Alaska Living Will Requirements

Alaska does not have a legally separate living-will statute. AS 13.52 (the Health Care Decisions Act) defines one umbrella term, the advance health care directive, as either an individual instruction (treatment wishes), a durable power of attorney for health care (agent designation), or both together in the same writing.

AS 13.52.010(a) lets an adult give an individual instruction, oral or written. AS 13.52.100 confirms the chapter does not affect a capable person's own right to make health care decisions and presumes capacity. Alaska's general age-of-majority statute, AS 25.20.010, sets adulthood at 18.

This witness rule applies only to the durable-power-of-attorney-for-health-care component, not to a stand-alone individual instruction, which needs no witness at all under AS 13.52.010(a). Where witnesses are used, a witness may not be the principal's designated agent, a health care provider employed at the principal's care institution, or an employee of that provider or institution. Only ONE of the two witnesses, not both, must additionally be unrelated to the principal by blood, marriage, or adoption and not entitled to any part of the principal's estate.

As an alternative to two witnesses, the durable power of attorney for health care may be acknowledged before a notary public at a place in Alaska. This is an in-state location requirement, not a generic notary option. It applies to the agent-designation component; a stand-alone individual instruction needs neither witnesses nor a notary.

Subsection (b), not (a), authorizes a durable power of attorney for health care, letting you name an agent to make health care decisions if you lack capacity. That is a separate function from the living-will treatment-wishes instruction covered on this page: naming an agent gives someone else decision-making authority, rather than stating your own wishes directly. For full agent-designation guidance, see Alaska Healthcare Power of Attorney.

A durable power of attorney for health care may authorize an agent to make any health care decision the principal could have made with capacity, and the optional statutory form's Part 1(2) gives a specific line for the principal to state limits on that authority.

AS 13.52.055(b) is a mandatory override: a directive or decision to withhold or withdraw life-sustaining procedures may not be given effect if the patient is a pregnant woman who lacks capacity, the withdrawal would likely cause death, and the fetus could probably develop to live birth if treatment continued. All four conditions must be met, and the rule can override the patient's own written wishes.

Treatment instructions may be revoked at any time, in any manner communicating intent to revoke (subsection (b)). Revoking an agent's designation requires a signed writing or personally informing the supervising provider (subsection (a)), a stricter standard. Directives related to mental illness follow their own rule keyed to a specific competency finding (subsection (c)). A divorce, annulment, dissolution, or legal separation automatically revokes a spouse named as agent unless stated otherwise (subsection (e)), and a later conflicting directive revokes an earlier one to the extent of the conflict (subsection (f)).

Part 4 of Alaska's optional statutory form lets a person state advance wishes about psychotropic medications, electroconvulsive treatment, and admission to a mental health facility. Admission consented to by an agent or surrogate under this authority is capped at no more than 17 days (AS 13.52.120(f)). Revocation of a directive addressing mental illness follows its own competency-based rule (AS 13.52.020(c)), separate from the chapter's general revocation standard.

Federal HIPAA regulations (45 CFR Section 164.508) govern how your health care agent can be authorized to access your protected health information once the agent-designation portion of your directive is in effect. This authorization supports the agent-decision-maker half of your directive; it does not change or expand your own treatment-wishes instructions.

Federal law requires Medicare- and Medicaid-participating hospitals, skilled nursing facilities, home health agencies, and hospice programs to maintain written policies informing patients of their rights under Alaska law to make health care decisions, including refusing treatment and formulating an advance health care directive.

Federal Medicare and Medicaid conditions of participation at 42 CFR Section 489.102 require participating facilities to provide written information about advance directive rights and to document in the medical record whether a patient has executed one, applicable regardless of state.

Naming a first and second alternate agent is a feature of Alaska's optional statutory form (Part 1(1)). Separately, if a person has no agent, guardian, or named surrogate available, AS 13.52.030(c) sets a default priority order of family members who may act as surrogate: spouse, then adult child, then parent, then adult sibling.

Subsection (j), not (a), lets a written advance health care directive include the individual's nomination of a guardian of the person, which a court may consider if guardianship proceedings become necessary.

Alaska defines a fixed, two-condition 'qualifying condition' directly by statute: a terminal condition or permanent unconsciousness, each with its own multi-part conjunctive definition. A terminal condition is an incurable or irreversible illness that will cause death in a short time without life-sustaining procedures, has no reasonable prospect of recovery, imposes severe pain or an inhumane burden, and offers only minimal medical benefit from continued treatment. Permanent unconsciousness requires a high degree of medical certainty that the condition is permanent, that thought and awareness are absent, and that continued treatment offers only minimal medical benefit. The optional statutory form's end-of-life choice tracks these two conditions directly.

Artificial nutrition and hydration, defined by statute as nutrition or hydration delivered intravenously or through a feeding tube, is its own dedicated, separately-marked choice on Alaska's optional statutory form, distinct from the general life-sustaining-treatment choice. You may elect to receive it indefinitely, receive it unless it clearly increases suffering, receive it on a limited trial basis, or decline it consistent with your general treatment choice.

The current anatomical-gift provisions, beginning at AS 13.52.173, let a donor, an agent (unless restricted by the durable power of attorney), a parent of an unemancipated minor, a guardian, or a surrogate make an anatomical gift before death for transplantation, therapy, research, or education. Alaska's optional AS 13.52.300 form includes its own dedicated Part 3 for anatomical gifts.

An advance health care directive validly made under another state's law, or under Alaska's own law, is valid in Alaska regardless of where or when it was executed or communicated.

A health care provider or institution that intentionally violates the Health Care Decisions Act is liable for $10,000 or actual damages, whichever is greater, plus attorney fees. The same statutory damages apply to anyone who intentionally falsifies, forges, conceals, defaces, or destroys a person's advance health care directive or its revocation without consent, or who coerces or fraudulently induces someone to give, revoke, or withhold a directive.