Kentucky Living Will Requirements: Witnesses, Pregnancy Clause, Revocation

To make a valid living will in Kentucky, you must be at least 18 years old with decisional capacity, complete the directive using the language set out in state statute, and sign it either in the presence of two qualified adult witnesses or before a notary public. Kentucky living will requirements are set by the Living Will Directive Act (KRS 311.621 to 311.643), and the Office of the Attorney General publishes a free standardized form you can fill out without a lawyer.

Who Can Make One

You need to be 18 or older and have what the statute calls decisional capacity, meaning you understand the nature and consequences of the healthcare choices you are putting in writing.¹ The form itself contains a statement that you are “emotionally and mentally competent” to make the directive, and your witnesses confirm this when they sign.²

You do not need to be terminally ill, elderly, or facing any particular diagnosis. A healthy adult of any age can execute one, and many do.

What You Can Put in the Directive

Kentucky’s form lets you address up to four separate areas in one document:¹

Life-prolonging treatment. You can direct that treatment be withheld or withdrawn so you die naturally with only pain medication, or you can specify that you want all available treatment continued.
Artificial nutrition and hydration. This is a separate checkbox from the life-prolonging treatment decision because many people draw a different line on feeding tubes and IV fluids than they do on ventilators or resuscitation.
Healthcare surrogate. You can name one or more adults to make medical decisions for you when you lose decisional capacity, and you can name a successor surrogate as a backup.
Organ and tissue donation. You can authorize giving all or part of your body after death for transplantation, research, or other purposes under Kentucky’s anatomical gift statute.

You are not required to address all four. The directive is valid even if you complete only one section.

One trap to avoid: if you check the boxes giving specific instructions on life-prolonging treatment or artificial nutrition, your surrogate must follow those choices. The surrogate only gets independent authority to decide what is in your best interest if you deliberately leave those treatment sections blank.³ Checking a treatment box and also authorizing a surrogate best-interest determination on the same question creates a conflict the packet warns against. When two or more surrogates serve at the same time, they must agree unanimously on every decision unless your directive says otherwise.¹

Signing: Witnesses or Notary

After you fill the form out, you must sign and date it either in front of two adult witnesses or before a notary public or other person authorized to administer oaths.² If you use witnesses, both must be present at the same time and must watch you sign.

Kentucky disqualifies several categories of people from serving as witnesses:

Your blood relatives
Anyone who would inherit from you under Kentucky’s descent and distribution rules
Your attending physician
Anyone directly financially responsible for your healthcare
Employees of a healthcare facility where you are currently a patient, unless the employee is acting specifically as a notary public

A neighbor, coworker, or friend with no connection to your medical care or your estate is usually a safe choice. If you are completing the form from a hospital bed, remember the notary exception: many hospitals have notaries on staff who can validly notarize your signature even though they could not serve as witnesses.

The Pregnancy Clause

Kentucky’s standardized form contains a built-in pregnancy provision. If you have been diagnosed as pregnant and your attending physician is aware of it, the directive has no force or effect for the duration of the pregnancy.² This clause is printed into the form, so it applies automatically. You cannot add language to opt out of it. The directive resumes its full legal effect after the pregnancy ends.

When It Actually Takes Effect

Signing the form does not put its treatment instructions into play immediately. The form’s own language limits those instructions to situations where you no longer have decisional capacity and either have a terminal condition or are permanently unconscious.² As long as you can communicate your own choices, you make your own medical decisions regardless of what the document says.

The surrogate designation works a bit differently. It activates any time you lose decisional capacity, even temporarily, such as while you are under anesthesia or sedated after an accident. The surrogate still has to follow whatever written instructions you gave in the treatment sections.

How to Revoke It

You can cancel your living will at any time, in any way you can communicate, regardless of your mental or physical condition at that moment.⁴ Kentucky accepts three methods:

Telling your attending physician or another healthcare provider that you revoke it
Destroying the document, either by you or by someone acting in your presence on your instructions
Signing and dating a written revocation

Revocation becomes effective once it is communicated to your attending physician or other healthcare provider. If you revoke the directive but never tell your doctor, the medical team may keep relying on the old instructions. Tell your surrogate too, and retrieve or destroy the copies you handed out.

Make Sure It Can Be Found

A directive nobody can locate during a crisis does you no good. Keep the original somewhere you can reach quickly, and give copies to your surrogate, your successor surrogate, and your primary care physician, with a request that it be added to your medical record.³ Many hospitals accept digital uploads into their electronic health record systems. When you are admitted anywhere, confirm during intake that your directive is on file rather than assuming a copy you handed over years ago has followed you through every provider.

One limit worth knowing: a living will on its own usually will not stop emergency responders from performing standard resuscitation in the field. Kentucky generally requires EMS to follow standard protocols unless they see a Medical Orders for Scope of Treatment (MOST) form or another medical order approved by the Kentucky Board of Medical Licensure.¹ A MOST form is a separate physician’s order designed for people who are seriously ill or medically frail, and it supplements the living will without conflicting with it; if the two documents disagree, the living will controls.⁵ If honoring a do-not-resuscitate wish outside the hospital matters to you, ask your physician whether a MOST form should go alongside your directive.

1
Justia. Kentucky Code 311.623 – Living Will Directive or Medical Order for Scope of Treatment
2
Justia. Kentucky Code 311.625 – Form of Living Will Directive
3
Office of the Attorney General. Living Will Packet
4
Kentucky Legislative Research Commission. Kentucky Code 311.633 – Revocation of Directive
5
Kentucky Legislative Research Commission. Kentucky Code 311.6225 – Kentucky Medical Order for Scope of Treatment (MOST) Form