Who Decides Without a Directive
Ala. Code § 22-8A-11 — a surrogate in a set order: guardian, spouse, adult child, parent, sibling, next of kin
With no advance directive or available proxy, a surrogate may decide with the attending physician whether to give, withhold or withdraw life-sustaining treatment, once two physicians have certified a terminal illness or injury or permanent unconsciousness and the patient cannot understand or direct their care with no hope of regaining that ability.
Who handles this in Alabama: legal aid programs, lawyer referral and the state offices, listed in the Alabama directory.
| Order | Surrogate |
|---|---|
| OrderFirst | SurrogateA court appointed guardian authorized to make these decisions |
| OrderSecond | SurrogateThe spouse, unless legally separated or in a divorce case |
| OrderThird | SurrogateAn adult child |
| OrderFourth | SurrogateA parent |
| OrderFifth | SurrogateAn adult sibling |
| OrderSixth | SurrogateAn adult relative of the next closest degree of kinship |
The surrogate decides as closely as possible as the patient would have, taking into account the patient's known religious, spiritual, personal and moral beliefs.
Sources for this section (1)
- Ala. Code § 22-8A-11 — Surrogate; Requirements; Considerations; Persons Who May Serve as Surrogate; Validity of Decisions; Liability; Form; Declaratory and Injunctive Relief; Violations
Legal information, not legal advice. Verified as of October 2026. Applying it to a particular situation is the work of a licensed Alabama attorney.