Default Health-Care Surrogate Priority in Alaska

At a glance

Requirements one by one

When the default route opens

The primary physician must determine that an adult lacks capacity, and no appointed agent or guardian may be reasonably available (§ 13.52.030(a)). Capacity is rebuttably presumed (§ 13.52.100(b)). For an emergency mental-health treatment decision, § 13.52.030(b) instead requires a determination by two physicians, one a psychiatrist, or a physician and a professional mental-health clinician.

Family and other eligible people

An adult may identify an individual as surrogate by personally informing the supervising provider (§ 13.52.030(c)). If no such person is reasonably available, the statute ranks a spouse who is not legally separated, adult child, parent and adult sibling. If none is available, an adult who has shown special care and concern, knows the patient's values and is reasonably available may act (§ 13.52.030(d)).

Decision within one class

If multiple adult children, parents or siblings assume authority and disagree, the provider follows the majority of that class who communicated views. On an informed even split, that class and lower-priority people cannot decide; the primary physician consults the reasonably available members of the divided class and makes a best-interest decision (§ 13.52.030(f)).

Who is available and eligible

The patient may disqualify a potential surrogate by signed writing or by personally informing the supervising provider (§ 13.52.030(j)). An unrelated owner, operator or employee of the treating facility cannot serve, and the provider may demand a declaration under penalty of perjury to establish claimed authority (§ 13.52.030(k)–(l)).

Decisions limited or excluded

The surrogate follows individual instructions and known wishes, otherwise the patient's best interest and values (§ 13.52.030(g)). Under § 13.52.040(b), an agent decision prevails over a guardian absent contrary court order. Under § 13.52.045, withdrawal of life-sustaining procedures requires the statute's writing or qualifying-condition/best-interest route; § 13.52.160 requires the primary physician and an available second physician to determine a qualifying condition. Under § 13.52.050, Alaska restricts abortion, sterilization, psychosurgery and organ removal without contrary written direction, except to preserve life or prevent serious health impairment. Under § 13.52.055(b), the law limits life-sustaining withdrawal during certain pregnancies.

No surrogate or disputed authority

A surrogate decision ordinarily works without judicial approval (§ 13.52.030(i)). The primary-physician tie rule in § 13.52.030(f) resolves an even family split. The superior court may direct or enjoin a health-care decision or grant other equitable relief on petition by the listed patient, decision-maker or care provider (§ 13.52.140).

What trips people up

The patient’s personal oral designation comes before the family list; it is not confined to a spouse or child (§ 13.52.030(c)). An emergency mental-health decision also needs the separate two-clinician finding, even if a surrogate is otherwise eligible (§ 13.52.030(b)).

Common questions

Can a close friend decide?

Yes, either if the patient personally designated the friend or if nobody in the listed classes is reasonably available and the friend meets the special-care and values test (§ 13.52.030(c)–(d)).

Can a lower-priority sibling break a tie between adult children?

No. On an informed even split, the physician consults the divided class and decides by best interest; lower classes are disqualified from that decision (§ 13.52.030(f)).

Statutes and sources

• Alaska Stat. §§ 13.52.030, .040, .045, .050, .055, .100, .140 and .160 — current official section pages linked and quoted above, accessed 2026-10-08.