Alaska: Living Will and Advance Health-Care Instruction Requirements
The short answer
Alaska's Health Care Decisions Act lets an adult give an individual health-care instruction orally or in writing and condition it on a specified event; an instruction alone needs no signature, date, witnesses, or notary. No universal terminal-condition or incapacity trigger applies, although the primary physician ordinarily determines capacity or another activating condition unless a written directive says otherwise, with special rules for mental illness. The instruction may address treatment, artificial nutrition and hydration, and pain relief, subject to pregnancy, generally accepted standards, provider refusal and transfer, and Alaska's narrower recognition rule for documents made elsewhere.
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This is the general rule in Alaska. Ezel applies current Alaska law to your specific facts and answers with citations to the statutes.
| Governing law and document | Alaska Health Care Decisions Act, AS 13.52.010–.395. 'Individual instruction' is adult's direction about own health-care decision and, alone or with health-care POA, is an 'advance health care directive' (§§ 13.52.010(a), 13.52.390(1), (23)). Optional combined statutory form (§ 13.52.300); instruction remains distinct from agent appointment and DNR orders |
|---|---|
| Who may make an instruction | Adult may give instruction (§ 13.52.010(a)). Capacity means ability to receive/evaluate information and make/effectively communicate health-care decisions (§ 13.52.390(8)); individual is rebuttably presumed able to make decision and give/revoke directive (§ 13.52.100(b)). No emancipated-minor route in § 13.52.010(a) |
| Oral, written, and signature form | Instruction may be oral or written and limited to specified condition (§ 13.52.010(a)). No signature, date, delivery, acknowledgment, or electronic-specific form required for instruction alone. Optional combined form asks for signature/date and execution blocks, but § 13.52.010(l) preserves an otherwise-valid instruction even if accompanying health-care POA fails witnessing/other requirements |
| Witness, notary, and disqualifications | No witness or notary for standalone individual instruction (§ 13.52.010(a), (l)). Two-personally-known-witness OR in-state-notary rule and witness disqualifications in § 13.52.010(b), (d), (e) govern durable health-care POA, not instruction-only validity. Do not import combined form's agent-appointment execution blocks into treatment instruction |
| Covered conditions and trigger | No universal incapacity, terminal, PVS, or clinician trigger; adult may make instruction effective now or on specified condition (§ 13.52.010(a)). Unless written directive specifies otherwise, primary physician determines capacity/recovery or other activating condition; court determines in mental-illness case unless emergency, then primary physician/other provider (§ 13.52.010(g)). Optional form offers terminal and permanent-unconsciousness choices (§ 13.52.300) |
| Treatment, nutrition, hydration, and comfort | Instruction may address any health-care decision, including provide/withhold/withdraw artificial nutrition/hydration when consistent with generally accepted standards (§ 13.52.390(18), (23)). Optional form offers prolong-life OR comfort-only choices for terminal condition/permanent unconsciousness, 4 feeding/hydration choices, pain-relief choice, and custom instructions (§ 13.52.300). Provider may refuse medically ineffective or standards-conflicting care (§ 13.52.060(f)) |
| Pregnancy and other statutory limits | Withholding/withdrawal instruction cannot be given effect when patient is pregnant, lacks capacity, withdrawal likely causes her death, and continued procedures probably permit fetal development to live birth (§ 13.52.055); provider first takes reasonable pregnancy-check steps, and field emergencies are excluded. Chapter does not authorize mercy killing, assisted suicide, or euthanasia (§ 13.52.120(d)); optional form's pregnancy blank remains subject to § 13.52.055 |
| Revocation, notice, and registry | Except mental-illness and anatomical-gift rules, revoke all/part of instruction anytime and in any manner communicating intent (§ 13.52.020(b)); later conflicting directive revokes earlier to conflict. Mental-illness revocation requires principal with capacity/competence and communication to provider (§ 13.52.020(c)). Informed provider/agent/guardian/surrogate promptly relays revocation to supervising provider/institution; provider records existence (§§ 13.52.020(d), 13.52.060(b)). No directive registry in chapter |
| Provider duties, recognition, and effect | Provider/institution/facility complies with instruction and reasonable interpretation; conscience/policy or medically ineffective/accepted-standard refusal requires prompt notice, continuing care, and immediate transfer cooperation unless assistance refused (§ 13.52.060). Good-faith, accepted-standard immunity (§ 13.52.080). Directive made elsewhere is valid only if it complies with Alaska chapter, regardless where/when made (§ 13.52.010(k)); copy equals original (§ 13.52.110) |
Compare this rule across all 50 states + DC →
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).
Source links
Every statute quoted above, linked, with the date we checked it.
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