Advance Directive Pregnancy Exclusions Struck in Michigan

Like dozens of other states, Michigan limits the effects of an advance directive when the patient is pregnant.  

• MCL 700.5507(5)(3) (“This patient advocate designation cannot be used to make a medical treatment decision to withhold or withdraw treatment from a patient who is pregnant that would result in the pregnant patient’s death.”)
• MCL 700.5509(l)(d) (“The designation cannot be used to make a medical treatment decision to withhold or withdraw treatment from a patient who is pregnant that would result in the pregnant patient’s death.”)
• MCL 700.5512(1) (“A patient advocate cannot make a medical treatment decision ... to withhold or withdraw treatment from a pregnant patient that would result in the pregnant patient’s death.”).

But on April 16, 2026 (coincidentally National Healthcare Decisions Day), the Michigan Court of Claims ruled that all pregnancy-related exclusions are unconstitutional and invalid. The Court directed they be struck and given no force or effect. Koskenoja v. Whitmer, No. 25-000165-MM (Mich. Ct. Claims 2026).

Judge Sima Patel