Alaska Living Will: What It Covers, How to Sign, and When It Takes Effect

A living will in Alaska isn't a standalone document — it's Part II of the state's advance health care directive under AS 13.52. But it carries a legal advantage most people don't know about: your treatment instructions remain valid even if the healthcare agent section of your directive fails due to witnessing errors.

That makes the living will section the most legally resilient part of Alaska's end-of-life planning framework.

What an Alaska Living Will Actually Does

Your living will documents treatment preferences for situations where you can't speak for yourself. Under AS 13.52, you can specify:

• Life-sustaining treatment: Whether you want CPR, mechanical ventilation, dialysis, or similar interventions continued, withheld, or withdrawn.
• Artificial nutrition and hydration: Whether tube feeding and IV fluids should be provided or discontinued.
• Comfort care directives: Pain management, palliative sedation, and environment-of-care preferences.
• Specific medical conditions: You can set different instructions based on whether your condition is terminal, irreversible, or involves permanent unconsciousness.

The statutory form uses an initialing format — you initial each preference rather than checking boxes. This forces you to actively consider each choice rather than defaulting to a blanket "do everything" or "do nothing."

How a Living Will Differs from a Healthcare Power of Attorney

This is where Alaska families get confused. Your living will states what you want. A healthcare power of attorney appoints someone to make decisions for you. They're complementary, not interchangeable.

Under AS 13.52.010(l), here's the critical legal distinction: individual instructions (the living will) remain enforceable even if your agent designation fails. If your witnesses don't qualify or your notarization has a defect, the treatment preferences you documented still bind your providers. The agent appointment requires perfect execution; the treatment instructions do not.

That means even an imperfectly executed directive still protects your core wishes.

Signing Requirements

Your living will must meet the same execution requirements as the full advance directive:

• Written, dated, and signed by you
• Validated by either two qualified adult witnesses or a notary public
• At least one witness must be independent (no family relationship, no estate interest)

For rural Alaska families, the two-witness method eliminates the need for notary access. Remote Online Notarization (RON) is also available since 2021 — the notary joins via video but must be physically in Alaska during the session.

When It Takes Effect

Your living will only activates when your primary physician determines in writing that you lack decision-making capacity. Until that determination happens, you make your own medical decisions — the document is dormant.

If you later regain capacity, the living will goes dormant again. You can revoke it at any time while competent, in any manner that communicates your intent.

Why It Matters for Medevac Situations

In bush Alaska, a medical emergency often means a flight to Anchorage or a regional hub. Emergency crews operate under default protocols — aggressive, invasive interventions including intubation and chemical stabilization. Without a visible living will or POLST, they have no authority to do otherwise.

Having your living will scanned into the tribal EHR or filed at the receiving hospital means the treatment team knows your preferences before you arrive. That's the difference between care aligned with your values and care dictated by protocol defaults.

The Alaska Advance Directive & Living Will Kit includes the complete statutory form with plain-language explanations for every treatment preference, plus a distribution checklist to ensure your document reaches the right providers.

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