Living Will and Advance Health-Care Instruction Requirements in Alaska

At a glance

Alaska's Health Care Decisions Act, AS 13.52, calls the adult's own treatment direction an individual instruction. An instruction and a durable health-care power of attorney are both advance health care directives, but they have different creation rules. This page covers the instruction.

Requirements one by one

An individual instruction may be oral or written

Under § 13.52.010(a), an adult may give an instruction orally or in writing and may make it effective only if a specified condition arises. The instruction-only route does not require a signature, date, witnesses, a notary, or a statutory form.

The optional § 13.52.300 form is a combined document and tells the user to sign, date, and complete the agent-appointment execution block. But § 13.52.010(l) expressly preserves an individual instruction that is valid on its own even if the accompanying durable power of attorney fails the chapter's witnessing or other requirements. The two-witness-or-notary rule therefore belongs to the agent appointment, not to a standalone instruction.

The adult chooses the activating condition

Alaska imposes no universal incapacity, terminal-condition, or permanent- unconsciousness trigger. The adult may give a presently effective instruction or name the future condition that activates it (§ 13.52.010(a)).

Unless a written directive specifies another method, the primary physician determines lack or recovery of capacity and any other condition affecting the instruction. A court makes the determination in a mental-illness case unless it is an emergency; in an emergency, the primary physician or another provider does so (§ 13.52.010(g)).

The instruction may address any health-care decision

An individual instruction is a direction concerning the adult's own health-care decision. The statutory definition expressly includes providing, withholding, or withdrawing artificial nutrition and hydration when consistent with generally accepted standards (§ 13.52.390(18), (23)).

The optional form offers a prolong-life choice and a comfort-only choice tied to terminal condition or permanent unconsciousness. It separately offers four feeding-and-hydration approaches, a pain-relief choice, and space for custom instructions. Those form choices are examples, not the limits of the broader § 13.52.010(a) instruction.

What trips people up

• The pregnancy blank does not override the statute. Although the optional form invites a pregnancy instruction, § 13.52.055 prevents a contrary withholding or withdrawal instruction from taking effect when the patient is pregnant and lacks capacity, withdrawal likely would cause her death, and continued procedures probably would permit fetal development to live birth. The supervising provider must take reasonable steps to determine pregnancy; the section excludes field emergency services.
• Alaska uses its own validity test for documents made elsewhere. Under § 13.52.010(k), a directive made under another state's law is valid for this chapter only if it also complies with Alaska's chapter.
• Mental-illness revocation is narrower. The ordinary instruction may be revoked in any manner communicating intent, but § 13.52.020(c) requires capacity and competence for revocation in a mental-illness case and makes it effective on communication to a physician or other provider.

Common questions

Do I need witnesses or a notary for treatment instructions? No. § 13.52.010(a) permits an oral or written instruction. The witness and notary blocks apply to a durable health-care power of attorney, and § 13.52.010(l) protects the instruction even if that appointment is defectively executed.

May I revoke orally? Ordinarily yes. Other than the agent designation, and subject to the separate mental-illness and anatomical-gift rules, § 13.52.020(b) permits revocation at any time and in any manner communicating intent. An informed provider, agent, guardian, or surrogate promptly relays it to the supervising provider and treating institution.

What if a provider refuses the instruction? Section 13.52.060 generally requires compliance. A conscience-based policy, medically ineffective care, or generally accepted standards may support refusal, but the provider must give prompt notice, continue care until transfer, and immediately cooperate with transfer unless assistance is refused.

Does Alaska maintain a directive registry? Chapter 13.52 establishes no directive registry. The supervising provider instead records a known directive or revocation, requests a written copy, and keeps a furnished copy in the health-care record (§ 13.52.060(b)).

Statutes and sources

• Alaska Stat. §§ 13.52.010 and 13.52.020 — oral or written instruction, conditions, determination, separate validity, interstate rule, and revocation. Alaska Legislature (accessed 2026-07-31).
• Alaska Stat. §§ 13.52.055 and 13.52.060 — pregnancy, records, compliance, refusal, continuing care, and transfer. Same official source (accessed 2026-07-31).
• Alaska Stat. §§ 13.52.080, 13.52.100, 13.52.110, and 13.52.120 — immunity, capacity presumption, copies, accepted standards, and statutory limits. Same official source (accessed 2026-07-31).
• Alaska Stat. §§ 13.52.300 and 13.52.390 — optional combined form and definitions. Same official source (accessed 2026-07-31).