Kentucky: Health Care Power of Attorney Requirements
The short answer
Kentucky folds the health care agent appointment into a single 'living will directive' (advance directive) under the Living Will Directive Act. It is valid if it is in writing, dated, and signed by you (or at your direction), and then either witnessed by two or more adults or acknowledged before a notary — witnesses and a notary are alternatives, not both. Your surrogate can act only once your attending physician determines you lack decisional capacity, and no blood relative, heir, attending physician, facility employee, or person financially responsible for your care may witness or notarize it.
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This is the general rule in Kentucky. Ezel applies current Kentucky law to your specific facts and answers with citations to the statutes.
| Governing law & document | Kentucky Living Will Directive Act, KRS 311.621–311.643; one combined 'living will directive' (advance directive) that both records treatment wishes and designates a health care surrogate. Optional statutory form at KRS 311.625(1). |
|---|---|
| Who can sign | An adult (18 or older and of sound mind) with decisional capacity; the advance directive must be in writing, dated, and signed by the grantor or, at the grantor's direction, by another person (KRS 311.623(1); 311.621(1); 311.625(2)). |
| Witnesses or notary | Either witnessed by two or more adults in the grantor's presence and in each other's presence, OR acknowledged before a notary public or other officer authorized to administer oaths. Witnesses and a notary are alternatives; you need one or the other, not both (KRS 311.625(2)). |
| Who can't witness or serve | No witness or notary may be a blood relative, a beneficiary under Kentucky's descent-and-distribution statutes, an employee of the facility where the grantor is a patient (unless serving as notary), the attending physician, or anyone directly financially responsible for the grantor's care (KRS 311.625(2)). A facility's employee, owner, director, or officer may not serve as surrogate unless related within the fourth degree or in the same religious or fraternal order (KRS 311.625(4)); a person convicted of a felony under the adult-protection chapter is barred from serving as surrogate for the victim (KRS 209.115). |
| When the agent can act | Springing. The surrogate may not make a health care decision in any situation in which the attending physician has determined in good faith that the grantor has decisional capacity, so authority begins only on loss of decisional capacity (KRS 311.629(2)). A later court-appointed fiduciary is bound by the directive and the surrogate keeps acting (KRS 311.6231). |
| Agent's powers & limits | The surrogate may make any health care decision the grantor could make, in accordance with the grantor's wishes as stated in the directive (KRS 311.629(1)). The statute lists no categorical exclusions; its main limits are on ending artificial nutrition and hydration, allowed only in four defined situations, and on a pregnant grantor, who must receive life-sustaining treatment and ANH unless two physicians certify it futile or harmful (KRS 311.629(3)–(4)). |
| How to revoke | Revoke by a signed, dated writing; by an oral statement (while you have decisional capacity) before two adults, one of them a health care provider; or by destroying the document. An oral revocation overrides any prior written directive, and a new surrogate designation revokes the prior one (KRS 311.627). No automatic revocation on divorce. |
| Out-of-state directives | No express reciprocity provision. The Act does not preclude providers from following other written advance directives consistent with accepted medical practice (KRS 311.637(6)), and 'advance directive' is defined broadly to include any document giving health-care directions (KRS 311.621(2)). |
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Kentucky does not have a standalone "health care power of attorney." Instead it
folds the appointment of a medical decision-maker into a single document called a
living will directive (the statute also calls it an advance directive).
One part of that directive records your treatment wishes; another part lets you
designate a health care surrogate — the person who makes medical decisions
for you if you lose the ability to make them yourself. This page is about
executing that surrogate designation. The rules live in the Kentucky Living Will
Directive Act, KRS 311.621 to 311.643.
Requirements one by one
Governing law and document
There is one instrument. Under KRS 311.623(1), "[a]n adult with decisional
capacity may make a written living will directive" that can direct end-of-life
treatment, direct the use of artificial nutrition and hydration, and "[d]esignate
one (1) or more adults as a surrogate or successor surrogate to make health care
decisions on behalf of the grantor." So the treatment instructions and the
surrogate appointment are two parts of the same directive. Kentucky publishes an
optional statutory form at KRS 311.625(1), but the form is not mandatory —
the statute says a directive need only be "substantially in the following form,"
and other written directives are expressly allowed.
Who can sign
The signer must be an adult — defined at KRS 311.621(1) as "a person eighteen
(18) years of age or older and who is of sound mind" — who has decisional
capacity, meaning "the ability to make and communicate a health care decision."
Under KRS 311.625(2) the directive must be "in writing, dated, and signed by the
grantor, or at the grantor's direction." That last phrase lets someone who cannot
physically sign have another person sign for them, at their direction.
Witnesses or notary
This is the step people most often get wrong. KRS 311.625(2) gives you a
choice: the directive must be "either witnessed by two (2) or more adults in
the presence of the grantor and in the presence of each other, or acknowledged
before a notary public or other person authorized to administer oaths." You do
not need both. Two qualified witnesses and a notary are interchangeable ways to
validate the document. If you use witnesses, they must sign in your presence and
in each other's presence.
Who can't witness or serve
KRS 311.625(2) bars five categories from acting as a witness or as the notary:
"(a) A blood relative of the grantor; (b) A beneficiary of the grantor under
descent and distribution statutes of the Commonwealth; (c) An employee of a health
care facility in which the grantor is a patient, unless the employee serves as a
notary public; (d) An attending physician of the grantor; or (e) Any person
directly financially responsible for the grantor's health care." Note the narrow
carve-out: a facility employee may act as your notary, but not as a witness.
A separate limit governs who may serve as surrogate. Under KRS 311.625(4), an
"employee, owner, director, or officer of a health care facility where the grantor
is a resident or patient shall not be designated or act as surrogate unless
related to the grantor within the fourth degree of consanguinity or affinity or a
member of the same religious or fraternal order." And under KRS 209.115, anyone
"convicted of a felony" under Kentucky's adult-protection chapter is disqualified
from serving as "health care surrogate as to the victim of the offense."
When the surrogate can act
The surrogate's authority is springing — it never operates while you can still
decide for yourself. KRS 311.629(2) provides that the 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." So the
attending physician's determination that you have lost decisional capacity is what
switches the surrogate's authority on. Kentucky's statute gives no option to make
the surrogate effective immediately while you still have capacity. If a court later
appoints a guardian or other fiduciary over you, that does not override your
directive: KRS 311.6231 makes the fiduciary "bound by the terms of the grantor's
advance directive," and your surrogate "may continue to act."
Surrogate's powers and limits
Once the authority is in effect, KRS 311.629(1) lets the surrogate "make health
care decisions for the grantor which the grantor could make individually if he or
she had decisional capacity," but "all the decisions shall be made in accordance
with the desires of the grantor as indicated in the advance directive." Unlike
some states, Kentucky's statute does not enumerate a list of decisions no
agent may ever make (such as commitment, psychosurgery, or sterilization); the
main statutory limits are two. First, withdrawing artificial nutrition and
hydration is allowed only in the four situations listed in KRS 311.629(3)
(imminent death, permanent unconsciousness with an authorizing directive,
inability to assimilate it, or burden outweighing benefit), and never when needed
for comfort or pain relief. Second, KRS 311.629(4) requires that a pregnant
grantor receive life-sustaining treatment and ANH unless the attending physician
and one other physician certify that the treatment will not permit a live birth,
will physically harm the woman, or will prolong severe pain.
How to revoke
KRS 311.627(1) gives you three ways to revoke: "(a) A writing declaring an
intention to revoke, which writing shall be signed and dated by the grantor; (b)
An oral statement of intent to revoke made by a grantor with decisional capacity
in the presence of two (2) adults, one (1) of whom shall be a health care
provider; or (c) Destruction of the document." An oral revocation "shall override
any previous written advance directive," and making a new surrogate designation
revokes the earlier one. Kentucky's Act has no provision automatically
revoking a spouse-surrogate on divorce — a gap worth knowing.
Out-of-state directives
Kentucky's Act has no express provision saying a directive validly executed in
another state is honored here. What it does say, in KRS 311.637(6), is that the
Act "shall not restrict or preclude medical personnel, physicians, nurses, or
health care facilities from following other written advance directives consistent
with accepted medical practice," and the definition of "advance directive" in KRS
311.621(1) is broad enough to include "any other document that provides directions
relative to health care." A directive from another state may therefore be honored,
but Kentucky does not guarantee it the way states with a formal reciprocity clause
do.
What trips people up
- You do not need a notary if you have two witnesses. People often assume a
medical directive must be notarized. In Kentucky it is one option, not a
requirement — two qualified adult witnesses do the same job (KRS 311.625(2)). - A relative or heir cannot witness or notarize. Blood relatives, anyone who
would inherit from you, your attending physician, and anyone paying for your
care are all disqualified (KRS 311.625(2)). A common mistake is having an adult
child sign as a witness; that invalidates the witness path. - Divorce does not cancel a spouse-surrogate. Unlike many states, Kentucky
has no statute revoking your spouse's authority when you divorce. If you named
your spouse and later divorce, you must sign a new directive (or revoke under
KRS 311.627) to remove them. - The surrogate cannot act while you still can. Even after you sign, the
surrogate has no authority until your attending physician determines you lack
decisional capacity (KRS 311.629(2)).
Common questions
Does a Kentucky living will directive have to be notarized?
No. You can either have it notarized or have two qualified adult witnesses sign it
in your presence and each other's — your choice (KRS 311.625(2)).
Can I name someone to make decisions now, before I lose capacity?
Kentucky's surrogate authority is springing by law. The surrogate can act only
after your attending physician determines you lack decisional capacity (KRS
311.629(2)); there is no box to make it effective immediately.
Can my surrogate stop a feeding tube?
Only in narrow circumstances. Withdrawing artificial nutrition and hydration is
limited to the four situations in KRS 311.629(3), and never when it is needed for
comfort or to relieve pain.
Will the directive I signed in another state work in Kentucky?
Possibly. Kentucky has no reciprocity clause, but providers are not barred from
following other written directives consistent with accepted medical practice (KRS
311.637(6)). To be safe, sign a Kentucky directive if you live or expect care here.
Statutes and sources
- KRS 311.623(1) — an adult with decisional capacity may make a written living
will directive designating a surrogate.
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=44036 (accessed 2026-07-16) - KRS 311.621(1) — definitions of "adult," "decisional capacity," and "advance
directive."
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=44034 (accessed 2026-07-16) - KRS 311.625 — form of the directive; execution requirement (dated, signed,
and either two adult witnesses or a notary), the five disqualified witnesses/
notaries, and the bar on a facility employee serving as surrogate.
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591 (accessed 2026-07-16) - KRS 209.115 — a person convicted of a felony under the adult-protection
chapter cannot serve as health care surrogate for the victim.
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=39694 (accessed 2026-07-16) - KRS 311.629 — powers of the health care surrogate; springing effect; limits
on withdrawing artificial nutrition and hydration; pregnancy rule.
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=30567 (accessed 2026-07-16) - KRS 311.6231 — a later court-appointed fiduciary is bound by the directive;
the surrogate may continue to act.
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=30561 (accessed 2026-07-16) - KRS 311.627 — revocation by signed writing, oral statement before two adults
(one a provider), or destruction.
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=30565 (accessed 2026-07-16) - KRS 311.637(6) — the Act does not preclude providers from following other
written advance directives.
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=44038 (accessed 2026-07-16)
Source links
Every statute quoted above, linked, with the date we checked it.
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