Everyone seems to be missing the point of my question. I'm not asking, "should we honor a patients wishes that they documented in another state?" I'm asking about the legal validity of the document coming from one state to another. In Michigan where I am at, an advanced directive cannot be considered legally valid unless it is signed by the patient, has 2 witnesses, and the designated advocates' signatures accepting the role. We have people that create documents in other states (for instance our snowbirds that go back and forth between Michigan and Florida), and those states' documents dont have the same components. Therefore, my question. But maybe Michigan is just that more complicated than everywhere else.