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In Ohio, the Do Not Resuscitate (DNR) Order form serves as a crucial tool for individuals wishing to express their preferences regarding medical interventions in the event of a life-threatening situation. This form allows patients to indicate whether they wish to receive or forego resuscitation efforts, such as cardiopulmonary resuscitation (CPR), in case their heart or breathing stops. The DNR Order is typically completed by a patient, often in consultation with a healthcare provider, ensuring that their wishes are clearly documented and respected. Importantly, the form must be signed by both the patient and a physician to be valid. Additionally, it is essential for individuals to discuss their decisions with family members and caregivers, as this can help avoid confusion during critical moments. The DNR Order form is recognized statewide, providing peace of mind that one’s choices will be honored across different healthcare settings. Understanding the implications and requirements of this form is vital for anyone considering end-of-life care options in Ohio.

Documents used along the form

When considering a Do Not Resuscitate (DNR) Order in Ohio, several other documents may be relevant. These forms help clarify your medical wishes and ensure that your healthcare preferences are respected. Below is a list of common forms that often accompany a DNR Order.

  • Advance Directive: This document outlines your preferences for medical treatment in case you become unable to communicate your wishes. It can include instructions about life-sustaining treatments, organ donation, and more.
  • Healthcare Power of Attorney: This form allows you to designate someone to make healthcare decisions on your behalf if you are unable to do so. This trusted person can ensure your wishes are followed.
  • Living Will: A living will specifies the types of medical treatments you want or do not want in situations where you are terminally ill or permanently unconscious. It provides clear guidance to healthcare providers and loved ones.
  • Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order that reflects your wishes regarding treatments like resuscitation, intubation, and feeding tubes. It is typically used for patients with serious health conditions.
  • Do Not Intubate (DNI) Order: Similar to a DNR, a DNI order specifically states that you do not want to be placed on a ventilator. It is an important document for those who want to avoid invasive breathing support.
  • California Civil Form: To ensure your case is processed smoothly, fill out the California Civil Form by clicking the button below: California PDF Forms.
  • Organ Donation Registration: If you wish to donate your organs after death, this form allows you to express that desire. It can be included with your DNR Order to ensure your wishes are known.
  • Medical Information Release Form: This document permits healthcare providers to share your medical information with designated individuals. It can be useful for ensuring that your healthcare agent has access to necessary information.

These documents work together to provide a comprehensive picture of your healthcare preferences. Having them in place can help alleviate confusion and ensure that your wishes are honored in critical situations.

Ohio Do Not Resuscitate Order Example

Ohio Do Not Resuscitate Order

This Do Not Resuscitate (DNR) order is made according to Ohio law. It is valid in the state of Ohio for individuals who wish to refuse resuscitation in the event of cardiac or respiratory arrest.

Patient Information:

  • Full Name: _______________________________
  • Date of Birth: ___________________________
  • Address: _________________________________
  • City: _____________________ State: _________ Zip Code: _________

Physician Information:

  • Physician's Name: ________________________
  • Physician's Signature: _____________________
  • Date: ________________________________

Patient's Health Care Representative:

  • Full Name: _______________________________
  • Relationship to Patient: ___________________
  • Phone Number: ___________________________

Statement of Wishes:

In the event that I experience a cardiac or respiratory arrest, I do not wish to receive cardiopulmonary resuscitation (CPR) or other resuscitative measures. I understand the implications of this decision.

Additional Instructions:

__________________________________________

__________________________________________

__________________________________________

This DNR order shall remain in effect until revoked in writing by the patient or their authorized representative.

Signed: __________________________________ (Patient/Representative)

Date: _________________________________________

This document serves as a formal communication of the individual's wishes regarding resuscitation. It should be kept in a prominent place and shared with medical personnel.

FAQ

What is a Do Not Resuscitate (DNR) Order in Ohio?

A Do Not Resuscitate Order is a medical order that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient’s heart stops beating or they stop breathing. In Ohio, this order is legally recognized and is intended for individuals who wish to avoid aggressive resuscitation efforts in the event of a medical emergency.

Who can request a DNR Order in Ohio?

In Ohio, a DNR Order can be requested by a patient who is 18 years or older and has the capacity to make medical decisions. If the patient is unable to make decisions, a legally authorized representative, such as a family member or guardian, may request the order on their behalf.

How do I obtain a DNR Order in Ohio?

To obtain a DNR Order in Ohio, follow these steps:

  1. Consult with your healthcare provider to discuss your wishes regarding resuscitation.
  2. If appropriate, your doctor will complete a DNR Order form.
  3. Ensure that the form is signed by both you (or your representative) and your physician.
  4. Keep a copy of the signed DNR Order in a visible location, such as on your refrigerator or with your medical records.

Is a DNR Order the same as an Advance Directive?

No, a DNR Order is not the same as an Advance Directive. An Advance Directive is a broader legal document that outlines your wishes regarding medical treatment and appoints a person to make decisions on your behalf if you are unable to do so. A DNR Order specifically addresses your preferences regarding resuscitation efforts.

Where should I keep my DNR Order?

It is important to keep your DNR Order in a place where it can be easily accessed by healthcare providers. Common recommendations include:

  • Placing a copy on your refrigerator.
  • Carrying a wallet card that indicates you have a DNR Order.
  • Storing a copy with your medical records or with a trusted family member.

What happens if I change my mind about my DNR Order?

If you decide to revoke or change your DNR Order, you can do so at any time. To revoke the order, simply destroy the original document and notify your healthcare provider. It is also advisable to inform family members and keep them updated on your current wishes.

Will my DNR Order be honored in all healthcare settings?

Yes, a valid DNR Order should be honored in all healthcare settings, including hospitals, nursing homes, and during emergency medical services. However, it is crucial to ensure that the order is properly completed and signed to avoid any confusion.

Can I have a DNR Order if I am pregnant?

In Ohio, the legal requirements for a DNR Order include:

  • The order must be signed by the patient or their legally authorized representative.
  • The order must also be signed by a physician.
  • The form should clearly state the patient’s wishes regarding resuscitation.

Can a DNR Order be used outside of Ohio?

A DNR Order issued in Ohio may not be automatically recognized in other states. Each state has its own laws regarding DNR Orders. If you travel or move to another state, it is advisable to check that state's regulations and, if necessary, obtain a new DNR Order that complies with local laws.

Key takeaways

When considering the Ohio Do Not Resuscitate Order (DNR) form, it’s important to understand its purpose and how to properly fill it out. Here are some key takeaways to keep in mind:

  1. Purpose of the DNR: The DNR order informs medical personnel that you do not wish to receive cardiopulmonary resuscitation (CPR) in the event of a cardiac arrest.
  2. Eligibility: Any adult can complete a DNR order, but it’s advisable to discuss it with your healthcare provider to ensure it aligns with your medical wishes.
  3. Completion Process: The form must be filled out completely and signed by both the patient (or their legal representative) and a physician to be valid.
  4. Visibility: Keep the DNR order in a visible location, such as on the refrigerator or with your medical records, so that emergency personnel can easily access it.
  5. Revocation: You can revoke the DNR order at any time. This can be done verbally or in writing, but it’s essential to inform your healthcare provider and update your records accordingly.
  6. State-Specific Regulations: Be aware that DNR laws and regulations can vary by state. Familiarize yourself with Ohio’s specific requirements to ensure compliance.

Understanding these key points can help ensure that your wishes regarding resuscitation are respected and followed by healthcare providers in Ohio.

PDF Form Breakdown

Fact Name Description
Purpose The Ohio Do Not Resuscitate (DNR) Order form allows individuals to refuse resuscitation efforts in the event of cardiac or respiratory arrest.
Governing Law The DNR Order in Ohio is governed by Ohio Revised Code Section 2133.21 to 2133.27.
Eligibility Any adult capable of making healthcare decisions can complete a DNR Order. This includes individuals with terminal conditions or those who wish to avoid aggressive resuscitation efforts.
Signature Requirements The form must be signed by the patient or their legal representative and a physician to be valid.