Ohio Living Will Requirements

Your Ohio living will, called a 'declaration' under the statute, must comply with the Modified Uniform Rights of the Terminally Ill Act, Ohio Revised Code Chapter 2133. This chapter governs the declaration entirely on its own, as a separate legal document from Ohio's durable power of attorney for health care statute.

Terminal condition means an irreversible, incurable, and untreatable condition caused by disease, illness, or injury from which, to a reasonable degree of medical certainty determined by your attending physician and one other examining physician, there can be no recovery and death is likely to occur within a relatively short time if life-sustaining treatment is not administered.

Permanently unconscious state means, to a reasonable degree of medical certainty determined by your attending physician and one other examining physician, both that you are irreversibly unaware of yourself and your environment, and that you have a total loss of cerebral cortical functioning resulting in no capacity to experience pain or suffering. Both parts of this two-part definition must be present, not just an inability to interact with your surroundings.

Your declaration must be dated and signed, then either witnessed by two qualifying adults or acknowledged before a notary public. These are two independently sufficient, co-equal routes to a valid declaration, not a primary method with notarization as a fallback; the disqualified witnesses are anyone related to you by blood, marriage, or adoption, your attending physician, and the administrator of any nursing home where you're receiving care.

You may revoke your declaration at any time and in any manner that communicates your intent to revoke; Ohio does not limit revocation to a fixed list of specific methods. The revocation is effective once you express that intent, except that if your attending physician already knew about the declaration, it becomes effective specifically once the revocation is communicated to that physician. A later declaration also automatically revokes an earlier one unless it says otherwise.

If you want nutrition or hydration withheld or withdrawn specifically because you are permanently unconscious, Ohio requires a statement in capital letters or other conspicuous type plus your initials or signature placed directly next to it. This separate, specifically marked election applies only when your declaration relies on the permanently unconscious trigger; if you rely on a terminal condition instead, nutrition and hydration are already addressed through the general comfort-care rules, with no separate initialed line required.

Life-sustaining treatment cannot be withheld or withdrawn under your declaration if you are pregnant and doing so would terminate the pregnancy, unless your attending physician and one other examining physician determine, to a reasonable degree of medical certainty, that the fetus would not be born alive.

Ohio's Anatomical Gift Act provisions let you authorize donation of your own body or body parts upon death, for transplantation, therapy, research, or education.

Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to ask patients whether they have an advance directive and to give them written information about their right under Ohio law to make one, including this declaration.

Federal HIPAA regulations govern how your protected health information may be released to someone else. Because your Ohio living will does not itself name an agent, this authorization is most relevant if you also sign a separate Ohio health care power of attorney naming someone to access your records; it does not expand what your declaration alone authorizes.

Ohio has a separate, genuinely distinct advance directive for psychiatric care preferences, the Declaration for Mental Health Treatment under Ohio Revised Code Sections 2135.01 to 2135.14. It lets you state mental health treatment preferences and designate a proxy for mental health decisions, but it is its own document with its own execution rules, not part of this living will, and it does not supersede your other advance directives.

A Do Not Resuscitate (DNR) order and Ohio's DNR Comfort Care Protocol are a separate physician's order, not part of your living will declaration itself. A DNR order is typically used alongside a declaration to translate your treatment wishes into an actionable medical order for emergency personnel, but it does not replace, and is not required by, your declaration.

Federal regulations implementing the Patient Self-Determination Act require Medicare- and Medicaid-participating providers to maintain written policies on advance directives, including this Ohio declaration, and to provide that information to patients at admission.

A declaration executed under another state's law, or one that substantially complies with Ohio Revised Code Sections 2133.01 to 2133.15, is considered valid in Ohio. This rule addresses how Ohio treats declarations signed in other states; it does not govern how other states treat a declaration signed in Ohio.

Ohio's declaration statute does not provide an itemized statutory checklist naming specific interventions like CPR, dialysis, or antibiotics. Instead, your single treatment choice under Section 2133.02, combined with the comfort-care carve-out at Section 2133.12, governs all forms of life-sustaining treatment; you may still describe specific interventions in your own words if you want to be explicit.

Withholding or withdrawing life-sustaining treatment in accordance with your declaration is not, for any purpose, a suicide, aggravated murder, murder, or other homicide offense (Section 2133.12(A)). Separately, your attending physician's responsibility to provide comfort care is never affected by your declaration, and medication given to relieve pain or discomfort remains protected even if it may appear to hasten death (Section 2133.12(E)).

Your declaration does not take legal effect automatically; it requires your attending physician and one other examining physician to determine you are in a terminal condition or permanently unconscious state, and your attending physician to separately determine you can no longer make informed decisions. If you also have a valid health care power of attorney and the two documents conflict once those determinations are made, Ohio law makes your living will declaration supersede the health care power of attorney.