Alabama Medical Power of Attorney: Health Care Proxy Form and Duties

When a medical crisis hits and you cannot speak for yourself, someone has to make decisions on your behalf. In Alabama, that person is your Health Care Proxy — appointed through Section 2 of the Alabama Advance Directive for Health Care. Without one, your family faces a statutory hierarchy that may not match your preferences, and potentially a probate court proceeding that costs thousands.

How Alabama's Medical Power of Attorney Works

Alabama does not use a separate "medical power of attorney" form. Instead, the healthcare proxy appointment is built into the same Advance Directive for Health Care governed by the Alabama Natural Death Act (§ 22-8A-4). Section 2 of this form lets you name a primary proxy and an alternate.

The proxy's authority is strictly limited to medical decisions. They cannot access, manage, or transfer your bank accounts, real estate, or financial assets — that requires a separate Financial Durable Power of Attorney under Alabama Code § 26-1A-1.

Choosing Your Proxy's Authority Level

When completing the form, you must initial one of two authority options:

Directive-only authority: Your proxy can only follow the exact instructions written in your living will (Section 1). They have no power to make decisions on anything you did not explicitly address.

General and custom authority: Your proxy can follow your written instructions and also make decisions on medical matters you did not cover, based on what they believe you would want. This is the more practical choice for most people because no living will can anticipate every clinical scenario.

You also initial a separate Yes/No for whether your proxy can authorize the withdrawal of feeding tubes and IV fluids. If you initial "No" (or leave it blank), Alabama law prevents your proxy from making that decision — even if they hold general authority.

What Your Health Care Proxy Can Do

Once your attending physician certifies that you lack the capacity to make your own medical decisions, your proxy gains immediate authority to:

• Consent to or refuse medical treatments — including surgeries, medications, diagnostic tests, and experimental therapies
• Access your medical records under HIPAA — your proxy becomes your "personal representative" under federal privacy rules, with unrestricted access to your protected health information, clinical charts, and lab results
• Communicate with your healthcare team — attend care conferences, receive progress updates, and ask questions about prognosis and treatment options
• Direct transfers between facilities — authorize or refuse transfers to other hospitals, rehabilitation centers, or long-term care facilities

What Your Proxy Cannot Do

Alabama law explicitly prohibits your proxy from authorizing:

• Psychosurgery
• Involuntary commitment to a mental health facility
• Sterilization
• Abortion
• Any procedure prohibited under Alabama law

These restrictions apply regardless of what your written instructions say. Even general authority does not override these statutory limits.

The Proxy Acceptance Requirement

A detail that invalidates more directives than any other: Alabama Code § 22-8A-4(b) requires your proxy to physically sign the acceptance line in Section 2 of the form. This is not optional. If your proxy has not signed their acceptance, their appointment may not be legally enforceable when it matters most.

This means you need to have the conversation with your chosen proxy before you sign the form — not just write their name down and hope they agree to serve.

When No Proxy Is Appointed

If you become incapacitated without a designated proxy, Alabama falls back to its statutory surrogate hierarchy under § 22-8A-11:

1. Judicially appointed guardian (if one exists)
2. Spouse (unless legally separated or divorcing)
3. Adult child
4. Parent
5. Adult sibling
6. Next of kin by closest degree

The surrogate must complete the official "Certification of Health Care Decision Surrogate" form and certify they have contacted all individuals in their class or above who have either consented or raised no objection.

When family members disagree — common in blended families, second marriages, and estranged relationships — the only resolution is probate court. Alabama guardianship filings range from $37 to $218 depending on the county, but total costs including attorney fees, guardian ad litem appointments, and capacity evaluations run $2,000–$10,000 for uncontested cases.

Preparing Your Proxy for the Role

Naming someone is the easy part. Preparing them is what actually matters. Your proxy should know:

• Your specific wishes about feeding tubes, ventilators, and CPR — not just "I don't want to be kept alive on machines" but exactly which interventions you do and do not want under which conditions
• The locations of your signed directive (physician's office, hospital records, home)
• Your primary care physician's name and contact information
• Your preferences about organ donation, comfort care, and pain management
• Any religious or personal values that should guide decisions the form does not address

The Alabama Advance Directive & Living Will Kit includes a dedicated proxy briefing guide that walks your designated decision-maker through their legal authority, statutory limitations, and practical steps for communicating with hospital staff — so they are not learning their role for the first time in a hospital corridor.

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