Patients, Doctors Challenge Michigan's ‘Pregnancy Exclusion' Law In End-Of-Life Care

Michigan Advance

October 24, 2025

A group of patients, doctors and advocates are suing Gov. Gretchen Whitmer in the Michigan Court of Claims to argue for the unconstitutionality of a so-called “Pregnancy Exclusion” in state law that determines a person’s right to choose their end-of-life care.

The lawsuit specifically concerns the Michigan Estates and Protected Individuals Code, which dictates the process for designating a patient advocate, who can determine a person’s medical care if they are not able to do so themselves. However, pregnancy creates an exception to this.

“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 reads.

Filed on Thursday, the lawsuit alleges that the statute is a violation of due process rights and of equal protection for pregnant people, as well as freedom of speech rights.

The lawsuit, filed by Compassion Legal: The End-of-Life Justice Center at Compassion & Choices; If/When/How: Lawyering for Reproductive Justice; Perkins Coie LLP; and Mogill & Lemanski, PLLC, also argues that this goes against Michigan’s constitutional protections for reproductive freedom, which includes “the right to make and effectuate decisions about all matters relating to pregnancy.”

“Denying individuals the right to refuse treatment because they are pregnant is fundamentally at odds with the Michigan Constitution,” said Jess Pezley, senior staff attorney at Compassion Legal, in a press release.

Stacey LaRouche, a press secretary for Whitmer, wrote to the Advance in response to the suit, “Governor Whitmer has been a champion for reproductive freedom, and led the fight to protect and expand our rights following the repeal of Roe v. Wade, when other states did nothing. We cannot comment on pending litigation, but will be following this closely.”

Dr. Viktoria Koskenoja, an Emergency Medicine Physician in Skandia, Mich., and her husband, Sam Holcomb, are both plaintiffs in the case. Koskenoja designated Holcomb as her patient advocate, should she ever not be capable of making her own medical decisions — and included directions around potential pregnancy in her guidance to him.

“I made the decision to include them anyway because I felt so strongly that my ability to control my own medical care shouldn’t depend on my pregnancy status,” she said in the press release, despite her lawyer encouraging her not to.

“When I agreed to become my wife’s patient advocate, I made a commitment to speak for her if she could not speak for herself, and honor her most personal decisions,” Holcomb added.

The lawsuit has been assigned to Michigan Court of Claims Judge Sima Patel, who earlier this year struck down Michigan’s mandatory 24-hour waiting period for receiving abortions.

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