Mich. Comp. Laws Ann. § 700.5508 - Determination of advocate's authority to act

A patient advocate may only make decisions on behalf of the patient when a physician or psychologist determines that the patient is “unable to participate in medical treatment or…mental health treatment decisions.” A physician or psychologist must place a written summary of such a determination in the patient’s medical record and must review this determination “not less than annually.”

A patient’s advocate designation must contain a procedure for determining the patient’s ability to participate in medical treatment or mental health decisions if their religious beliefs will prevent a physician or psychologist from conducting an evaluation of their competency.

If a dispute occurs regarding a patient’s ability to make medical decisions, a party may file a petition in court in order to obtain a judicial determination. Within 7 days of receiving a petition, a court will appoint a “guardian ad litem” to represent the patient and conduct a hearing.  The court must make a determination of the patient’s ability within 7 days of the hearing. If the court determines that the patient is not capable of making decisions, then the patient advocate will have full authority to act on their behalf.

A patient advocate may authorize organ donation so long as the advocate complies with relevant organ donation laws and a physician or psychologist has determined the patient is incapable of making decisions or a physician has declared the patient dead.