Living will requirements in Kentucky

Which document is this, really

Kentucky’s living will has an official name printed right on the statutory form: the Living Will Directive, made under the Kentucky Living Will Directive Act, KRS 311.621 to 311.643. It is not only a living will. The one document you sign also designates your health care surrogate, and a successor surrogate if you want one, records your wishes about life-prolonging treatment and artificially provided nutrition and hydration, and lets you make an anatomical gift election, all above a single signature block.

The statute is specific about how closely you have to follow its printed wording. A Living Will Directive “shall be substantially in the following form,” which means you do not have to reproduce it verbatim and may add other directions consistent with accepted medical practice, but the surrogate designation, the treatment elections, and the signing block have to stay. Kentucky does not offer a separate statutory form for naming just a surrogate. If you want someone with authority to make health care decisions for you, that appointment lives inside this same Living Will Directive, not in a document of its own.

This is the shape Myend’s free Healthcare Directive prepares for Kentucky: your surrogate, your treatment wishes, and your anatomical gift choice, gathered into one document, ready for the same signing.

Who can make a Living Will Directive in Kentucky

Kentucky defines an adult, for this purpose, as someone eighteen years of age or older who is of sound mind, and the Living Will Directive form repeats that exact standard in its own attestation language. Sound mind is not something a doctor certifies ahead of time. It is the everyday judgment your witnesses, or your notary, are making when they sign alongside you, that you understood what the document said and meant to sign it. That definition is a closed one. It has no branch for an emancipated minor and none for a married minor, so eighteen is where Kentucky draws the line for who may sign.

Signing it so it counts

Kentucky gives you a straight either/or for making your signature count: two adult witnesses, or a notary public or other person authorized to administer oaths. Either route makes the Living Will Directive valid on its own, and you do not need both.

1. 1You sign

   You date and sign the Living Will Directive yourself, or direct someone else to sign it for you.

2. 2Two witnesses, or a notary

   Two adults watch you sign, in your presence and in the presence of each other, or a notary public or other person authorized to administer oaths takes your acknowledgment instead. Choose one route, not both.

3. 3Who cannot serve

   Five categories are barred from acting as either a witness or a notary for your directive: a blood relative of yours, anyone who would inherit from you under the Commonwealth’s descent and distribution statutes, an employee of the health care facility where you are a patient (unless that employee is the one serving as notary), your attending physician, and anyone directly financially responsible for your health care.

Kentucky’s statute says nothing about electronic signatures or remote witnessing for the Living Will Directive. What it does say is that your witnesses sign in your presence and in the presence of each other, which describes a signing everyone attends together; whether any other arrangement satisfies that is a question the Act leaves open.

Naming your surrogate

Kentucky’s own term for the person who makes health care decisions for you is surrogate, defined in the Act as an adult who has been designated to make those decisions on your behalf. You can name one or more adults as your surrogate, and a successor surrogate as well, all inside the same Living Will Directive.

Kentucky bars one category from serving: an employee, owner, director, or officer of the health care facility where you are a resident or patient, unless that person is related to you within the fourth degree of consanguinity or affinity, or belongs to the same religious or fraternal order as you. Outside that single exception, the Act does not narrow who you can name. If you name two or more surrogates to serve at the same time, every decision has to be by their unanimous consent unless your directive says otherwise, which is worth thinking about before you name a pair who disagree.

Once you no longer have decisional capacity, your surrogate carries out the treatment wishes, the artificial nutrition and hydration choices, and the anatomical gift election you set out in the same document.

When it takes effect

Kentucky switches the two halves of the document on at different moments. Your surrogate’s authority begins when you no longer have decisional capacity, meaning you can no longer make and communicate a health care decision yourself. The form says exactly that in its own designation line, and the Act adds the mirror image: your surrogate may not make a health care decision in any situation where your attending physician finds in good faith that you still have that capacity.

The treatment directions are gated separately, and more heavily. Withholding or withdrawing life-prolonging treatment turns on your having a terminal condition or being permanently unconscious, and Kentucky builds two physicians into the definition of each: your attending physician and one other, to a reasonable degree of medical probability, not one physician’s opinion alone. A terminal condition has to be incurable, irreversible, and likely to cause death within a relatively short time. Permanent unconsciousness rests on a clinical examination showing no cerebral cortical function that would indicate consciousness or the ability to interact with your surroundings.

If you are pregnant

Two different texts speak to this, and they do not say quite the same thing. The Living Will Directive form you sign states it plainly: if you have been diagnosed as pregnant and your attending physician knows it, the directive has no force or effect for the rest of the pregnancy. Read on its own, that is a flat suspension.

But the statute that actually governs what your surrogate can authorize, KRS 311.629(4), is narrower. It requires life-sustaining treatment and artificially provided nutrition and hydration to keep being given to a pregnant patient unless your attending physician and one other physician who has examined you certify, to a reasonable degree of medical certainty and on your medical chart, that continuing will not maintain you in a way that permits the pregnancy to continue toward a live birth, or that it will be physically harmful to you, or that it will prolong severe pain that medication cannot relieve.

Changing or cancelling it

You can revoke your Living Will Directive in any of three ways: sign and date a new writing that says you are revoking it, tell two adults out loud, while you still have decisional capacity, that you intend to revoke it, with at least one of the two a health care provider (an oral revocation made this way overrides anything written), or physically destroy the document yourself, or have someone else destroy it in your presence and at your direction.

Revocation takes effect the moment you do it, though your attending physician or facility is not required to act on it until they actually receive notice, at which point the time, date, and place of that notice goes into your medical record. Tell your surrogate and your physician directly rather than assuming word travels on its own. You can also revoke or limit just the surrogate designation, in whole or in part, at any time you still have decisional capacity; naming a new surrogate cancels the old designation unless you say otherwise.

Making sure it is found

Kentucky generally does not run a central registry where a living will gets filed. What works instead is copies: one for your surrogate, one for your physician, and one for the hospital you would most likely use, with the signed original kept somewhere your family already knows to check.

This is not a POLST

Kentucky’s medical orders program is called Kentucky MOST, Medical Orders for Scope of Treatment, administered by the Kentucky Board of Medical Licensure. It is a different kind of paperwork from your Living Will Directive. A MOST form carries specific medical orders that a clinician fills out with you once you are already living with serious illness, written to follow you into whichever setting your care reaches next, an emergency room, a nursing facility, home, or the back of an ambulance. Your Living Will Directive works earlier than that, filled out ahead of any diagnosis, and it needs no clinician’s signature to be valid.

If the two ever point in different directions, Kentucky law resolves it: where a Living Will Directive and a MOST form conflict, the Living Will Directive’s provisions control. Myend prepares the Living Will Directive. It does not, and cannot, produce a MOST form, because that has to come from your treating clinician.

What is different about Kentucky

The form Kentucky hands you says pregnancy suspends it outright. The statute that actually governs your surrogate’s authority says something narrower.

Most states either split the living will and the agent appointment into two documents, or combine them into a form that does two jobs. Kentucky’s Living Will Directive does three: it names your surrogate, it records your treatment and artificial-nutrition wishes, and it lets you make an anatomical gift election, all above one signature.

Its pregnancy rule is the most distinctive thing about it, because Kentucky effectively publishes two different answers depending on which text you read. The form itself says a known pregnancy suspends the directive completely. The operative statute governing your surrogate’s actual authority, KRS 311.629(4), is conditional rather than absolute: treatment continues by default, and can only be withheld or withdrawn if two physicians certify one of three specific findings. Kentucky has not reconciled the two in the statute itself, so anyone relying on the form’s plain wording alone is reading a broader rule than the one that actually controls at the bedside.

One more Kentucky habit is worth knowing before you choose your witnesses. In some states, choosing a notary instead of witnesses sidesteps the disqualification rules entirely. Kentucky does not work that way. The same five-category bar applies whether you use two witnesses or a notary, with one narrow exception, a facility employee may act as your notary even though that same person could not act as your witness. And the list does not reach the person you are naming as your surrogate; unless they independently fall into one of the five categories, Kentucky does not stop your surrogate from also witnessing your signature.

Common questions

Sources and review