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AN ACT relating to medical order for scope of treatment. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 311.621 is amended to read as follows: 3
As used in KRS 311.621 to 311.643: 4
(1) "Adult" means a person eighteen (18) years of age or older and who is of sound 5
mind; 6
(2) "Advance directive" means a living will directive made in accordance with KRS 7
311.621 to 311.643, a living will or designation of health care surrogate executed 8
prior to July 15, 1994, and any other document that provides directions relative to 9
health care to be provided to the person executing the document; 10
(3) "Advanced practice registered nurse" or "APRN" has the same meaning as in 11
KRS 314.011; 12
(4) "Artificially-provided nutrition and hydration" means sustenance or fluids that are 13
artificially or technologically administered; 14
(5)[(4)] "Attending physician" means the physician who has primary responsibility for 15
the treatment and care of the patient; 16
(6)[(5)] "Decisional capacity" means the ability to make and communicate a health 17
care decision; 18
(7)[(6)] "Directive" means a living will directive in writing voluntarily made by an 19
adult in accordance with the provisions of KRS 311.621 to 311.643; 20
(8)[(7)] "Grantor" means an adult who has executed an advance directive in 21
accordance with KRS 311.621 to 311.643; 22
(9)[(8)] "Health care decision" means consenting to, or withdrawing consent for, any 23
medical procedure, treatment, or intervention; 24
(10)[(9)] "Health care facility" means any institution, place, building, agency, or portion 25
thereof, public or private, whether organized for profit or not, used, operated, or 26
designed to provide medical diagnosis, treatment, nursing, rehabilitative, or 27 UNOFFICIAL COPY 22 RS BR 152
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preventive care, and licensed pursuant to KRS Chapter 216B; 1
(11)[(10]) "Health care provider" means any health care facility or provider of health 2
services, including but not limited to, those licensed, certified, or regulated under 3
the provisions of KRS Chapters 211, 216, 311, 312, 313, or 314; 4
(12)[(11)] "Life-prolonging treatment" means any medical procedure, treatment, or 5
intervention which: 6
(a) Utilizes mechanical or other artificial means to sustain, prolong, restore, or 7
supplant a spontaneous vital function; and 8
(b) When administered to a patient would serve only to prolong the dying process. 9
"Life-prolonging treatment" shall not include the administration of medication 10
or the performance of any medical procedure deemed necessary to alleviate 11
pain; 12
(13)[(12)] "Medical order for scope of treatment" form" or "MOST form" means an 13
actionable medical order signed by a patient, a patient's legal surrogate, or a 14
responsible party, and the patient's provider[physician] directing the use of life-15
sustaining treatment for the patient. A medical order for scope of treatment, if 16
completed, shall implement or apply a health power of attorney or a living will 17
directive if one exists; 18
(14) "Patient's provider" means a physician, physician assistant, or an advance 19
practice registered nurse; 20
(15)[(13)] "Permanently unconscious" means a condition which, to a reasonable degree 21
of medical probability, as determined solely by the patient's attending physician and 22
one (1) other physician on clinical examination, is characterized by an absence of 23
cerebral cortical functions indicative of consciousness or behavioral interaction with 24
the environment; 25
(16)[(14)] "Physician" means a person licensed to practice medicine in the 26
Commonwealth of Kentucky; 27 UNOFFICIAL COPY 22 RS BR 152
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(17)[(15)] "Physician assistant" has the same meaning as in KRS 311.840; 1
(18) "Responsible party" means an adult who has authority under KRS 311.631 to make 2
a health care decision for a patient who has not executed a living will directive; 3
(19)[(16)] "Surrogate" means an adult who has been designated to make health care 4
decisions in accordance with KRS 311.621 to 311.643; and 5
(20)[(17)] "Terminal condition" means a condition caused by injury, disease, or illness 6
which, to a reasonable degree of medical probability, as determined solely by the 7
patient's attending physician and one (1) other physician, is incurable and 8
irreversible and will result in death within a relatively short time, and where the 9
application of life-prolonging treatment would serve only to artificially prolong the 10
dying process. 11
Section 2. KRS 311.6225 is amended to read as follows: 12
(1) An adult with decisional capacity, an adult's legal surrogate, or a responsible party 13
may complete a medical order for scope of treatment directing medical 14
interventions. The form shall have the title "MOST, Medical Orders for Scope of 15
Treatment" and an introductory section containing the patient's name and date of 16
birth, the effective date of the form, including the statement "Form must be 17
reviewed at least annually" and the statements "HIPAA permits disclosure of 18
MOST to other health care professionals as necessary" and "This document is based 19
on this person's medical condition and wishes. Any section not completed indicates 20
a preference for full treatment for that section." The form shall be in substantially 21
the following order and format and shall have the following contents: 22
(a) Section A of the form shall direct cardiopulmonary resuscitation when a 23
person has no pulse and is not breathing by selection of one (1) of the 24
following: 25
1. "Attempt Resuscitation (CPR)"; or 26
2. "Do Not Attempt Resuscitation"; and 27 UNOFFICIAL COPY 22 RS BR 152
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include the statement "When not in cardiopulmonary arrest, follow orders in 1
B, C, and D."; 2
(b) Section B of the form shall direct the scope of treatment when a person has a 3
pulse or is breathing by selection of one (1) of the following: 4
1. Full scope of treatment, including the use of intubation, advanced airway 5
interventions, mechanical ventilation, defibrillation or cardioversion as 6
indicated, medical treatment, intravenous fluids, and comfort measures. 7
This option shall include the statement "Transfer to a hospital if 8
indicated. Includes intensive care. Treatment Plan: Full treatment, 9
including life support measures."; 10
2. Limited additional intervention, including the use of medical treatment, 11
oral and intravenous medications, intravenous fluids, cardiac monitoring 12
as indicated, noninvasive bi-level positive airway pressure, a bag valve 13
mask, and comfort measures. This option excludes the use of intubation 14
or mechanical ventilation. This option shall include the statement 15
"Transfer to a hospital if indicated. Avoid intensive care. Treatment 16
Plan: Provide basic medical treatments."; or 17
3. Comfort measures, including keeping the patient clean, warm, and dry; 18
use of medication by any route; positioning, wound care, and other 19
measures to relieve pain and suffering; and the use of oxygen, suction, 20
and manual treatment of airway obstruction as needed for comfort. This 21
option shall include the statement "Do not transfer to a hospital unless 22
comfort needs cannot be met in the patient's current location (e.g. hip 23
fracture).". 24
These options shall be followed by a space for other instructions; 25
(c) Section C of the form shall direct the use of oral and intravenous antibiotics 26
by selection of one (1) of the following: 27 UNOFFICIAL COPY 22 RS BR 152
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1. Antibiotics if indicated for the purpose of maintaining life; 1
2. Determine use or limitation of antibiotics when infection occurs; 2
3. Use of antibiotics to relieve pain and discomfort; or 3
4. No antibiotics, use other measures to relieve symptoms. 4
This option shall include a space for other instructions; 5
(d) Section D of the form shall: 6
1. Have the heading "Medically Administered Fluids and Nutrition: The 7
provision of nutrition and fluids, even if medically administered, is a 8
basic human right and authorization to deny or withdraw shall be limited 9
to the patient, the surrogate in accordance with KRS 311.629, or the 10
responsible party in accordance with KRS 311.631."; 11
2. Direct the administration of fluids if physically possible as determined 12
by the patient's provider[physician] in accordance with reasonable 13
medical judgment and in consultation with the patient, surrogate, or 14
responsible party by selecting one (1) of the following: 15
a. Long-term intravenous fluids if indicated; 16
b. Intravenous fluids for a defined trial period. This option shall be 17
followed by "Goal:................."; or 18
c. No intravenous fluids, provide other measures to ensure comfort; 19
and 20
3. Direct the administration of nutrition if physically possible as 21
determined by the patient's provider[physician] in accordance with 22
reasonable medical judgment and in consultation with the patient, 23
surrogate, or responsible party by selecting one (1) of the following: 24
a. Long-term feeding tube if indicated; 25
b. Feeding tube for a defined trial period. This option shall be 26
followed by "Goal:................."; or 27 UNOFFICIAL COPY 22 RS BR 152
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c. No feeding tube. This option shall be followed by a space for 1
special instructions; 2
(e) Section E of the form shall: 3
1. Have the heading "Patient Preferences as a Basis for this MOST Form" 4
and shall include the language "Basis for order must be documented in 5
medical record"; 6
2. Provide direction to indicate whether or not the patient has an advance 7
medical directive such as a health care power of attorney or living will 8
and, if so, a place for the printed name, position, and signature of the 9
individual certifying that the MOST is in accordance with the advance 10
directive; and 11
3. Indicate whether oral or written directions were given and, if so, by 12
which one (1) or more of the following: 13
a. Patient; 14
b. Parent or guardian if patient is a minor; 15
c. Surrogate appointed by the patient's advance directive; 16
d. The judicially appointed guardian of the patient, if the guardian has 17
been appointed and if medical decisions are within the scope of the 18
guardianship; 19
e. The attorney-in-fact named in a durable power of attorney, if the 20
durable power of attorney specifically includes authority for health 21
care decisions; 22
f. The spouse of the patient; 23
g. An adult child of the patient or, if the patient has more than one (1) 24
child, the majority of the adult children who are reasonably 25
available for consultation; 26
h. The parents of the patient; and 27 UNOFFICIAL COPY 22 RS BR 152
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i. The nearest living relative of the patient or, if more than one (1) 1
relative of the same relation is reasonably available for 2
consultation, a majority of the nearest living relatives; 3
(f) A signature portion of the form shall include spaces for the printed name, 4
signature, and date of signing for: 5
1. The patient's provider[physician]; 6
2. The patient, parent of minor, guardian, health care agent, surrogate, 7
spouse, or other responsible party, with a description of the relationship 8
to the patient and contact information, unless based solely on advance 9
directive; and 10
3. The health care professional preparing the form, with contact 11
information; 12
(g) A section of the form shall be titled "Information for patient, surrogate, or 13
responsible party named on this form" with the following language: "The 14
MOST form is always voluntary and is usually for persons with advanced 15
illness. MOST records your wishes for medical treatment in your current state 16
of health. The provision of nutrition and fluids, even if medically 17
administered, is a basic human right and authorization to deny or withdraw 18
shall be limited to the patient, the surrogate in accordance with KRS 311.629, 19
or the responsible party in accordance with KRS 311.631. Once initial 20
medical treatment is begun and the risks and benefits of further therapy are 21
clear, your treatment wishes may change. Your medical care and this form can 22
be changed to reflect your new wishes at any time. However, no form can 23
address all the medical treatment decisions that may need to be made. An 24
advance directive, such as the Kentucky Health Care Power of Attorney, is 25
recommended for all capable adults, regardless of their health status. An 26
advance directive allows you to document in detail your future health care 27 UNOFFICIAL COPY 22 RS BR 152
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instructions or name a surrogate to speak for you if you are unable to speak for 1
yourself, or both. If there are conflicting directions between an enforceable 2
living will and a MOST form, the provisions of the living will shall prevail."; 3
(h) A section of the form shall be titled "Directions for Completing and 4
Implementing Form" with these four (4) subdivisions: 5
1. The first subdivision shall be titled "Completing MOST" and shall have 6
the following language: 7
"MOST must be reviewed, prepared, and signed by the patient's 8
provider[physician] in personal communication with the patient, the 9
patient's surrogate, or responsible party. 10
MOST must be reviewed and contain the original or electronic signature 11
of the patient's provider[physician] to be valid. Be sure to document the 12
basis in the progress notes of the medical record. Mode of 13
communication (e.g., in person, by telephone, etc.) should also be 14
documented. 15
The signature of the patient, surrogate, or a responsible party is required; 16
however, if the patient's surrogate or a responsible party is not 17
reasonably available to sign the original form, a copy of the completed 18
form with the signature or electronic signature of the patient's surrogate 19
or a responsible party must be signed by the patient's 20
provider[physician] and placed in the medical record. 21
Use of original form is required. Be sure to send the original form with 22
the patient. 23
There is no requirement that a patient have a MOST."; 24
2. The second subdivision shall be titled "Implementing MOST" and shall 25
have the following language: "If a health care provider or facility cannot 26
comply with the orders due to policy or personal ethics, the provider or 27 UNOFFICIAL COPY 22 RS BR 152
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facility must arrange for transfer of the patient to another provider or 1
facility."; 2
3. The third subdivision shall be titled "Reviewing MOST" and shall have 3
the following language: 4
"This MOST must be reviewed at least annually or earlier if: 5
The patient is admitted and/or discharged from a health care facility; 6
There is a substantial change in the patient's health status; or 7
The patient's treatment preferences change. 8
If MOST is revised or becomes invalid, draw a line through Sections A-9
E and write "VOID" in large letters."; and 10
4. The fourth subdivision shall be titled "Revocation of MOST" and shall 11
have the following language: "This MOST may be revoked by the 12
patient, the surrogate, or the responsible party."; and 13
(i) A section of the form shall be titled "Review of MOST" and shall have the 14
following columns and a number of rows as determined by the Kentucky 15
Board of Medical Licensure: 16
1. "Review Date"; 17
2. "Reviewer and Location of Review"; 18
3. "[MD/DO ]Signature of the patient's provider (Required)"; 19
4. "Signature of Patient, Surrogate, or Responsible Party (Required)"; and 20
5. "Outcome of Review, describing the outcome in each row by selecting 21
one (1) of the following: 22
a. No Change; 23
b. FORM VOIDED, new form completed; or 24
c. FORM VOIDED, no new form". 25
(2) The Kentucky Board of Medical Licensure shall promulgate administrative 26
regulations in accordance with KRS Chapter 13A to develop the format for a 27 UNOFFICIAL COPY 22 RS BR 152
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standardized medical order for scope of treatment form to be approved by the board, 1
including spacing, size, borders, fill and location of boxes, type of fonts used and 2
their size, and placement of boxes on the front or back of the form so as to fit on a 3
single sheet. The board shall create an electronically fillable version of the MOST 4
form that can be accessed on the board's Web site. The board may not alter the 5
wording or order of wording provided in subsection (1) of this section, except to 6
provide translated versions of the MOST form, add identifying data such as form 7
number and date of promulgation or revision and instructions for completing, 8
reviewing, and revoking the election of the form. The board shall provide a 9
Spanish translation of the MOST form in print and in an electronically fillable 10
version. The board shall consult with appropriate professional organizations to 11
develop the format for the medical order for scope of treatment form, including: 12
(a) The Kentucky Association of Hospice and Palliative Care; 13
(b) The Kentucky Board of Emergency Medical Services; 14
(c) The Kentucky Hospital Association; 15
(d) The Kentucky Association of Health Care Facilities; 16
(e) LeadingAge Kentucky; 17
(f) The Kentucky Right to Life Association; and 18
(g) Other groups interested in end-of-life care. 19
(3) The medical order for scope of treatment form developed under subsection (2) of 20
this section shall include but not be limited to: 21
(a) An advisory that completing the medical order for scope of treatment form is 22
voluntary and not required for treatment; 23
(b) Identification of the person who discussed and agreed to the options for 24
medical intervention that are selected; 25
(c) All necessary information necessary to comply with subsection (1) of this 26
section; 27 UNOFFICIAL COPY 22 RS BR 152
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(d) The effective date of the form; 1
(e) The expiration or review date of the form, which shall be no more than one (1) 2
calendar year from the effective date of the form; 3
(f) Indication of whether the patient has a living will directive or health care 4
power of attorney, a copy of which shall be attached to the form if available; 5
(g) An advisory that the medical order for scope of treatment may be revoked by 6
the patient, the surrogate, or a responsible party at any time; and 7
(h) A statement written in boldface type directly above the signature line for the 8
patient that states "You are not required to sign this form to receive 9
treatment." 10
(4) The[A] patient's provider[physician] shall document the medical basis for 11
completing a medical order for scope of treatment in the patient's medical record. 12
(5) The patient, the surrogate, or a responsible party shall sign the medical order for 13
scope of treatment form; however, if it is not practicable for the patient's surrogate 14
or a responsible party to sign the original form, the surrogate or a responsible party 15
shall sign a copy of the completed form and return it to the health care provider 16
completing the form. The copy of the form with the signature of the surrogate or a 17
responsible party, whether in electronic or paper form, shall be signed by the 18
patient's provider[physician] and shall be placed in the patient's medical record. 19
When the signature of the surrogate or a responsible party is on a separate copy of 20
the form, the original form shall indicate in the appropriate signature field that the 21
signature is attached. 22
(6) A portable patient medical order from another state that is executed by an adult 23
with decisional capacity, an adult's legal surrogate, or a responsible party shall 24
be honored in Kentucky if: 25
(a) The form was executed according to the laws and rules of that state; and 26
(b) The patient's provider, who is licensed according to the laws and rules of 27 UNOFFICIAL COPY 22 RS BR 152
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that state, has signed and dated the form, either manually or electronically. 1
(7) The MOST form may be electronic or printed on any color of paper and the form 2
shall be honored on any color of paper. 3
Section 3. KRS 311.623 is amended to read as follows: 4
(1) An adult with decisional capacity may make a written living will directive that does 5
any or all of the following: 6
(a) Directs the withholding or withdrawal of life-prolonging treatment; or 7
(b) Directs the withholding or withdrawal of artificially provided nutrition or 8
hydration; or 9
(c) Designates one (1) or more adults as a surrogate or successor surrogate to 10
make health care decisions on behalf of the grantor. During any period in 11
which two (2) or more surrogates are serving, all decisions shall be by 12
unanimous consent of all the acting surrogates unless the advance directive 13
provides otherwise; or 14
(d) Directs the giving of all or any part of the adult's body upon death for any 15
purpose specified in KRS 311.1929. 16
(2) Except as provided in KRS 311.633, a living will directive made pursuant to this 17
section or a medical order for scope of treatment made pursuant to KRS 311.6225 18
shall be honored by a grantor's family, regular family physician or attending 19
physician, physician assistant, advanced practice registered nurse, and any health 20
care facility of or in which the grantor is a patient. 21
(3) For purposes of KRS 311.621 to 311.643, notification to any emergency medical 22
responder as defined by KRS Chapter 211 or any paramedic as defined by KRS 23
Chapter 311, of a person's authentic wish not to be resuscitated shall be recognized 24
only if on a standard form or identification approved by the Kentucky Board of 25
Medical Licensure, in consultation with the Cabinet for Health and Family Services, 26
or a standard medical order for scope of treatment form approved by the Kentucky 27 UNOFFICIAL COPY 22 RS BR 152
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Board of Medical Licensure pursuant to KRS 311.6225. 1
Section 4. KRS 311.633 is amended to read as follows: 2
(1) It shall be the responsibility of the grantor or the responsible party of the grantor to 3
provide for notification to the grantor's attending physician, physician assistant, or 4
advanced practice registered nurse, and health care facility where the grantor is a 5
patient that an advance directive or a medical order for scope of treatment has been 6
made. If the grantor is comatose, incompetent, or otherwise mentally or physically 7
incapable, any other person may notify the attending physician, physician assistant, 8
or advanced practice registered nurse of the existence of an advance directive or a 9
medical order for scope of treatment. An attending physician, physician assistant, 10
or advanced practice registered nurse who is notified shall promptly make the 11
living will directive or a copy of the advance directive or a medical order for scope 12
of treatment a part of the grantor's medical records. 13
(2) An attending physician, physician assistant, advanced practice registered nurse, or 14
health care facility which refuses to comply with the advance directive or a medical 15
order for scope of treatment made pursuant to KRS 311.6225 of a patient or 16
decision made by a surrogate or responsible party shall immediately inform the 17
patient or the patient's responsible party and the family or guardian of the patient of 18
the refusal. No physician, physician assistant, advanced practice registered nurse, 19
or health care facility which refuses to comply with the advance directive or medical 20
order for scope of treatment of a qualified patient or decision made by a responsible 21
party shall impede the transfer of the patient to another physician, physician 22
assistant, advanced practice registered nurse, or health care facility which will 23
comply with the advance directive or medical order for scope of treatment. If the 24
patient, the family, or the guardian of the patient has requested and authorized a 25
transfer, the transferring attending physician, physician assistant, or advanced 26
practice registered nurse and health care facility shall supply the patient's medical 27 UNOFFICIAL COPY 22 RS BR 152
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records and other information or assistance medically necessary for the continued 1
care of the patient, to the receiving physician, physician assistant, or advanced 2
practice registered nurse, and health care facility. 3
(3) No physician, physician assistant, advanced practice registered nurse, nurse, staff 4
member, or employee of a public or private hospital, or employee of a public or 5
private health care facility, who shall state in writing to the hospital or health care 6
facility his objection to complying with the advance directive of a patient, a health 7
care decision of a responsible party under KRS 311.621 to 311.643, or a medical 8
order for scope of treatment under KRS 311.6225, on moral, religious, or 9
professional grounds, shall be required to, or held liable for refusal to, comply with 10
the advance directive, health care decision, or medical order for scope of treatment 11
as long as the physician, nurse, staff member, or employee complies with the 12
requirements of subsection (2) of this section regarding patient notification and 13
patient transfer. 14
(4) It shall be unlawful discriminatory practice for any person to impose penalties or 15
take disciplinary action against or deny or limit licenses, certifications, degrees, or 16
other approvals or documents of qualification to any physician, physician assistant, 17
advanced practice registered nurse, nurse, staff member, or employee who refuses 18
to comply with the advance directive of a patient, a health care decision by a 19
responsible party under KRS 311.621 to 311.643, or a medical order for scope of 20
treatment, as long as the physician, physician assistant, advanced practice 21
registered nurse, nurse, staff member, or employee complies with the provisions of 22
subsection (2) of this section regarding notification and transfer. 23
Section 5. KRS 311.635 is amended to read as follows: 24
(1) A health care facility, physician, physician assistant, advanced practice registered 25
nurse, or any[other] person acting under the direction of a physician shall not be 26
subject to criminal prosecution or civil liability or be deemed to have engaged in 27 UNOFFICIAL COPY 22 RS BR 152
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unprofessional conduct as a result of the withholding or the withdrawal of life-1
prolonging treatment or artificially provided nutrition and hydration from a patient 2
in a terminal condition in accordance with an advance directive executed pursuant 3
to KRS 311.621 to 311.643. A person who authorizes the withholding or 4
withdrawal of life-prolonging treatment or artificially provided nutrition and 5
hydration from a patient in a terminal condition in accordance with an advance 6
directive shall not be subject to criminal prosecution or civil liability for the action. 7
(2) An independent investigation of a surrogate's authority shall not be necessary unless 8
a person is in possession of information as to the surrogate's disqualification. No 9
surrogate, responsible party, physician, physician assistant, advanced practice 10
registered nurse, or health care facility acting in good faith, shall be subject to 11
criminal or civil liability for giving instructions as a surrogate, making a health care 12
decision as a responsible party under KRS 311.621 to 311.643, or carrying out, or 13
refusing to carry out pursuant to KRS 311.633, the surrogate's or responsible party's 14
instructions or acting in reliance on the grantor's designation of a surrogate or a 15
health care decision by a responsible party under KRS 311.621 to 311.643. 16
(3) The provisions of this section shall apply unless it is shown by a preponderance of 17
the evidence that the person: 18
(a) Authorizing or effectuating the withholding or withdrawal of life-prolonging 19
treatment; 20
(b) Giving instructions as a surrogate; 21
(c) Making a health care decision as a responsible party under KRS 311.621 to 22
311.643; 23
(d) Carrying out, or refusing to carry out, the surrogate's or responsible party's 24
instructions; or 25
(e) Acting in reliance on the grantor's designation of a surrogate or a health care 26
decision by a responsible party under KRS 311.621 to 311.643, did not, in 27 UNOFFICIAL COPY 22 RS BR 152
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good faith, comply with the provisions of KRS 311.621 to 311.643. 1
(4) An advance directive made in accordance with KRS 311.621 to 311.629 shall be 2
presumed to have been made voluntarily and validly executed unless the attending 3
physician, physician assistant, advanced practice registered nurse, or health care 4
facility has actual knowledge to the contrary. 5
Section 6. KRS 311.637 is amended to read as follows: 6
(1) The withholding or withdrawal of life-prolonging treatment or artificially provided 7
nutrition and hydration from a grantor in accordance with the provisions of KRS 8
311.621 to 311.643 shall not, for any purpose, constitute a suicide. The making of 9
an advance directive under KRS 311.621 to 311.629, a medical order for scope of 10
treatment under KRS 311.6225, or a health care decision by a responsible party 11
under KRS 311.621 to 311.643 shall not affect in any manner the sale, procurement, 12
or issuance of any policy of life insurance, nor shall it be considered to modify the 13
terms of an existing policy of life insurance. Notwithstanding any term of the policy 14
to the contrary, no policy of life insurance shall be legally impaired or invalidated in 15
any manner by a health care decision made by a surrogate or responsible party or by 16
the withholding or withdrawal from an insured patient any medical procedure or 17
intervention which would serve only to prolong artificially the dying process. 18
(2) No person, corporation, or governmental agency shall require or induce any person 19
to execute a living will directive or a medical order for scope of treatment under 20
KRS 311.6225, or to make a health care decision as a responsible party under KRS 21
311.621 to 311.643, as a condition for a contract or for the provision of any service, 22
medical treatment, or benefit. 23
(3) Nothing in KRS 311.621 to 311.643 shall be construed to impose any liability on a 24
surrogate or responsible party for any expenses of the grantor for which the 25
surrogate or responsible party would not otherwise have been liable. 26
(4) KRS 311.621 to 311.643 shall not create a presumption concerning the intention of 27 UNOFFICIAL COPY 22 RS BR 152
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an adult who has revoked or has not executed an advance directive or a medical 1
order for scope of treatment under KRS 311.6225, with respect to the use, 2
withholding, or withdrawal of life-prolonging treatment if a terminal condition 3
exists. 4
(5) KRS 311.621 to 311.643 shall not affect the common law or statutory right of an 5
adult to make decisions regarding the use of life-prolonging treatment, so long as 6
the adult is able to do so, or impair or supersede any common law or statutory right 7
that an adult has to effect the withholding or withdrawing of medical care. 8
(6) KRS 311.621 to 311.643 shall not preclude or restrict the right of persons to make 9
advance directives outside the provisions of KRS 311.621 to 311.643; and KRS 10
311.621 to 311.643 shall not restrict or preclude medical personnel, physicians, 11
physician assistants, advanced practice registered nurses, nurses, or health care 12
facilities from following other written advance directives consistent with accepted 13
medical practice. 14