As an attorney in the Estate Planning group, my job requires me to think about the "worst case scenario" from all angles. For example, what happens if you are injured to the point of being unable to make your own medical decisions, and are not married but have a significant other in your life that you have been with for a substantial amount of time – who gets to make medical decision for you? In most states, it is not that significant other (most name a spouse first, without language for a life partner or significant other). If you want control over who makes decisions for you when you are unable to make them for yourself (and who can get information about your health condition), put it in writing.
HIPAA (the Health Insurance Portability and Accountability Act) restricts who your health care provider can disclose certain information about your health and demographics to; in some cases this could mean that if you are not married, a hospital may withhold information about your health to anyone but close relatives (i.e. you are injured while skiing with friends in Colorado, all your family lives out of state, doctors can only tell your friends that you're alive until they are able to get in touch with a relative – this "worst case" scenario is a true story that happened to a friend mine while we all waited in the surgical ICU). However, HIPAA just states who can get information, not who can make decisions. If you are unable to make medical care decision on your own, the decision making can only be done for you by certain individuals (Continuing on with my story, if your parents are on their way to Colorado to help you but neither one has a cell phone and you suddenly slip into a coma and care decisions need to be made - no one can make decisions for you until your parents are reached again).
Forty states have laws directing who can make those decisions for you, or how to determine who can make those decisions for you. In most cases, for adults, the spouse is named first, followed by your children, then your parents, then your more distant relatives. Some states will eventually allow a friend, partner, or significant other to make these decisions for you, but many do not (Michigan does not specifically state that a significant other or unrelated party can act, they would have to be court appointed). In some states, if you do not have a spouse, children or parents to act for you, a guardian ad litem will have to be named through the court.
The good news is that this is an easy fix. Almost every state, including Michigan, will honor who you name in writing as your patient advocate (a.k.a. health care proxy, agent, etc.), so it is best to have your advance health care directives in place. Most states simply require that the person named be over 18, competent, and agree to take on this role. Through a Designation of Patient Advocate and Living Will, you can name specific persons to get information about your current health condition, you can name a specific person to act on your behalf when you are unable, and even go so far as to state what your specific wishes regarding treatment are. The best and most effective way to do this is to call an attorney to ensure that the document complies with your state's specific laws.
(Editor's Note: Attorney Jessica DesNoyers authored this post while working in Varnum's Grand Haven office. Jessica is currently with another firm.)