Michigan law states that adults have the right to accept or refuse any medical treatment, as long as they are "competent," or able to understand the condition and treatment. This means you have the right to decide whether to accept or reject any treatment.

If you become unable to make medical decisions, somebody else must do it for you, and that can be either a member of your family or the courts. This means that someone else may be put in the position of making a decision for you that you might not have wanted. In order to avoid that situation, the law allows you to plan ahead and make advance directives. An advance directive is a set of instructions for medical treatment that is used if you become unable to make medical decisions. HMOs, doctors and hospitals are required to tell you about them.

You name someone to make decisions for you by completing either a Durable Power of Attorney for health care or a Patient Advocate Designation form. The forms can be picked up from many sources: hospitals, nursing homes, lawyers, etc. You should pick the form that best suits you, because all forms are not the same.

The person you name as your patient advocate can be anyone you choose, as long as he or she is at least 18 years old. Because the responsibility is a serious one, it is a good idea to have the designated person sign an acceptance form, and also to name a second choice.

Once you have named your patient advocate, two neutral persons must witness the form being signed. The witnesses cannot be someone who might stand to gain from your death. Therefore, most family members, heirs and people named in the will cannot be a witness, nor can employees of the health care provider or insurance carrier.

Instructions for the patient advocate do not need to be written. By naming an advocate, you give full authority concerning medical decisions you want them to make, with one exception: If you want the advocate to have the authority to withdraw or refuse life support, that directive must be put into writing. If there are special instructions you would like followed, they too should be written.

You can change these instructions at any time; the advocate can be changed, or the entire designation canceled. You are not required by law to have an advance directive and a health care provider cannot refuse to treat you because you do not have a Patient Advocate Designation. It is simply a security measure to ensure that your wishes are carried out should you become unable to make medical decisions.

To receive a copy of the Patient Advocate Designation form for a nominal fee, please contact the Michigan State Medical Society at 517.336.5769. Completed forms may be faxed to the Michigan State Medical Society at 517.336.5797. For additional assistance, contact your health care provider, an attorney or the Michigan Hospital Association at 517.323.3443. You also may visit the State Bar of Michigan Web site for more information and free sample forms.