Durable Power Of Attorney For Health Care (Page 6 of 15) in pdf

SECTION III: DESIRES AND PREFERENCES FOR TREATMENT

This is the section of the document where you may state your desires regarding the care, custody,

and medical treatment you should or should not receive, and under what circumstances treatment should

be administered, continued, refused, or withdrawn. Here you may direct your treatment regarding

mechanical life-supports (like respirators or kidney dialysis), ordinary or routine treatments (simple

surgeries, use of antibiotics, insulin, heart or blood pressure medications, etc.), and basic care (including

the provision of food and water). As with the other sections of your durable power document, you may

attach additional pages if the space provided is inadequate.

MICHIGAN LAW DOES NOT REQUIRE THAT YOU FILL OUT THIS SECTION OR PROVIDE AN

ATTACHMENT ACCOMPLISHING THE SAME PURPOSE. The law stipulates that your advocate must act in

your best interests and that health care providers should only comply with your advocate’s direction if he or

she is reasonably believed to be acting within the authority granted in your designation of the patient

advocate. Thus, directions your advocate gives which are consistent with your statement in this section are

not likely to be questioned.

SECTION IV: SIGNATURE AND WITNESSING

Michigan law requires that before a patient advocate can execute any of his or her duties and re-

sponsibilities, he or she must sign an acceptance to the designation. The first provision of Section IV sim-

ply insures that you are aware that this designation must be signed before the power of attorney

be-

comes effective. It also will indicate whether the designation and acceptance process were completed at

one time.

Next, your signature is required. Finally, the requirements pertaining to the witnessing of the desig-

nation are contained within this section. Please note the limitations on who may serve as a witness.

SECTION V: ACCEPTANCE OF THE DESIGNATION

As noted above, the advocate whom you name must sign an acceptance of your appointment before

he or she can act on your behalf. Michigan law requires that certain information regarding the rights, au-

thorities, and limits related to durable power designations be contained within this acceptance. The accep-

tance provided in Section V of the form meets these requirements.

The name of the person you are appointing should appear in the first blank, and your name

(principal) should appear in the second blank. The third blank should contain the date on which you signed

your durable power document. The acceptance may be signed on the same day, or at a later time. Finally,

your advocate’s signature and the date of his or her signing are needed at the end of the acceptance.

Durable Power Of Attorney For Health Care Page 6