Judge Declares Pregnancy Clause in Advance Care Law Unconstitutional
Lansing — A Michigan judge has struck down a provision of state law that prevents patient advocates from carrying out end-of-life directives for pregnant women, ruling that it violates women's reproductive freedom rights.
Court of Claims Judge Sima Patel issued the decision Thursday after a lawsuit challenging the Estates and Protected Individuals Code (EPIC). The law prohibits a patient advocate from withholding or withdrawing life-sustaining treatment if the patient is pregnant.
"The court concludes that the personal decision whether to forego 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 wrote.
The lawsuit was filed by physicians and patient advocates against Attorney General Dana Nessel, Secretary of State Jocelyn Benson, Gov. Gretchen Whitmer and Department of Health and Human Services officials. The defendants agreed to stipulate that the provisions were unconstitutional but argued they would not enforce them.
"No one should feel disempowered in healthcare decisions as consequential as those surrounding birth and death," said Jess Pezley, a senior staff attorney for Compassion & Choices, which helped bring the lawsuit. "The court's decision is a win for patient-directed care, rightly recognizing that individuals and their loved ones hold the power to make these deeply personal end-of-life decisions."
Genevieve Marnon, legislative director for Right to Life of Michigan, called the ruling narrow while noting it reflects the broad impact of Proposal 3 passed in 2022.
"I'm optimistic the patient advocate will still be able to exercise medical judgment based on the facts at hand at the time," Marnon said.
Patel ruled that the law creates uncertainty for healthcare providers and patients because it "overrides the decision of a pregnant patient who has executed a valid patient advocate designation expressing their decision to refuse life-sustaining treatment."
The court found the provisions "deny, burden, and infringe" on individual rights by preventing capable individuals from making informed advanced healthcare decisions.
"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," Patel wrote, noting that hospitals remain bound to follow the law even if officials say they won't enforce it.