Alabama Medical Power of Attorney

How Medical Decision-Making Authority Works in Alabama

Alabama doesn't have a standalone "medical power of attorney" statute in the way some states do. Instead, healthcare decision-making authority is structured through the Advance Directive for Health Care, governed by the Alabama Natural Death Act under Chapter 8A of Title 22.

This advance directive combines a living will with a healthcare proxy designation. The proxy is the person authorized to make medical decisions when the signer cannot communicate informed consent — essentially functioning as a medical power of attorney, though Alabama law uses different terminology.

The distinction matters because families searching for a "medical power of attorney" in Alabama sometimes download a financial power of attorney form by mistake. A financial POA under the Alabama Uniform Power of Attorney Act (Title 26, Chapter 1A) covers property, banking, and business matters. It has no authority over medical treatment decisions. These are two separate legal instruments with different execution requirements.

The Age 18 to 19 Gap That Confuses Everyone

Alabama sets its age of majority at 19, not 18. This creates a transition period that catches families off guard.

At 18, a young adult may be able to sign a healthcare proxy designation if they are competent to understand the nature and effect of the document. The advance directive's capacity requirement, rather than a financial power-of-attorney rule, controls whether the designation is valid.

But parental authority over general matters — including some medical decisions — continues until 19. Senate Bill 101, effective October 2025, raised the medical age of consent from 14 to 16. Healthcare providers cannot deny parents access to a minor child's health information until the individual reaches 19, unless restricted by a court order.

At 19, everything changes. Full HIPAA privacy protections take effect. Without a signed healthcare proxy or HIPAA release, doctors cannot share diagnoses, treatment plans, or medication information with parents. For families of young adults with intellectual or developmental disabilities, this creates a potential communication blackout that can be dangerous during a medical emergency.

Execution Requirements

The healthcare proxy designation within an advance directive must meet specific criteria to be legally valid in Alabama:

Witnesses, not a notary. Unlike a financial POA (which requires notarization), the advance directive requires two witnesses. Both must be at least 19 years old. Neither can be the designated proxy, related to the signer by blood or marriage, entitled to inherit from the signer, or financially responsible for the signer's medical care.

Capacity to sign. The signer must be a competent adult who understands the nature and effect of the document. For young adults with disabilities, this means the individual must be able to comprehend — at a basic level — that they are naming someone to make medical decisions for them during periods when they cannot communicate.

No notarization substitute. A notary stamp does not satisfy the two-witness requirement. This trips up families who handle the financial POA first (notary only) and assume the same process applies.

When the Proxy's Authority Activates

The healthcare proxy does not have standing authority. The proxy can make decisions only when two physicians determine that the person who signed the directive is terminally ill, permanently unconscious, or unable to communicate informed consent.

This means a parent named as healthcare proxy cannot override their adult child's medical decisions when the child is conscious and able to communicate. The proxy is a safety net, not a transfer of ongoing authority.

For families who need day-to-day medical coordination without waiting for a crisis, a separate HIPAA authorization form accomplishes that goal. The HIPAA form lets the young adult authorize specific family members to receive medical information and discuss care with providers while retaining full decision-making authority themselves.

What This Doesn't Cover

A healthcare proxy handles medical decisions during incapacity. It does not cover:

• Financial management — requires a separate durable financial power of attorney
• Educational decisions — requires an educational representative appointment through the school district (for special education students after age 19) or a supported decision-making agreement
• Government benefits — Social Security requires a separate representative payee designation through the SSA, which does not recognize court guardianships or powers of attorney
• Housing and employment decisions — a Colby Act supported decision-making agreement can provide structured support without removing the young adult's legal authority

The Alabama Adult Guardianship & Alternatives Guide maps these tools against a six-domain decision framework so families can identify exactly which documents they need — and which ones they don't.

Practical Steps for Families

The best time to execute the healthcare proxy is between the young adult's 18th and 19th birthdays, while the young adult has capacity to understand and sign it. At 19, the HIPAA wall goes up.

1. Use the statutory form from Alabama Code § 22-8A-4 for the advance directive (which includes the proxy designation).
2. Find two qualifying witnesses — not family members, not the person being named as proxy.
3. Have the young adult sign in the presence of both witnesses.
4. Deliver copies to every physician and specialist the young adult sees regularly.
5. Consider executing a separate HIPAA authorization form at the same time for routine medical communication.

If the young adult lacks the capacity to understand and sign these documents, the healthcare proxy route won't work. In that case, families may need to explore guardianship through the probate court or a supported decision-making agreement under the Colby Act, depending on the individual's functional abilities.

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