Medical power of attorney in Kentucky: how it works, how to sign
The short answer
In Kentucky, you name a health care surrogate in a living will directive. Sign and date it before two adult witnesses or a notary, and no relative or heir can witness. If you name nobody, the law turns to a guardian, then your spouse, adult children, parents, nearest relatives, and finally a qualifying adult friend.
The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?
Kentucky puts the answer in a document called a "living will directive," which can name a "health care surrogate." This page covers how to sign one, who can't be your witness, and what happens if you name nobody. It is part of our estate planning guides for each state. For the basics of the role, see what a medical power of attorney is.
What is the Kentucky document called?
Many states call this a health care power of attorney. Kentucky's statutory document is the living will directive (KRS 311.623). In one document you can:
- Name one or more health care surrogates, plus backups.
- Write down your wishes about life-prolonging treatment and tube feeding.
- Make anatomical gifts.
The umbrella term in Kentucky law is "advance directive" (KRS 311.621). So when a hospital asks whether you have an advance directive, this is what they mean.
If you name two or more surrogates to serve together, they must agree unanimously unless your directive says otherwise. Most people name one surrogate and a backup instead.
How do I sign one in Kentucky?
The directive must be in writing, dated, and signed by you, or by someone at your direction (KRS 311.625). Then it needs one of these:
- Two or more adult witnesses, who sign in your presence and in each other's, or
- A notary (or another officer who can give oaths).
Kentucky has a statutory form, and the directive should be in substantially that form. You can add other instructions to it.
New in 2026: starting July 15, 2026, advance directives can be signed, witnessed and notarized electronically, with witnesses present electronically (2026 Ky. Acts ch. 134). Paper still works.
Kentucky's financial power of attorney follows different rules. Our Kentucky power of attorney guide covers that document.
Who can't be my witness or my surrogate?
Kentucky rules out the same people as witnesses and as the notary (KRS 311.625):
| Person | Can be a witness? | Can be the notary? |
|---|---|---|
| A blood relative | No | No |
| Anyone who would inherit from you if you had no will | No | No |
| An employee of a health care facility where you are a patient | No | Yes |
| Your attending physician | No | No |
| Anyone directly paying for your health care | No | No |
| A friend or neighbor who is none of the above | Yes | Yes |
The simplest path is a notary who doesn't know you, or two friends who aren't related to you.
There is also a limit on who can be your surrogate. An employee, owner, director or officer of the facility where you live or are a patient can't serve. The exception is someone related to you within the fourth degree, or a member of the same religious or fraternal order.
What can my surrogate decide?
Your surrogate makes the health care decisions you would make if you could (KRS 311.629). In day-to-day terms, that means talking with your doctors, reading your chart, and agreeing to or declining a test, a surgery or a new medicine.
Your surrogate is a fiduciary: legally required to act in your interest and follow what you wrote.
Kentucky is careful about tube feeding. A surrogate may stop artificial nutrition and hydration only in listed situations: death is imminent, you are permanently unconscious and your directive allows it, your body can't absorb it, or the burden outweighs the benefit. Never when it is needed for comfort or pain relief.
Do I need a separate living will?
No. In Kentucky the living will and the surrogate are in the same document. The living will directive can tell doctors to withhold or withdraw life-prolonging treatment and tube feeding, and it names your surrogate too (KRS 311.623).
The directive has no effect during a pregnancy known to your doctor. Our post on health care power of attorney vs living will explains how the two ideas work together, and treatment preferences helps you think through what to write.
Who decides if I haven't named anyone?
Most states have a law that lists which relatives can make medical decisions for you if you haven't named anyone. Kentucky does. If you can't decide and have no directive covering the decision, the first available, willing and able person in this order decides (KRS 311.631):
| Order | Who |
|---|---|
| 1 | A court-appointed guardian with medical authority |
| 2 | An agent under a durable power of attorney that specifically includes health care decisions |
| 3 | Your spouse |
| 4 | An adult child, or a majority of the adult children reasonably available |
| 5 | Your parents |
| 6 | Your nearest living relative, or a majority of the nearest relatives of the same degree |
| 7 | An adult friend |
The friend was added in 2024 (effective July 15, 2024). A friend qualifies only if they have kept regular contact with you and know your activities, your health, and your religious and moral beliefs.
Whoever decides must act in good faith, follow any advance directive, and act in your best interest.
Notice where the friend sits: last, behind cousins and other distant relatives. If the person who really knows your wishes is a friend, a partner or a niece, naming them as your surrogate moves them to the front. Our page on who decides for me walks through the question, and our post on medical decisions without a power of attorney compares other states. The 50-state guide to default decision-makers has the full list.
Here is a typical case, a composite. Shirley is 71, divorced, and lives in Louisville. Her brother lives in Florida. Her friend Ann goes to church with her every Sunday and knows exactly what she would want. Shirley names Ann as her health care surrogate and her brother as backup.
How do I choose my surrogate?
Once the signing is done, the practical questions matter most. Is the person willing? Can they get to the hospital? Will they follow your wishes even when they'd choose differently?
A short checklist:
- They know what you want, because you've told them.
- They can stay calm in a hospital hallway and ask questions.
- They live close enough, or can travel when needed.
- You've named a backup in case they can't.
Our post on how to choose a medical power of attorney has more questions to ask.
Some people would like a professional standing by, first or behind a friend. A Kinly membership includes a medical power of attorney written for your state, and Trella Trust Company can be named in the role, first or as the backup to someone you choose.
Once your health papers are done, our Kentucky probate guide covers what happens to your home and savings later.
Common questions
What is a medical power of attorney called in Kentucky?
Kentucky's statutory document is the living will directive. It can name a health care surrogate and record your treatment wishes in one place. The general term is advance directive.
Does a Kentucky living will directive need to be notarized?
Not necessarily. It can be signed before two adult witnesses or acknowledged before a notary. Relatives, heirs, your doctor and people paying for your care can't fill either role.
Who makes medical decisions in Kentucky if there's no directive?
A guardian, then an agent under a power of attorney that includes health care, then your spouse, adult children, parents, nearest relatives, and finally a qualifying adult friend.
Can a friend make medical decisions for me in Kentucky?
Yes, as the last option on the default list, if they've kept regular contact and know your health and beliefs. Naming the friend as your surrogate puts them first instead.
Can I sign my Kentucky advance directive electronically?
Yes, starting July 15, 2026. A 2026 law allows electronic signing, witnessing and notarizing of advance directives.
Sources
- KRS 311.621: Definitions (Kentucky General Assembly)
- KRS 311.623: Living will directive (Kentucky General Assembly)
- KRS 311.625: Form of living will directive (Kentucky General Assembly)
- KRS 311.629: Powers of health care surrogate (Kentucky General Assembly)
- KRS 311.631: Responsible parties authorized to make health care decisions (Kentucky General Assembly)
- 2026 Ky. Acts ch. 134 (SB 50) (Kentucky General Assembly)
This page is general information, not legal or financial advice. Laws vary by state.