The records of the Michigan Medical Self-Determination Association are comprised of material documenting its eight-year history from 1984 to 1992. The collection will interest researchers examining the role of citizen groups in securing living will legislation during a nationwide medical advance directive movement. It also depicts the role such groups often play in drawing attention to legislative issues, garnering support, and influencing legislative activity.
A small, wholly volunteer organization, MMSA's energies were focused more on outreach and projects related to its purposes than on maintaining documentation of its efforts. Thus, the material is limited in scope and content.
There are three small series in the collection: Board of Directors, Educational/Outreach Activity, Legislative/ Lobbying Activity.
Originally the Living Will Association of Washtenaw County (LAW), the Michigan Medical Self-Determination Association (MMSA), was established by Miriam Samson as an advocacy organization for the rights of terminally-ill patients. Rep. David Hollister addressed the first informal meeting on October 25, 1983, and on October 19, 1984, the official organizing meeting of the Association was held. According to adopted bylaws, its purposes were "To inform and educate the general public, legal and medical professionals, and others in related fields on the problems and needs of all persons involved in the dying process and death; to support judicial and legislative action involved in the dying process and death; to support judicial and legislative action concerning the right to die with dignity; and to distribute literature that furnishes information on the individual's right to die with dignity." Throughout its eight-year history, MMSA focused on legislative and educational activities geared toward these purposes, becoming the largest organization of its kind in the state.
The living will, a document in which a person, in the event of incapacitation, expresses in advance his or her wishes concerning the use of medical measures to prolong life, was first legalized in California in 1976. In ensuing years, a number of states passed similar measures. LAW kept in close contact with Michigan state legislators, particularly Rep. David Hollister and Rep. Perry Bullard, each of whom had worked for many years to pass living will legislation in the state. By 1984, when the organization was established, twenty states had enacted legislation and during 1985 and 1986, sixteen more followed. LAW monitored activity in other states, held periodic public meetings, published a newsletter, and managed a speaker's bureau. An all-volunteer association, its only income came from donations and a one-time membership fee of $15. It offered living wills upon request at no charge, processing requests from all over the United States.
In 1987, LAW sent out hundreds of letters to voters urging them to contact legislators in support of Rep. Bullard's House Bill 4176, "The Michigan Medical Self-Determination Act," written to establish the right of individuals to specify wishes regarding medical treatment through a legal living will. The same campaign supported Rep. Hollister's House Bill 4647, written to establish the legality of appointing a durable power of attorney for care, custody, and medical treatment decisions. The organization targeted and contacted undecided legislators throughout Michigan. In 1987, LAW elected to change its name to Michigan Medical Self-Determination Association (MMSA), reflecting its interest in outreach to the entire state and its support for House Bills 4176 and 4647. Both bills were receiving strong opposition at the time, particularly from Right to Life organizations.
In August of 1990, the United States Supreme Court in the case of Nancy Cruzan, upheld the right of the State of Missouri to demand "clear and convincing evidence" of the wishes of an incompetent person before life-sustaining treatment is withdrawn, agreeing that such evidence was lacking in the case. In reaction to the Cruzan ruling, MMSA responded to over 2,000 requests for living wills. In the same year, it published and distributed to 200 hospitals "Proposed Guidelines on Foregoing Life-Sustaining Treatment."
Federal legislation took effect in the fall of 1991 requiring hospitals and nursing homes participating in Medicare or Medicaid to inform patients whether their state allowed them to refuse treatment prolonging their lives if they became incapacitated. The measure, "The Patient Self-Determination Act", allowed for a signed advance directive in the form of a living will or the designation of someone to make health care decisions when the patient could not. Michigan was one of seven states at the time of passage without legislation, although efforts had been ongoing for more than fifteen years.
In December of 1990, Governor James J. Blanchard signed into law Rep. David Hollister's bill legalizing a durable power of attorney for health care decisions. While still believing in the need for continuing education and further living will legislation, MMSA elected to dissolve in 1992, citing that it had achieved its purposes in educating the public about living wills, durable power of attorney, and advance medical directives. Among the individuals active in the organization were Miriam Samson (President, 1984-1990), Jenny Bates, Dr. Ronald Bishop, Rev. Richard Weeden, and Ingrid Deininger.
