This information is approved and/or reviewed by U-M Health System providers but it is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition.
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Advance Directives/Living
Wills
Translated
versions are available from Interpreter Services
As a competent adult, you have the right to decide to accept or refuse
any medical treatment. "Competent" means you understand your
condition and the results your decision may have. As long as you are competent,
you are the only person who can decide what medical treatment you want and do not want to receive. Your doctors will give you information
and advice about the pros and cons of different kinds of treatment, but
only you can choose whether to say "yes" or "no".
You can say "no" even if the treatment you refuse might keep
you alive longer and even if your doctor or your family wants you to have
it.
Someday, you may
become too sick to make your own decisions about your medical care. If
that happens, then decisions will have to be made for you. If you have
not given any instructions, no one will know what you would have decided.
Following are answers to several commonly asked questions about advance directives which we hope will help you to understand your rights.
What is an advance directive?
Advance directives are documents signed by a competent person giving direction to health care providers about treatment choices in certain circumstances. There are two types of advance directives. A durable power of attorney for health care ("durable power") allows you to name a "patient advocate" to act for you and carry out your wishes. A living will allows you to state your wishes in writing, but does not name a patient advocate.
Why have an advance directive?
Many people have strong feelings about the kind of medical care they would like to receive or refuse in certain circumstances. An advance directive allows you to clearly state your feelings.
What decisions should I consider?
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Who would you like to make treatment decisions for you, if you become unable to so?
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How do you feel about ventilators, surgery, resuscitation (CPR), drugs or tube feeding if you were to become terminally ill? If you were unconscious and not likely to wake up? If you were senile?
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What kind of medical treatment would you want if you had a severe stroke or other medical condition that made you dependant on others for all your care?
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What sort of mental, physical, or social abilities are important for you to enjoy living?
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Do you want to receive every treatment your care-givers recommend?
What is a Durable Power of Attorney for health care?
It is a legal document that allows you to name anyone at least eighteen years old to be your advocate and make health care decisions for you. You can pick a family member, friend or any other person you trust, but be sure the person you choose is willing to serve. A durable power can be used to accept or refuse any treatment. If you want your patient advocate to be able to refuse any treatment and let you die, you must say so specifically in the durable power document. A durable power goes into effect only when you are not able to make decisions for yourself.
Must I have a Durable Power of Attorney for Health Care?
No. You have this option, but no one can require you to have a durable power. You can make your wishes known by talking with your family or doctor or by writing them down, but unless you have a durable power, a patient advocate does not have legal authority to act for you.
Must I give written instructions about my treatment?
No. You can simply name a patient advocate. But, remember that your advocate can only have life-sustaining care stopped if you say so in your durable power. It is probably better to have written instructions because then everyone can read them and understand your wishes. If you do not want to name an advocate, you can write a "living will" stating your choices. Even though there is not a Living Will law in Michigan, courts and health care providers still find these documents useful because they show your choices for care. Or, you can simply make sure your family and care-givers know what you want if you were to get sick. It is important for hospitals to understand your wishes. Writing them down makes it clear what you want.
Must I make decisions now about my future medical treatment?
No. You do not have to have a durable power or living will and you do not have to tell anyone your wishes. You can still make treatment choices while you you are competent. If you are no longer competent, but you have made sure your family and care-givers know what you would want, it will be easier to follow your wishes. If you have not made your wishes known to famiy and care-givers, a court may have to name a guardian to make decisions for you.
What should I do if I want an advance directive?
You can obtain sample forms from the Admitting Office, or the Patient Services Office at the University of Michigan Health System. Forms are also available from the State Bar of Michigan, the Michigan State Medical Society, your state representative and senior citizen groups. Sample forms are available:
Durable Power of Attorney for Health Care Form
Legal advice is not required, but if you wish, your attorney can also help you prepare a document. You should talk to the person you have chosen to make sure that individual understands your wishes and is willing to act as your advocate. We also urge you to discuss your wishes with your family, friends, and health care team. By law, your family, physicians and employees of your health care facility are not allowed to be a witnesses for a document.
If I write an advance directive, can I change my mind later?
Yes. You can change the document at any time. It is a good idea to review your advance directive each year to be sure it still says how you want to be treated and names an advocate you trust.
At the University of Michigan Health System...
Our hospital policies
provide that only the competent patient, not friends or family,
can make health care decisions. If you are not able to make decisions,
we first seek instructions from the patient advocate named in your durable
power. If there is no durable power, we are guided by your living will.
If you have not written an advance directive, we try to determine your
wishes by reviewing any statements, oral or written, you have made. We
have discussions with your family about what your wishes would be and
how best to fulfill them. If we are sure about what you would want, we
attempt to follow your wishes. If we do not know or are not sure about
what you want, or if there is a disagreement about whether to treat you
or not, we will continue to provide care, although we may have to ask
a court to appoint a guardian to make decisions for you. We want to understand
and carry out your choices for health care.
Treatment decisions are difficult. We encourage you to think about your wishes in advance, discuss your options with your family, friends, and health care professionals, and make plans for your future health care needs.
Last updated March 2005