Court of Claims strikes down Michigan’s ‘pregnancy exclusion’ in end-of-life care

The Michigan Court of Claims struck down multiple provisions of the state’s Estates and Protected Individuals Code that were collectively considered the “pregnancy exclusion” — portions of the law that limited the decisions for end-of-life care that could be made on behalf of a pregnant individual. 

Michigan Court of Claims Judge Sima Patel, who struck down Michigan’s mandatory 24-hour waiting period for receiving abortions in 2025, wrote in a judgment released on Thursday that the provisions in question “infringe the fundamental right to reproductive freedom,” as was enshrined in the Michigan Constitution in 2022. 

“These provisions do not protect the health of an individual seeking care,” the decision read. “Rather, they prevent individuals who are capable of becoming pregnant of making autonomous decisions about the type of healthcare they will receive in the event they are incapacitated.”

Patel continued on to say that the provisions in question prevent a patient advocate — someone named by a patient to make medical decisions in the case that they are incapacitated — from making decisions in line with the care and custody desired by the patient, only if that patient is pregnant. 

“A patient advocate cannot make a medical treatment decision under [state law] to withhold or withdraw treatment from a pregnant patient that would result in the pregnant patient’s death,” the statute read prior to the court’s decision.

Patients, doctors challenge Michigan’s ‘pregnancy exclusion’ law in end-of-life care

During the lawsuit, the defendants — including Gov. Gretchen Whitmer, Attorney General Dana Nessel and Department of Health and Human Services Director Elizabeth Hertel — agreed with the facts brought by the group of patients, doctors and advocates, that the provisions in question were unconstitutional. 

However, they argued that their respective departments would simply not enforce those provisions, not requiring the court to get involved. Patel, however, disagreed with this, as there would be no guarantee that those elected and appointed to relevant government positions in 2026 and beyond would share the same interpretation.

“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 in her decision. “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.”