Before you sit down to draft your health care directive you need to take a few minutes to think about how you would like some common end-of-life medical decisions to be handled. Some examples of questions that often arise when a terminally ill patient is unresponsive include:

• When cardiopulmonary resuscitation (CPR) should be administered
• Taking liquid and foods through either feeding tubes or intravenously
• Mechanical ventilation if you are unable to breathe on your own
• Whether you should receive antibiotics or other medications
• End-of-life care (palliative care) choices about things like pain management, invasive treatments, and wanting to die at home
• Whether you would like to donate your organs, tissue, or body

There is no requirement that all—or any—of those situations be directly addressed in your health care directive. You can address those issues with blanket statements either rejecting or requesting the medical treatments that would prolong your life.

A durable power of attorney for health care lets you designate another person to make decisions regarding your medical treatment if you are unable to do so yourself. Someone with durable power of attorney for health care is sometimes called a “patient advocate” or “health care proxy.” You can also empower someone with health care power of attorney to make decisions regarding your mental health care and organ donation.

Someone with durable power of attorney is only allowed to make medical decisions on your behalf if you become unable to communicate your wishes regarding treatment. That incapacity could either be temporary, such as if you are badly injured in an accident, or if you have been rendered permanently unable to communicate.

The types of decisions that someone with health care power of attorney is usually allowed to make on your behalf include:

• What medical care you should receive
• The hospital or other facility where you are treated
• Which doctors and medical professionals will provide your treatment
• Whether you should be moved to a nursing home or other long-term care facility

Whether you choose to do it yourself, hire an attorney, or use a safe and easy service like FindLaw’s, the language you use in your health care directive is vital. It must be both specific enough that your loved ones and doctors understand your intentions, but general enough that it will apply to a broad range of situations. Many health care directives simply list common end-of-life medical treatments and whether you find them acceptable.

However, Michigan allows you to use general terms to express your wishes when it comes to your medical care after a doctor has declared you to be terminally ill and permanently unconscious. For example, you could simply state that you authorize any and all measures be taken that to prolong your life. Likewise, you can say you only want treatment that will make you comfortable.

There are no statutes in Michigan that specifically address health care directives. That means there are no state requirements that your health care directive be witnessed or notarized to be valid. And while there are several state court decisions which have found them to be legally binding, your health care directive is more likely to be upheld by the courts if it has been witnessed and notarized.

You should also discuss your health care directive with your family and doctors so that they are aware of your wishes. Those discussions will also help avoid future disputes over your intentions with regard to end-of-life care.

As a general rule, the more people who know of your health care directive, the better. You want anyone who will have a say in your medical care to have a copy they can refer to in case of an emergency. That means you should give copies to all of your doctors and any hospitals where you might receive treatment. If you have given someone health care power of attorney then they should receive a copy as well as your family members. Finally, it is generally recommended that you keep a copy of your health care directive with your other estate planning documents.