What Does a DNR Order in Ohio mean?
A DNR Order (Do not resuscitate Order) Cannot Be Executed Unless Signed By A Physician
I received a telephone call a week or so ago from a client who was concerned that, based upon some things that he had recently heard, he may have executed some estate planning documents that would prevent him from being put on a ventilator if he contracted the coronavirus. I am sure that he is not the only one who has had that concern, so I believe that this is a good time to explain this issue in greater detail.
First, here in Ohio a DNR Order (Do not resuscitate order) form states that health care providers will not perform CPR (cardio pulmonary resuscitation), will not administer resuscitation medications with the intent of restarting the heart or breathing, will not insert an airway adjunct, will not de-fibrillate, cardiovert or initiate pacing and will not initiate continuous cardiac monitoring.
A DNR Order may be DNR Comfort Care (effective immediately) or DNR Comfort Care-Arrest (effective upon cardiac or respiratory arrest). A DNR Order must be signed and issued by a physician. This is where much confusion comes from. The DNR order is not a document executed by the client as part of his or her estate plan. While a few individuals may have a DNR Order already in place after having consulted with his or her physician and requested that the physician issue one, the vast majority of people do not have a DNR Order in place.
Physician Can Issue A DNR Order In A Living Will IF The Individual Is Permanently Unconscious Or Terminally Ill
The confusion often lies within the Living Will that many individuals do have. Here in Ohio, your standard Living Will does address the issue of “Do Not Resuscitate”. Typically, a living will states that the individual executing the document wishes to use it as an authorization that the physician can issue a DNR Order if the individual is permanently unconscious or terminally ill. That is the key.
Permanently unconscious state means an irreversible condition in which I am permanently unaware of myself and my surroundings. My physician and one other physician must examine me and agree that the total loss of higher brain function has left me unable to feel pain or suffering.
Terminal condition or terminal illness means an irreversible, incurable and untreatable condition caused by disease, illness or injury. My physician and one other physician will have examined me and believe that I cannot recover and that death is likely to occur within a relatively short time if I do not receive life-sustaining treatment.
Notice, that permanently unconscious state requires that two doctors must deem you permanently unconscious and terminal condition requires an irreversible, incurable and untreatable condition. One of those two triggering events is required before your living will authorizes a physician to issue a DNR Order.
Ventilators Can Be Used To Assist In Breathing Despite Individual’s Living Will Order On DNR
For an individual who contracts coronavirus and must be put on a ventilator to help him or her breath, do either of these triggers apply? I do not think so. You are not permanently unconscious. You do not necessarily, have an irreversible, incurable and untreatable condition. Therefore, it is in my opinion, that for the typical estate planning client, who may have a will, power of attorney, health care power of attorney and living will, he or she does not need to be concerned that , if he or she contracts coronavirus, any of those documents would prevent a health care provider from providing a ventilator in order to assist with breathing should that be necessary.
On April 11, 2020, I posted “Better Understanding the Importance of Ohio Health Care Documents During the Coronavirus Pandemic” on the Ohio Family Law Blog. To read it, click here. Should you have any additional questions, please contact Holzfaster, Cecil, McKnight & Mues or your estate planning/elder law attorney for information.
DNR or Estate Planning Questions? Schedule An Appointment Today
At Holzfaster, Cecil, McKnight & Mues, located in Dayton, Ohio, top-notch estate planning doesn’t need to be complicated or expensive! To learn more, go to our website at www.hcmmlaw.com . Or, please contact us at (937) 293-2141 to schedule an appointment for an initial consultation which can be conducted either by phone or in person.
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Joseph E. Balmer
Joseph Balmer manages the Probate, Trust and Estate Administration department at Dayton, Ohio, law firm, Holzfaster, Cecil, McKnight & Mues, and has been certified by the Ohio State Bar Association as a specialist in Estate Planning, Trust and Probate Law since 2006.