dnrohio

OHIO'S LAW
ON
ADVANCE DIRECTIVES, 1991

Lawrence P. Ulrich, Ph.D.
Lawrence.Ulrich@notes.udayton.edu
http://homepages.udayton.edu/~ulrich/

DEFINITIONS AND SUMMARY OUTLINE

"Seed Pot"
Pottery by Mairus Chino
of Acoma

"Kokopelli"
Pottery by Mairus Chino
of Acoma

KEY DEFINITIONS

TERMINAL CONDITION

AN IRREVERSIBLE, INCURABLE, AND UNTREATABLE CONDITION CAUSED BY DISEASE, ILLNESS, OR INJURY TO WHICH, TO A REASONABLE DEGREE OF MEDICAL CERTAINTY AS DETERMINED IN ACCORDANCE WITH REASONABLE MEDICAL STANDARDS BY THE PATIENT'S ATTENDING PHYSICIAN AND ONE OTHER PHYSICIAN WHO HAS EXAMINED HIM/HER, BOTH OF THE FOLLOWING APPLY: (1) THERE CAN BE NO RECOVERY, AND (2) DEATH IS LIKELY TO OCCUR WITHIN A RELATIVELY SHORT TIME IF LIFE-SUSTAINING TREATMENT IS NOT ADMINISTERED.

LIFE-SUSTAINING TREATMENT

ANY MEDICAL PROCEDURE, TREATMENT, INTERVENTION, OR OTHER MEASURE INCLUDING ARTIFICIALLY OR TECHNOLOGICALLY SUPPLIED NUTRITION AND HYDRATION THAT, WHEN ADMINISTERED, WILL SERVE PRINCIPALLY TO PROLONG THE PROCESS OF DYING.

PERMANENTLY UNCONSCIOUS STATE

A STATE OF PERMANENT UNCONSCIOUSNESS THAT, TO A REASONABLE DEGREE OF MEDICAL CERTAINTY AS DETERMINED IN ACCORDANCE WITH REASONABLE MEDICAL STANDARDS BY THE PATIENT'S ATTENDING PHYSICIAN AND ONE OTHER PHYSICIAN WHO HAS EXAMINED HIM/HER, IS CHARACTERIZED BY BOTH OF THE FOLLOWING: (1) THE PATIENT IS IRREVERSIBLY UNAWARE OF HIMSELF/HERSELF AND HIS/HER ENVIRONMENT, AND (2) THERE IS A TOTAL LOSS OF CEREBRAL CORTICAL FUNCTIONING, RESULTING IN THE PATIENT'S HAVING NO CAPACITY TO EXPERIENCE PAIN OR SUFFERING.

COMFORT CARE

ARTIFICIALLY OR TECHNOLOGICALLY ADMINISTERED SUSTENANCE (NUTRITION) OR FLUIDS (HYDRATION) WHEN ADMINISTERED TO DIMINISH PAIN OR DISCOMFORT, NOT TO POSTPONE DEATH, AND ANY OTHER MEDICAL OR NURSING PROCEDURE, TREATMENT, INTERVENTION, OR OTHER MEASURE THAT WOULD BE TAKEN TO DIMINISH PAIN OR DISCOMFORT, NOT TO POSTPONE DEATH.

CLASSIFICATIONS

LIVING WILL DECLARATION
DURABLE POWER OF ATTORNEY FOR HEALTH CARE
THOSE WITHOUT A DOCUMENT

LIVING WILL DECLARATION

CONDITION

PATIENT MUST BE TERMINALLY ILL
IRREVERSIBLE LOSS OF DECISIONAL CAPACITY
CANNOT W/W COMFORT CARE
PHYSICIAN OR FACILITY CAN REFUSE TO COOPERATE
PATIENT HAS RIGHT TO BE TRANSFERRED
DIAGNOSIS CONFIRMED BY SECOND PHYSICIAN (SPECIALIST IF P.U.S)
48-HOUR NOTICE TO DESIGNATED PERSON (OR NEXT OF KIN) THAT LIVING WILL IS GOING TO BE INVOKED

AUTHORITY TO W/W MOST TREATMENTS IN MOST CASES

COMFORT CARE CANNOT BE W/W
MUST CHECK AND INITIAL W/W ARTIFICIAL NUTRITION AND HYDRATION STIPULATION
CANNOT W/W IN PREGNANCY IF FETUS CAN BE CARRIED TO VIABILITY

HONOR LIVING WILL FROM ANOTHER STATE

WITNESSES

TWO ADULTS OR
NOTARY PUBLIC
NO ONE RELATED BY BLOOD, MARRIAGE, ADOPTION
NOT ATTENDING PHYSICIAN
NOT ADMINISTRATOR OF NURSING HOME

DURABLE POWER OF ATTORNEY FOR HEALTH CARE

AUTHORITY

W/W TREATMENTS WHICH ARE NOT LIFE-SUSTAINING WHENEVER PRINCIPAL IS INCOMPETENT
CANNOT W/W LIFE-SUSTAINING TREATMENTS UNLESS PRINCIPAL IS TERMINALLY ILL AND IS HAS PERMANENTLY LOST DECISIONAL CAPACITY
AUTHORITY TO TERMINATE ARTIFICIAL NUTRITION AND HYDRATION MUST BE EXPLICITLY GRANTED BY PRINCIPAL'S CHECKING THE BOX AND INITIALING THE LINE
IRREVERSIBLE LOSS OF DECISIONAL CAPACITY REQUIRED TO W/W LIFE-SUSTAINING TREATMENTS
CANNOT W/W COMFORT CARE
PHYSICIAN OR FACILITY CAN REFUSE TO COOPERATE
PATIENT HAS RIGHT TO BE TRANSFERRED
DIAGNOSIS CONFIRMED BY SECOND PHYSICIAN (SPECIALIST IF P.U.S.)
PREVIOUS COMPETENT CONSENTS TO TREATMENT APPLY UNLESS PRINCIPAL'S CONDITION CHANGES SIGNIFICANTLY
CANNOT W/W IN PREGNANCY IF FETUS CAN BE CARRIED TO VIABILITY

GRANDFATHER OLD DURABLE POWER OF ATTORNEY FOR HEALTH CARE

CAUTION ABOUT SPECIAL STIPULATIONS (N/H)

HONOR DPA FROM OTHER STATES

WHO CANNOT SERVE AS ATTORNEY-IN-FACT

PERSONAL PHYSICIAN
ADMINISTRATOR OF RESIDENT'S EXTENDED CARE FACILITY

WITNESSES

TWO ADULTS OR
NOTARY PUBLIC
NO ONE RELATED BY BLOOD, MARRIAGE, ADOPTION
NOT ATTENDING PHYSICIAN
NOT ADMINISTRATOR OF NURSING HOME

THOSE WITHOUT A DOCUMENT

ORDER OF DECISION-MAKERS

GUARDIAN
SPOUSE
ADULT CHILDREN
PARENTS
ADULT SIBLINGS
NEXT REASONABLY CLOSE RELATIVE

AUTHORITY

MAKE ALL HEALTH CARE DECISIONS FOR PATIENTS IN TERMINAL CONDITION INCLUDING W/W LIFE-SUSTAINING TREATMENTS
12-MONTH WAITING PERIOD REQUIRED FOR PATIENTS IN P.U.S. FOR W/W LIFE-SUSTAINING TREATMENTS EXCEPT ARTIFICIAL NUTRITION AND HYDRATION
AFTER 12-MONTH PERIOD PROBATE COURT DECISION REQUIRED TO WITHDRAW ARTIFICIAL NUTRITION AND HYDRATION

CHALLENGES

NOT FROM STRANGERS

SPECIAL INTEREST GROUP
DISTRICT ATTORNEY
ATTORNEY GENERAL

NEXT AUTHORIZED PERSON(S) IN DECISION-MAKING LINE

CHALLENGES OF FACT

WHETHER PATIENT IS TERMINALLY ILL
WHETHER PATIENT HAS IRREVERSIBLY LOST DECISIONAL CAPACITY
NO CHALLENGE OF INTENT OR INTERPRETATION OF WISHES OF PATIENT

TIME PERIODS

48 HOURS TO FILE APPEAL WITH THE COURT
72 HOURS FOR COURT TO HEAR AND DECIDE