Kentucky Statutory Advance Directive for Mental Health Care
Living Wills - General - Kentucky
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An "advance directive" is a living will directive made in accordance with KRS 311.621 to 311.643, a living will or designation of health care surrogate or any other document that provides directions relative to health care to be provided to the person executing the document.
A "directive" is a living will directive in writing voluntarily made by an adult in accordance with the statutory provisions.
"Life prolonging treatment" is any medical procedure, treatment, or intervention which:
(1) Utilizes mechanical or other artificial means to sustain, prolong, restore, or supplant a spontaneous vital function; and
(2) When administered to a patient would serve only to prolong the dying process.
"Life prolonging treatment" does not include the administration of medication or the performance of any medical procedure deemed necessary to alleviate pain.
"Permanently unconscious" is a condition which, to a reasonable degree of medical probability, as determined solely by the patient's attending physician and one other physician on clinical examination, is characterized by an absence of cerebral cortical functions indicative of consciousness or behavioral interaction with the environment.
A "surrogate" is an adult who has been designated to make health care decisions in accordance with KRS 311.621 to 311.643.
A "terminal condition" is a condition caused by injury, disease, or illness which, to a reasonable degree of medical probability, as determined solely by the patient's attending physician and one other physician, is incurable and irreversible and will result in death within a relatively short time, and where the application of life prolonging treatment would serve only to artificially prolong the dying process.
An adult with decisional capacity may make a written living will directive that does any or all of the following:
(1) Directs the withholding or withdrawal of life prolonging treatment; or
(2) Directs the withholding or withdrawal of artificially provided nutrition or hydration; or
(3) Designates one or more adults as a surrogate or successor surrogate to make health care decisions on behalf of the grantor. During any period in which two or more surrogates are serving, all decisions must be by unanimous consent of all the acting surrogates unless the advance directive provides otherwise; or
(4) Directs the giving of all or any part of the adult's body upon death for any purpose specified in KRS 311.185.
Except as provided in KRS 311.633, a living will directive must be honored by a grantor's family, regular family physician or attending physician, and any health care facility of or in which the grantor is a patient.
A living will directive must be substantially in the statutory form and may include other specific directions which are in accordance with accepted medical practice and not specifically prohibited by any other statute. If any other specific directions are held by a court of appropriate jurisdiction to be invalid, that invalidity shall not affect the directive.
An advance directive may be revoked by:
(1) A writing declaring an intention to revoke, which writing shall be signed and dated by the grantor;
(2) An oral statement of intent to revoke made by a grantor with decisional capacity in the presence of two adults, one of whom shall be a health care provider; or
(3) Destruction of the document by the grantor or by some person in the grantor's presence and at the grantor's direction.
An oral statement by a grantor with decisional capacity to revoke an advance directive overrides any previous written advance directive made.
A surrogate designated pursuant to an advance directive may make health care decisions for the grantor which the grantor could make individually if he or she had decisional capacity, provided all the decisions must be made in accordance with the desires of the grantor as indicated in the advance directive. When making any health care decision for the grantor, the surrogate must consider the recommendation of the attending physician and honor the decision made by the grantor as expressed in the advance directive.
A surrogate may not make a health care decision in any situation in which the grantor's attending physician has determined in good faith that the grantor has decisional capacity.
A health care surrogate may authorize the withdrawal or withholding of artificially provided nutrition and hydration in the following circumstances:
(1) When inevitable death is imminent, which for the purposes of this provision shall mean when death is expected, by reasonable medical judgment, within a few days; or
(2) When a patient is in a permanently unconscious state if the grantor has executed an advance directive authorizing the withholding or withdrawal of artificially provided nutrition and hydration; or
(3) When the provision of artificial nutrition cannot be physically assimilated by the person; or
(4) When the burden of the provision of artificial nutrition and hydration itself shall outweigh its benefit.
Artificially provided nutrition and hydration cannot be withheld or withdrawn if it is needed for comfort or the relief of pain.
Life sustaining treatment and artificially provided nutrition and hydration must be provided to a pregnant woman unless, to a reasonable degree of medical certainty, the procedures will not maintain the woman in a way to permit the continuing development and live birth of the unborn child, will be physically harmful to the woman, or prolong severe pain which cannot be alleviated by medication.
The withholding or withdrawal of life prolonging treatment or artificially provided nutrition and hydration from a grantor in accordance with the statutory provisions does not, for any purpose, constitute a suicide.
ANATOMICAL GIFTS
(§§ 65-3210 through 65-3217)
Any individual of sound mind and eighteen years of age or more may give all or any part of his body for any purpose specified in KRS 311.185. An anatomical gift takes effect up on death.
A gift of all or part of the body may be made by will. The gift becomes effective upon the death of the testator without waiting for probate. If the will is not probated, or if it is declared invalid for testamentary purposes, the gift, to the extent that it has been acted upon in good faith, is nevertheless valid and effective.
A gift of all or part of the body may also be made by document other than a will. The gift becomes effective upon the death of the donor.
If the gift is made by the donor to a specified donee, the will, card, or other document, or an executed copy thereof, may be delivered to the donee to expedite the appropriate procedures immediately after death. Delivery is not necessary to the validity of the gift.
If the will, card, or other document or executed copy thereof, has been delivered to a specified donee, the donor may amend or revoke the gift by:
(1) The execution and delivery to the donee of a signed statement, or
(2) An oral statement made in the presence of two (2) persons and communicated to the donee, or
(3) A statement during a terminal illness or injury addressed to an attending physician and communicated to the donee, or
(4) A signed card or document found on his person or in his effects.
Any document of gift which has not been delivered to the donee may be revoked by the donor in the manner set out above or by destruction, cancellation, or mutilation of the document and all executed copies of the document.
An anatomical gift made by a will may also be amended or revoked in the manner provided for amendment or revocation of wills or as set out above.
Any gift of a transplantable organ identified by a will, card, or other document or executed copy thereof which stipulates remuneration of any type in return for the anatomical gift shall be null and void.
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