Life Sustaining Statute, Kansas
Statutory Declaration in Conformance with Kansas Natural Death Act, Kansas Statutes Section 65-28,103
DECLARATION OF ___________________Declaration made this __________ day of ________________ 20_____. I ____________, being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, do hereby declare:
If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two physicians who have personally examined me, one of whom shall be my attending physician, and the physicians have determined that my death will occur whether or not life- sustaining procedures are utilized and where the application of life-sustaining procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care.
In the absence of my ability to give directions regarding the use of such life-sustaining procedures, it is my intention that this declaration shall be honored by my family and physicians as the final expression of my legal right to refuse medical or surgical treatment and accept the consequences from such refusal.
I understand the full import of this declaration and I am emotionally and mentally competent to make this declaration.
________________________________________
City of residence: _________________
County of residence: _______________
State of residence: ________________
The Declarant has been personally known to me and I believe him or her to be of sound mind. I did not sign the Declarant’s signature above for or at the declaration of the Declarant. I am not related to the Declarant by blood or marriage, entitled to any portion of the estate of the Declarant according to the laws of in testate succession or under any will of Declarant or codicil thereto, or directly financially responsible for Declarant’s medical care.Witness _________________________________________________
Witness _________________________________________________
Date: _______________
Statutory Declaration in Conformance with Kansas Natural Death Act, Kansas Statutes Section 65-28,103
Review ListThis review list is provided to inform you about this document in question and assist you in its preparation. This simple Life Sustaining Declaration is valid in Kansas. Check with a local hospital or doctor’s office, as well as with an experienced medical attorney, to assure yourself of its compliance with current statute (s) in your state.
1. Make multiple copies. Give one to your doctor (s), the local hospital, and have others available through your attorney and family. Remember, these kinds of documents are needed in emergency situations at worst and under stressful circumstances at best. So be sure they are available to the appropriate people easily, when needed.
Frequently Asked Questions
What is the Kansas Natural Death Act?
The Kansas Natural Death Act is referenced in the statutory declaration provided in the article, which allows individuals to declare their wishes regarding life-sustaining procedures. It is codified in Kansas Statutes Section 65-28,103. The declaration is made in conformance with this act.
How do I make a declaration under the Kansas Natural Death Act?
To make a declaration, you must complete the statutory form provided in the article. This involves filling in your name, the date, and signing the declaration. The form must be made voluntarily and while of sound mind.
What is a terminal condition according to the Kansas Natural Death Act?
A terminal condition is defined as an incurable injury, disease, or illness certified by two physicians who have personally examined the patient. One of the physicians must be the attending physician. The physicians must determine that death will occur whether or not life-sustaining procedures are utilized.
What are life-sustaining procedures under the Kansas Natural Death Act?
Life-sustaining procedures are medical interventions that would serve only to artificially prolong the dying process when a patient has a terminal condition. The declaration directs that such procedures be withheld or withdrawn. The patient is then permitted to die naturally with only comfort care.
What is comfort care in the context of the Kansas Natural Death Act?
Comfort care refers to the administration of medication or the performance of any medical procedure deemed necessary to provide comfort. It is the only care permitted once life-sustaining procedures are withheld or withdrawn. This allows the patient to die naturally.
Who needs to certify a terminal condition for a declaration to take effect?
Two physicians who have personally examined the patient must certify the terminal condition. One of these physicians must be the attending physician. They must also determine that death will occur regardless of life-sustaining procedures.
What happens if I am unable to give directions regarding life-sustaining procedures?
The declaration states that in the absence of your ability to give directions, it is your intention that the declaration be followed. The article does not specify further details beyond this intention. The declaration itself serves as your directive.
Is the Kansas Natural Death Act declaration legally binding?
The declaration is made in conformance with the Kansas Natural Death Act, Kansas Statutes Section 65-28,103. It is a statutory form, which implies it is legally recognized. However, the article does not explicitly state its legal binding nature beyond the reference to the statute.
Can I withdraw or revoke a declaration made under the Kansas Natural Death Act?
The article does not address the revocation or withdrawal of a declaration. It only provides the form and conditions for making one. For information on revocation, you would need to consult the full statute or legal advice.
What is the purpose of the Kansas Natural Death Act declaration?
The purpose is to allow individuals to make known their desire that their dying not be artificially prolonged under certain circumstances. It directs that life-sustaining procedures be withheld or withdrawn when a terminal condition is certified. The individual is then permitted to die naturally with comfort care.
