Living will requirements in Alaska

Which document is this, really

Alaska’s Health Care Decisions Act uses one umbrella term for the paperwork you sign: the Advance Health Care Directive. That directive can be an individual instruction, the kind of treatment wishes most people mean by living will, a Durable Power of Attorney for Health Care naming the person who decides for you, or both combined into the same document. Alaska does not force you to choose between naming an agent and writing down your wishes.

The person you name to make decisions for you is your agent. Alaska prints a sample directive in its own chapter, and says plainly that it may be used, may be modified, or may be replaced by a different form that complies with the chapter.

This is exactly what Myend’s free Healthcare Directive prepares for Alaska: your treatment wishes and your choice of agent, gathered into one document, ready for that same signing.

Who can make one

You must be an adult to execute an Alaska Advance Health Care Directive, and the number behind that word is 18, Alaska’s general age of majority. The Health Care Decisions Act itself does not print a separate number for this chapter; it borrows the state’s ordinary line between minor and adult. Sound mind is not a formal exam or a certificate you need in hand. What matters is that, at the moment you sign, you understand what the directive says, what naming an agent means, and what happens to your own decisions once it takes effect.

Signing it so it counts

Alaska’s witnessing rule belongs to one half of the directive. The Durable Power of Attorney for Health Care, the part that names your agent, must be in writing, carry the date you executed it, be signed by you, and then be verified one of two ways: two witnesses, or a notary public. Either route makes it valid on its own. An individual instruction standing by itself is held to a looser standard, and the chapter says an instruction that would be valid on its own stays valid even where the power of attorney in the same writing misses the witnessing rule. Because Myend’s directive carries both halves, sign it the way the power of attorney requires and both halves are covered.

1. 1You date it, then sign or acknowledge your signature

   The power of attorney has to carry the date you executed it, so fill that in. Then sign the directive in front of your witnesses or your notary, or, if you already signed it earlier, acknowledge that signature to them instead.

2. 2Two witnesses who know you, or a notary

   Choose one route. Sign or acknowledge your signature in front of two individuals who personally know you, or skip the witnesses and have your signature acknowledged before a notary public at a place in Alaska instead.

3. 3If you use witnesses

   Neither witness can be a health care provider employed at the institution or facility where you are being treated, an employee of that provider, institution, or facility, or your agent. That bar applies to both witnesses.

If you choose the notary route instead, none of the witness rules apply, and the signature lines above are replaced by a notary acknowledgment block.

Naming your agent

Your Durable Power of Attorney for Health Care is where you name your agent, the person who makes health care decisions for you once your primary physician determines you cannot make them yourself. Alaska’s chapter draws a narrow line: an owner, operator, or employee of the health care institution where you are receiving care cannot serve as your agent, unless that person happens to be related to you by blood, marriage, or adoption. Outside that one restriction, anyone you trust can serve.

When it takes effect

Unless your Durable Power of Attorney for Health Care says otherwise, your agent has no authority until your primary physician determines you lack the capacity to make your own health care decisions, and that authority ends the moment your physician determines you have regained it. There is one detour: if the reason you cannot decide for yourself is mental illness, that determination goes to a court instead of your physician, except in an emergency, when another health care provider can make the call.

If you are pregnant

Alaska does not set your directive aside simply because you are pregnant. The law only pauses it when every one of four conditions holds true at the same time: you are pregnant and lack the capacity to decide for yourself, the choice on the table is to withhold or withdraw life-sustaining procedures, that withholding or withdrawal would, in reasonable medical judgment, be likely to cause your death, and it is probable that the fetus could still develop to the point of live birth if the life-sustaining procedures continued. If all four are true, your directive has no effect for as long as they remain true.

Changing or cancelling it

You can revoke the parts of your Advance Health Care Directive that state your own wishes at any time, in any manner that clearly communicates your intent to revoke, spoken or written. Revoking your agent’s appointment specifically works differently: it takes a signed writing, or personally telling the health care provider who is supervising your care that you revoke it.

A divorce, annulment, dissolution, or legal separation automatically revokes a spouse’s designation as your agent, unless the decree or your directive itself says otherwise. Signing a later directive that conflicts with an earlier one revokes the earlier one, but only to the extent the two actually disagree. Alaska’s chapter also sets separate, narrower revocation rules for principals with a mental illness, which sit outside what this page covers.

Making sure it is found

The best way to make sure your directive is found when it matters is handing out copies yourself: one to your agent, one to your regular physician, and one to the hospital you are most likely to use. Keep the signed original somewhere your family already knows to check first.

If you signed your directive somewhere else and are later treated in Alaska, state law recognizes it on one condition: an advance health care directive, including one made in compliance with another state’s laws, is valid here if it complies with Alaska’s chapter, regardless of where or when it was signed. Alaska is measuring your out-of-state document against its own rules rather than the rules you signed under, which is one more reason to check it against Alaska’s signing rule if you move here or spend real time in the state.

This is not a POLST

Alaska’s medical-order program for people who are already seriously ill is generally known as Alaska POLST, Physician Orders for Life-Sustaining Treatment. A POLST form is a set of specific medical orders a clinician signs together with someone facing serious illness, meant to travel with that person between hospital, home, and ambulance. Your Advance Health Care Directive is a different kind of document: something you complete in advance, before any of that is happening, and it needs no clinician’s signature. Myend prepares the Advance Health Care Directive. It does not, and cannot, produce a POLST, because that has to come from your treating clinician.

What is different about Alaska

Alaska pauses your directive during pregnancy only when four separate conditions all hold at once, not simply because you are pregnant.

Start with the halves. Alaska builds the directive as one instrument that can hold your individual instructions, your Durable Power of Attorney for Health Care, or both, so naming your agent and writing down your wishes happen in the same signing rather than on separate paper. But the two halves are not held to the same standard. The witnessing rule, and the requirement to be in writing at all, are written for the power of attorney. An individual instruction on its own may be oral, and the chapter goes further: an instruction that would be valid by itself stays valid even where the power of attorney sharing the page with it failed the witnessing rule. That is worth knowing and not worth relying on. An oral instruction is only as good as the memory of whoever heard it, which is exactly the problem a written directive exists to solve.

The witness rule for the power of attorney has a quirk worth knowing before you ask two people to stand up for you. Alaska bars a health care provider, a facility employee, or your agent from witnessing at all, full stop, no exception. But the rule about relatives and heirs reaches only one of your two witnesses. Read carefully, that means the other one is allowed to be your spouse, your child, or someone who inherits under your will, as long as the first witness is neither.

The pregnancy rule is the most distinctive piece of Alaska’s directive law. Rather than an automatic suspension for the rest of a pregnancy, the way several other states write it, Alaska ties the pause to a four-part test that has to hold all at once: that you are pregnant and lack capacity, a decision to withhold or withdraw life-sustaining procedures, reasonable medical judgment that doing so would likely cause death, and a probability that the fetus could still reach live birth if treatment continued. The same section also puts a duty on the supervising health care provider to take reasonable steps to find out whether a woman of childbearing age is pregnant before carrying out a decision that would affect a fetus, and it carves field emergency medical services out of the pause entirely.

Common questions

Sources and review