create legally binding advance directives to meet your needs without a living will. To learn more, please contact our law office to schedule a consultation.