(a) Except in the case of mental health treatment and except as provided by Alaska Stat. § 13.52.173 and 13.52.193, a surrogate may make a health care decision for a patient who is an adult if an agent or guardian has not been appointed or the agent or guardian is not reasonably available, and if the patient has been determined by the primary physician to lack capacity.
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Terms Used In Alaska Statutes 13.52.030

  • agent: means an individual designated in a durable power of attorney for health care to make a health care decision for the individual granting the power. See Alaska Statutes 13.52.390
  • available: means , when referring to a person, that the
    (A) person's existence is known. See Alaska Statutes 13.52.390
  • best interest: means that the benefits to the individual resulting from a treatment outweigh the burdens to the individual resulting from that treatment after assessing
    (A) the effect of the treatment on the physical, emotional, and cognitive functions of the patient. See Alaska Statutes 13.52.390
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • guardian: means a judicially appointed person having authority to make a health care decision for an individual. See Alaska Statutes 13.52.390
  • health care: means any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect an individual's physical or mental condition. See Alaska Statutes 13.52.390
  • health care decision: means a decision made by an individual or the individual's agent, guardian, or surrogate regarding the individual's health care, including
    (A) selection and discharge of health care providers and institutions. See Alaska Statutes 13.52.390
  • health care facility: means a nursing home, a rehabilitation center, a long-term care facility, and any other health care institution that administers health care and that provides overnight stays in the ordinary course of the facility's business. See Alaska Statutes 13.52.390
  • health care institution: means an institution, facility, or agency licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business. See Alaska Statutes 13.52.390
  • health care provider: means an individual licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business or practice of a profession. See Alaska Statutes 13.52.390
  • mental health treatment: means electroconvulsive treatment, treatment with psychotropic medication, or admission to and retention in a health care institution for mental health treatment. See Alaska Statutes 13.52.390
  • person: means an individual, corporation, business trust, estate, trust, partnership, joint venture, association, government, governmental subdivision, governmental agency, or another legal or commercial entity. See Alaska Statutes 13.52.390
  • primary physician: means a physician designated by an individual, or by the individual's agent, guardian, or surrogate, to have primary responsibility for the individual's health care or, in the absence of a designation or if the designated physician is not reasonably available, a physician who undertakes the responsibility. See Alaska Statutes 13.52.390
  • reasonably available: means available using a level of diligence appropriate to the seriousness and urgency of an individual's health care needs. See Alaska Statutes 13.52.390
  • supervising health care provider: means the primary physician or the physician's designee, or the health care provider or the provider's designee who has undertaken primary responsibility for an individual's health care. See Alaska Statutes 13.52.390
  • surrogate: means an individual, other than a patient's agent or guardian, authorized under this chapter to make a health care decision for the patient. See Alaska Statutes 13.52.390
  • writing: includes printing. See Alaska Statutes 01.10.060
(b) Subject to Alaska Stat. § 13.52.055(b), a surrogate may make a decision regarding mental health treatment for a patient who is an adult if

(1) an agent or guardian has not been appointed or the agent or guardian is not reasonably available;
(2) the mental health treatment is needed on an emergency basis; and
(3) the patient has been determined to lack capacity by

(A) two physicians, one of whom is a psychiatrist; or
(B) a physician and a professional mental health clinician.
(c) Except as provided for anatomical gifts in Alaska Stat. § 13.52.173, an adult may designate an individual to act as surrogate for that adult by personally informing the supervising health care provider. Except as provided by Alaska Stat. § 13.52.173 or 13.52.193, in the absence of a designation, or if the designee is not reasonably available, a member of the following classes of the patient’s family who is reasonably available, in descending order of priority, may act as surrogate:

(1) the spouse, unless legally separated;
(2) an adult child;
(3) a parent; or
(4) an adult sibling.
(d) Except as provided by (l) of this section or Alaska Stat. § 13.52.173 or 13.52.193, if none of the individuals eligible to act as surrogate under (c) of this section is reasonably available, an adult who has exhibited special care and concern for the patient, who is familiar with the patient’s personal values, and who is reasonably available may act as surrogate.
(e) A surrogate shall communicate the surrogate’s assumption of authority as promptly as practicable to the health care provider, the health care institution, and the members of the patient’s family specified in (c) of this section who can be readily contacted.
(f) If more than one member of a class under (c)(2) – (4) of this section assumes authority to act as surrogate, the members of that class do not agree on a health care decision, and the supervising health care provider is informed of the disagreement, the supervising health care provider shall comply with the decision of a majority of the members of that class who have communicated their views to the provider. If the class is evenly divided concerning the health care decision and the supervising health care provider is informed of the even division, that class and all individuals having a lower priority under (c)(2) – (4) of this section are disqualified from making the decision, and the primary physician, after consulting with all individuals in that evenly divided class who are reasonably available, shall make a decision based on the consultation and the primary physician’s own determination of the best interest of the patient.
(g) A surrogate shall make a health care decision in accordance with the patient’s individual instructions or other advance health care directives, if any, and other wishes to the extent known to the surrogate. Otherwise, the surrogate shall make the decision in accordance with the surrogate’s determination of the patient’s best interest. In determining the patient’s best interest, the surrogate shall consider the patient’s personal values to the extent known to the surrogate.
(h) If a patient’s primary health care provider observes that a surrogate is not abiding by the wishes, values, and best interest of the patient, the primary health care provider may decline to comply with a decision of the surrogate and shall notify the health care institution where the primary health care provider is providing health care to the patient.
(i) A health care decision made by a surrogate for a patient is effective without judicial approval.
(j) A patient who has capacity may, at any time, disqualify another person, including a member of the patient’s family, from acting as the patient’s surrogate by a signed writing or by personally informing the supervising health care provider of the disqualification.
(k) Unless related to the patient by blood, marriage, or adoption, a surrogate may not be an owner, operator, or employee of the health care facility where the patient is receiving care.
(l) A supervising health care provider may require an individual claiming the right to act as a surrogate for a patient to provide a written declaration under penalty of perjury stating facts and circumstances reasonably sufficient to establish the claimed authority.
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