Alabama does not use the term "living will" in its statutes. The equivalent document is the Advance Directive for Health Care, governed by the Alabama Natural Death Act (§ 22-8A-1 et seq.). It lets you specify what medical treatments you do or don't want if you become unable to speak for yourself — and name a health care proxy to make decisions on your behalf.
What is an Alabama Advance Directive for Health Care?
An Alabama Advance Directive for Health Care is a legal document that does two things at once. First, it records your instructions about end-of-life medical treatment — what you want and don't want if you are terminally ill, in a persistent vegetative state, or permanently unconscious. Second, it lets you appoint a health care proxy — a trusted person who can make medical decisions for you when you cannot speak for yourself.
Most people outside of legal settings call this a "living will." In Alabama, the official name is Advance Directive for Health Care, but both terms refer to the same document.
What decisions does it cover?
Your Alabama Advance Directive can address any of the following medical decisions:
- Life-sustaining treatment — whether to continue treatment that prolongs the dying process when there is no reasonable expectation of recovery
- Artificial nutrition and hydration — whether to start or continue feeding tubes or IV fluids if you cannot eat or drink on your own
- Cardiopulmonary resuscitation (CPR) — whether to attempt resuscitation if your heart or breathing stops
- Mechanical ventilation — whether to use a machine to breathe for you
- Dialysis — whether to continue kidney dialysis if you are in a terminal condition
- Comfort care — instructions to receive pain management and palliative care regardless of other treatment decisions
- Organ and tissue donation — your wishes regarding donation after death
Key distinction: An Advance Directive is only activated when you are unable to make or communicate your own medical decisions. While you are competent, you remain in full control of all medical choices — the document has no effect.
Alabama Advance Directive requirements — what makes it valid
Under Alabama's Natural Death Act, a valid Advance Directive must meet these requirements:
- Must be in writing
- You must be at least 19 years old and of sound mind when signing
- Must be signed by you (or by another person at your direction if you cannot sign)
- Must be witnessed by two adults who sign in your presence
- Witnesses cannot be your health care proxy, a blood relative, your spouse, your heir, or anyone who would benefit financially from your death
- Witnesses cannot be your attending physician or any employee of a health care facility where you are a patient
Notarization is not required for validity in Alabama — but having a notary acknowledge the document is strongly recommended, especially if the document may ever be presented in another state.
| Legal name | Advance Directive for Health Care |
| Governing law | Alabama Natural Death Act, § 22-8A-1 |
| Minimum age | 19 years old |
| Witnesses required | 2 adults (not family, heirs, or health care workers) |
| Notarization required | No — but recommended |
| Can name a proxy? | Yes — health care proxy section included |
| Can be revoked? | Yes — at any time while competent |
Living will vs. health care proxy — what's the difference
People often confuse these two roles. Alabama's Advance Directive combines both into one document, but they serve different purposes:
| Feature | Living Will / Directive | Health Care Proxy |
|---|---|---|
| What it does | Records your specific instructions in advance | Appoints someone to decide for you |
| When it applies | Situations you have specifically addressed in the document | Any medical decision when you're incapacitated |
| Limitation | Can't anticipate every possible scenario | Depends on choosing the right person |
| Alabama document | Both combined in one Advance Directive form | Both combined in one Advance Directive form |
The practical reason to do both in the same document: your written instructions can't anticipate every medical scenario. A health care proxy can fill in the gaps using their knowledge of your values and wishes.
How to make a valid Alabama Advance Directive
Choose your health care proxy carefully
Your proxy should be someone who understands your values, can handle pressure from medical staff or family members, and will honor your wishes even when it's emotionally difficult. Name an alternate proxy in case your first choice is unavailable.
Complete the Advance Directive form
Use Alabama's official Advance Directive for Health Care form, available through the Alabama Hospital Association or your attorney. Fill out both sections — your specific treatment instructions and your health care proxy designation.
Sign in front of two qualifying witnesses
Both witnesses must be adults who are not your family members, heirs, health care proxy, or health care workers involved in your treatment. All three sign at the same time.
Have a notary acknowledge the document (recommended)
While not legally required in Alabama, notarization protects against challenges and is required if your document needs to be honored in another state. Most banks, UPS Stores, and attorney offices provide notary services for $5–$15.
Distribute copies to the right people
Give signed copies to your health care proxy, your primary care physician, any specialists treating a chronic condition, and your hospital if you have one. Keep the original somewhere accessible — not in a safe deposit box that no one can open in an emergency.
Review it every few years
Your health and wishes may change. Review your Advance Directive after any major health diagnosis, after a significant life event, or whenever you feel your instructions no longer reflect your wishes.
What happens without an Advance Directive in Alabama?
Without a valid Advance Directive, medical decisions fall to your family — but not necessarily in the way you'd expect. Alabama follows a priority order for surrogate decision-makers:
- Your legal spouse
- Your adult children (majority decision if multiple)
- Your parents
- Your adult siblings (majority decision)
- A close friend
This sounds reasonable, but it creates real problems. Family members may disagree about what you would have wanted. Medical staff may be legally required to take aggressive measures to keep you alive even if that's not what you would choose. Disputes can end up in court — costly, slow, and deeply painful for everyone involved.
The Terri Schiavo case — which stretched across 15 years of court battles and became a national story — involved a Florida woman with no Advance Directive. Her husband and parents disagreed about her wishes. An Advance Directive with a clearly named proxy would have resolved the situation immediately.
How to revoke an Alabama Advance Directive
You can revoke your Advance Directive at any time as long as you are competent. There is no required form or process — revocation can be:
- Written revocation signed and dated by you
- Physical destruction of the document
- Verbal statement to your health care provider in the presence of a witness
If you revoke your directive, notify your health care proxy, physician, and anyone else who has a copy. Creating a new Advance Directive automatically supersedes any prior version.
Advance Directive vs. POLST — what's the difference
A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order — not just a planning document — signed by both you and your physician. It translates your wishes into immediate medical orders that emergency responders and hospital staff must follow. A POLST is typically used for people with serious illness or advanced age where end-of-life decisions may arise soon.
An Advance Directive is broader and works for anyone regardless of current health. For most healthy adults doing estate planning, an Advance Directive is the right starting point. For someone with a terminal diagnosis, a POLST may be appropriate in addition to the Advance Directive.