LANSING, Mich. (Michigan News Source) – A Michigan judge has struck down decades-old provisions that blocked patient advocates for pregnant women from carrying out end-of-life directives, ruling it violates the state’s constitutional right to reproductive freedom.
Court of Claims Judge Sima Patel, who was appointed by Democratic Michigan Governor Gretchen Whitmer in 2022, declared key portions of the Estates and Protected Individuals Code (EPIC) unconstitutional, saying the law improperly overrides a patient’s wishes simply because she is pregnant.
In her decision issued on April 16, Patel said, “The Court concludes that the personal decision whether to forego (sic) life-extending care in the face of an incapacitating condition and to designate a patient advocate to protect one’s wishes in this regard while incapacitated, even if pregnant, is a fundamental right to make and effectuate a decision related to pregnancy.”
Patel’s ruling relied on stipulations jointly agreed upon by state officials and the physicians and patient advocates who filed the lawsuit in October 2025 against Michigan Governor Whitmer, Secretary of State Jocelyn Benson, Attorney General Dana Nessel, Department of Health and Human Services Director Elizabeth Hertel and Michigan Department. of Licensing and Regulatory Affairs Director Marlon Brown.
When advance directives hit a legal wall.
The now-invalidated provisions struck down prevented a designated patient advocate from withdrawing life-sustaining treatment if it would result in the death of a pregnant patient – even if that was the patient’s clearly stated wish in their advance directive. With that restriction now removed, such decisions may proceed even if ending life-sustaining care also results in the death of the unborn child.
Patel found that the EPIC statute created unequal treatment, leaving pregnant patients unable to plan their end-of-life care the same way as others and injecting uncertainty for families and doctors.
Proposal 3’s long reach.
The ruling leans heavily on Michigan’s 2022 constitutional amendment guaranteeing reproductive freedom, which the court said includes decisions about medical care during pregnancy – even at the end of life. Genevieve Marnon, legislative director for Right to Life of Michigan, told Detroit News that the original law has rarely, if ever, used over the years and that the judge’s decision is an example of the “long reach of Proposal 3” which enshrined abortion rights and broader reproductive decision-making into the state constitution.
The bottom line.
While Democratic officials declined to defend the law and agreed it was unconstitutional, the court still issued a formal ruling, noting future leaders could try to enforce it saying, “There is no promise that the newly installed government officials will agree with the current defendants’ position and could insist on the enforcement of the challenged statutory provisions. Further, as long as the challenged provisions remain within the statutes, hospitals are bound to follow them. These are real harms that will impact patients and their designated patient advocates. Accordingly, the Court finds an actual case and controversy permitting the Court’s action.”
