Bill Text: OH HB79 | 2013-2014 | 130th General Assembly | Introduced

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Bill Title: To provide that an individual's statutory priority to decide whether or not to withhold or withdraw life-sustaining treatment for the individual's relative is forfeited if the individual is charged with felonious assault or aggravated assault resulting in the relative being in a terminal condition from the physical harm suffered.

Spectrum: Partisan Bill (Republican 5-0)

Status: (Introduced - Dead) 2013-02-26 - To Judiciary [HB79 Detail]

Download: Ohio-2013-HB79-Introduced.html

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As Introduced

130th General Assembly Regular Session 2013-2014

H. B. No. 79

Representative Boose 

Cosponsors: Representatives Adams, J., Becker, Blair, Grossman 

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A BILL

To amend sections 2133.08, 2133.09, and 2133.12 of

1

the Revised Code to provide that an individual's

2

statutory priority to decide whether or not to

3

withhold or withdraw life-sustaining treatment for

4

the individual's relative is forfeited if the

5

individual is charged with felonious assault or

6

aggravated assault resulting in the relative being

7

in a terminal condition from the physical harm

8

suffered.

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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 2133.08, 2133.09, and 2133.12 of the	10
Revised Code be amended to read as follows:	11

Sec. 2133.08.  (A)(1) If written consent to the withholding	12
or withdrawal of life-sustaining treatment, witnessed by two	13
individuals who satisfy the witness eligibility criteria set forth	14
in division (B)(1) of section 2133.02 of the Revised Code, is	15
given by the appropriate individual or individuals as specified in	16
division (B) of this section to the attending physician of a	17
patient who is an adult, and if all of the following apply in	18
connection with the patient, then, subject to section 2133.09 of	19
the Revised Code, the patient's attending physician may withhold	20
or withdraw the life-sustaining treatment:	21

(a) The attending physician and one other physician who	22
examines the patient determine, in good faith, to a reasonable	23
degree of medical certainty, and in accordance with reasonable	24
medical standards, that the patient is in a terminal condition or	25
the patient currently is and for at least the immediately	26
preceding twelve months has been in a permanently unconscious	27
state, and the attending physician additionally determines, in	28
good faith, to a reasonable degree of medical certainty, and in	29
accordance with reasonable medical standards, that the patient no	30
longer is able to make informed decisions regarding the	31
administration of life-sustaining treatment and that there is no	32
reasonable possibility that the patient will regain the capacity	33
to make those informed decisions.	34

(b) The patient does not have a declaration that addresses	35
the patient's intent should the patient be determined to be in a	36
terminal condition or in a permanently unconscious state,	37
whichever applies, or a durable power of attorney for health care,	38
or has a document that purports to be such a declaration or	39
durable power of attorney for health care but that document is not	40
legally effective.	41

(c) The consent of the appropriate individual or individuals	42
is given after consultation with the patient's attending physician	43
and after receipt of information from the patient's attending	44
physician or a consulting physician that is sufficient to satisfy	45
the requirements of informed consent.	46

(d) The appropriate individual or individuals who give a	47
consent are of sound mind and voluntarily give the consent.	48

(e) If a consent would be given under division (B)(3) of this	49
section, the attending physician made a good faith effort, and	50
used reasonable diligence, to notify the patient's adult children	51
who are available within a reasonable period of time for	52
consultation as described in division (A)(1)(c) of this section.	53

(2) The consulting physician under division (A)(1)(a) of this	54
section associated with a patient allegedly in a permanently	55
unconscious state shall be a physician who, by virtue of advanced	56
education or training, of a practice limited to particular	57
diseases, illnesses, injuries, therapies, or branches of medicine	58
or surgery or osteopathic medicine and surgery, of certification	59
as a specialist in a particular branch of medicine or surgery or	60
osteopathic medicine and surgery, or of experience acquired in the	61
practice of medicine or surgery or osteopathic medicine and	62
surgery, is qualified to determine whether the patient currently	63
is and for at least the immediately preceding twelve months has	64
been in a permanently unconscious state.	65

(B) For purposes of division (A) of this section and subject	66
to division (C)(2) of this section, a consent to withhold or	67
withdraw life-sustaining treatment may be given by the appropriate	68
individual or individuals, in accordance with the following	69
descending order of priority:	70

(1) If any, the guardian of the patient. This division does	71
not permit or require, and shall not be construed as permitting or	72
requiring, the appointment of a guardian for the patient.	73

(2) The patient's spouse;

74

(3) An adult child of the patient or, if there is more than	75
one adult child, a majority of the patient's adult children who	76
are available within a reasonable period of time for consultation	77
with the patient's attending physician;	78

(4) The patient's parents;

79

(5) An adult sibling of the patient or, if there is more than	80
one adult sibling, a majority of the patient's adult siblings who	81
are available within a reasonable period of time for that	82
consultation;	83

(6) The nearest adult who is not described in divisions	84
(B)(1) to (5) of this section, who is related to the patient by	85
blood or adoption, and who is available within a reasonable period	86
of time for that consultation.	87

(C)(1) If an appropriate individual or class of individuals	88
entitled to decide under division (B) of this section whether or	89
not to consent to the withholding or withdrawal of life-sustaining	90
treatment for a patient is not available within a reasonable	91
period of time for the consultation and competent to so decide, or	92
declines to so decide, then the next priority individual or class	93
of individuals specified in that division is authorized to make	94
the decision. However, an equal division in a priority class of	95
individuals under that division does not authorize the next class	96
of individuals specified in that division to make the decision. If	97
an equal division in a priority class of individuals under that	98
division occurs, no written consent to the withholding or	99
withdrawal of life-sustaining treatment from the patient can be	100
given pursuant to this section.	101

(2)(a) If an appropriate individual entitled to decide under	102
division (B) of this section whether or not to consent to the	103
withholding or withdrawal of life-sustaining treatment for a	104
patient who is in a terminal condition has been charged with the	105
offense of felonious assault under section 2903.11 of the Revised	106
Code or the offense of aggravated assault under section 2903.12 of	107
the Revised Code against the patient and the serious physical harm	108
or physical harm suffered by the patient as a result of the	109
offense directly caused the patient to be in a terminal condition,	110
the individual is not competent to so decide, and the next	111
priority individual or class of individuals specified in that	112
division is authorized to make the decision.	113

(b) If a member of a class of individuals entitled to decide	114
under division (B) of this section whether or not to consent to	115
the withholding or withdrawal of life-sustaining treatment for a	116
patient who is in a terminal condition has been charged with the	117
offense of felonious assault under section 2903.11 of the Revised	118
Code or the offense of aggravated assault under section 2903.12 of	119
the Revised Code against the patient and the serious physical harm	120
or physical harm suffered by the patient as a result of the	121
offense directly caused the patient to be in a terminal condition,	122
that member is not competent to so decide, and the other members	123
of the class of individuals are authorized to make the decision.	124

(D)(1) A decision to consent pursuant to this section to the	125
use or continuation, or the withholding or withdrawal, of	126
life-sustaining treatment for a patient shall be made in good	127
faith.	128

(2) Except as provided in division (D)(4) of this section, if	129
the patient previously expressed an intention with respect to the	130
use or continuation, or the withholding or withdrawal, of	131
life-sustaining treatment should the patient subsequently be in a	132
terminal condition or in a permanently unconscious state,	133
whichever applies, and no longer able to make informed decisions	134
regarding the administration of life-sustaining treatment, a	135
consent given pursuant to this section shall be valid only if it	136
is consistent with that previously expressed intention.	137

(3) Except as provided in division (D)(4) of this section, if	138
the patient did not previously express an intention with respect	139
to the use or continuation, or the withholding or withdrawal, of	140
life-sustaining treatment should the patient subsequently be in a	141
terminal condition or in a permanently unconscious state,	142
whichever applies, and no longer able to make informed decisions	143
regarding the administration of life-sustaining treatment, a	144
consent given pursuant to this section shall be valid only if it	145
is consistent with the type of informed consent decision that the	146
patient would have made if the patient previously had expressed an	147
intention with respect to the use or continuation, or the	148
withholding or withdrawal, of life-sustaining treatment should the	149
patient subsequently be in a terminal condition or in a	150
permanently unconscious state, whichever applies, and no longer	151
able to make informed decisions regarding the administration of	152
life-sustaining treatment, as inferred from the lifestyle and	153
character of the patient, and from any other evidence of the	154
desires of the patient, prior to the patient's becoming no longer	155
able to make informed decisions regarding the administration of	156
life-sustaining treatment. The Rules of Evidence shall not be	157
binding for purposes of this division.	158

(4)(a) The attending physician of the patient, and other	159
health care personnel acting under the direction of the attending	160
physician, who do not have actual knowledge of a previously	161
expressed intention as described in division (D)(2) of this	162
section or who do not have actual knowledge that the patient would	163
have made a different type of informed consent decision under the	164
circumstances described in division (D)(3) of this section, may	165
rely on a consent given in accordance with this section unless a	166
probate court decides differently under division (E) of this	167
section.	168

(b) The immunity conferred by division (C)(1) of section	169
2133.11 of the Revised Code is not forfeited by an individual who	170
gives a consent to the use or continuation, or the withholding or	171
withdrawal, of life-sustaining treatment for a patient under	172
division (B) of this section if the individual gives the consent	173
in good faith and without actual knowledge, at the time of giving	174
the consent, of either a contrary previously expressed intention	175
of the patient, or a previously expressed intention of the	176
patient, as described in division (D)(2) of this section, that is	177
revealed to the individual subsequent to the time of giving the	178
consent.	179

(E)(1) Within forty-eight hours after a priority individual	180
or class of individuals gives a consent pursuant to this section	181
to the use or continuation, or the withholding or withdrawal, of	182
life-sustaining treatment and communicates the consent to the	183
patient's attending physician, any individual described in	184
divisions (B)(1) to (5) of this section, except an individual who	185
is not competent to give consent under division (C)(2) of this	186
section, who objects to the application of this section to the	187
patient shall advise the attending physician of the grounds for	188
the objection. If an objection is so communicated to the attending	189
physician, then, within two business days after that	190
communication, the objecting individual shall file a complaint	191
against the priority individual or class of individuals, the	192
patient's attending physician, and the consulting physician	193
associated with the determination that the patient is in a	194
terminal condition or that the patient currently is and for at	195
least the immediately preceding twelve months has been in a	196
permanently unconscious state, in the probate court of the county	197
in which the patient is located for the issuance of an order	198
reversing the consent of the priority individual or class of	199
individuals. If the objecting individual fails to so file a	200
complaint, the individual's objections shall be considered to be	201
void.	202

A probate court in which a complaint is filed in accordance	203
with this division shall conduct a hearing on the complaint after	204
a copy of the complaint and a notice of the hearing have been	205
served upon the defendants. The clerk of the probate court in	206
which the complaint is filed shall cause the complaint and the	207
notice of the hearing to be so served in accordance with the Rules	208
of Civil Procedure, which service shall be made, if possible,	209
within three days after the filing of the complaint. The hearing	210
shall be conducted at the earliest possible time, but no later	211
than the third business day after the service has been completed.	212
Immediately following the hearing, the court shall enter on its	213
journal its determination whether the decision of the priority	214
individual or class of individuals to consent to the use or	215
continuation, or the withholding or withdrawal, of life-sustaining	216
treatment in connection with the patient will be confirmed or	217
reversed.	218

(2) If the decision of the priority individual or class of	219
individuals was to consent to the use or continuation of	220
life-sustaining treatment in connection with the patient, the	221
court only may reverse that consent if the objecting individual	222
establishes, by clear and convincing evidence and, if applicable,	223
to a reasonable degree of medical certainty and in accordance with	224
reasonable medical standards, one or more of the following:	225

(a) The patient is able to make informed decisions regarding	226
the administration of life-sustaining treatment.	227

(b) The patient has a legally effective declaration that	228
addresses the patient's intent should the patient be determined to	229
be in a terminal condition or in a permanently unconscious state,	230
whichever applies, or a legally effective durable power of	231
attorney for health care.	232

(c) The decision to use or continue life-sustaining treatment	233
is not consistent with the previously expressed intention of the	234
patient as described in division (D)(2) of this section.	235

(d) The decision to use or continue life-sustaining treatment	236
is not consistent with the type of informed consent decision that	237
the patient would have made if the patient previously had	238
expressed an intention with respect to the use or continuation, or	239
the withholding or withdrawal, of life-sustaining treatment should	240
the patient subsequently be in a terminal condition or in a	241
permanently unconscious state, whichever applies, and no longer	242
able to make informed decisions regarding the administration of	243
life-sustaining treatment as described in division (D)(3) of this	244
section.	245

(e) The decision of the priority individual or class of	246
individuals was not made after consultation with the patient's	247
attending physician and after receipt of information from the	248
patient's attending physician or a consulting physician that is	249
sufficient to satisfy the requirements of informed consent.	250

(f) The priority individual, or any member of the priority	251
class of individuals, who made the decision to use or continue	252
life-sustaining treatment was not of sound mind or did not	253
voluntarily make the decision.	254

(g) If the decision of a priority class of individuals under	255
division (B)(3) of this section is involved, the patient's	256
attending physician did not make a good faith effort, and use	257
reasonable diligence, to notify the patient's adult children who	258
were available within a reasonable period of time for consultation	259
as described in division (A)(1)(c) of this section.	260

(h) The decision of the priority individual or class of	261
individuals otherwise was made in a manner that does not comply	262
with this section.	263

(3) If the decision of the priority individual or class of	264
individuals was to consent to the withholding or withdrawal of	265
life-sustaining treatment in connection with the patient, the	266
court only may reverse that consent if the objecting individual	267
establishes, by a preponderance of the evidence and, if	268
applicable, to a reasonable degree of medical certainty and in	269
accordance with reasonable medical standards, one or more of the	270
following:	271

(a) The patient is not in a terminal condition, the patient	272
is not in a permanently unconscious state, or the patient has not	273
been in a permanently unconscious state for at least the	274
immediately preceding twelve months.	275

(b) The patient is able to make informed decisions regarding	276
the administration of life-sustaining treatment.	277

(c) There is a reasonable possibility that the patient will	278
regain the capacity to make informed decisions regarding the	279
administration of life-sustaining treatment.	280

(d) The patient has a legally effective declaration that	281
addresses the patient's intent should the patient be determined to	282
be in a terminal condition or in a permanently unconscious state,	283
whichever applies, or a legally effective durable power of	284
attorney for health care.	285

(e) The decision to withhold or withdraw life-sustaining	286
treatment is not consistent with the previously expressed	287
intention of the patient as described in division (D)(2) of this	288
section.	289

(f) The decision to withhold or withdraw life-sustaining	290
treatment is not consistent with the type of informed consent	291
decision that the patient would have made if the patient	292
previously had expressed an intention with respect to the use or	293
continuation, or the withholding or withdrawal, of life-sustaining	294
treatment should the patient subsequently be in a terminal	295
condition or in a permanently unconscious state, whichever	296
applies, and no longer able to make informed decisions regarding	297
the administration of life-sustaining treatment as described in	298
division (D)(3) of this section.	299

(g) The decision of the priority individual or class of	300
individuals was not made after consultation with the patient's	301
attending physician and after receipt of information from the	302
patient's attending physician or a consulting physician that is	303
sufficient to satisfy the requirements of informed consent.	304

(h) The priority individual, or any member of the priority	305
class of individuals, who made the decision to withhold or	306
withdraw life-sustaining treatment was not of sound mind or did	307
not voluntarily make the decision.	308

(i) If the decision of a priority class of individuals under	309
division (B)(3) of this section is involved, the patient's	310
attending physician did not make a good faith effort, and use	311
reasonable diligence, to notify the patient's adult children who	312
were available within a reasonable period of time for consultation	313
as described in division (A)(1)(c) of this section.	314

(j) The decision of the priority individual or class of	315
individuals otherwise was made in a manner that does not comply	316
with this section.	317

(4) Notwithstanding any contrary provision of the Revised	318
Code or of the Rules of Civil Procedure, the state and persons	319
other than individuals described in divisions (B)(1) to (5) of	320
this section are prohibited from filing a complaint under division	321
(E) of this section and from joining or being joined as parties to	322
a hearing conducted under division (E) of this section, including	323
joining by way of intervention.	324

(F) A valid consent given in accordance with this section	325
supersedes any general consent to treatment form signed by or on	326
behalf of the patient prior to, upon, or after the patient's	327
admission to a health care facility to the extent there is a	328
conflict between the consent and the form.	329

(G) Life-sustaining treatment shall not be withheld or	330
withdrawn from a patient pursuant to a consent given in accordance	331
with this section if the patient is pregnant and if the	332
withholding or withdrawal of the treatment would terminate the	333
pregnancy, unless the patient's attending physician and one other	334
physician who has examined the patient determine, to a reasonable	335
degree of medical certainty and in accordance with reasonable	336
medical standards, that the fetus would not be born alive.	337

Sec. 2133.09.  (A) The attending physician of a patient who	338
is an adult and who currently is and for at least the immediately	339
preceding twelve months has been in a permanently unconscious	340
state may withhold or withdraw nutrition and hydration in	341
connection with the patient only if all of the following apply:	342

(1) Written consent to the withholding or withdrawal of	343
life-sustaining treatment in connection with the patient has been	344
given by an appropriate individual or individuals in accordance	345
with section 2133.08 of the Revised Code, and divisions (A)(1)(a)	346
to (e) and (2) of that section have been satisfied.	347

(2) A probate court has not reversed the consent to the	348
withholding or withdrawal of life-sustaining treatment in	349
connection with the patient pursuant to division (E) of section	350
2133.08 of the Revised Code.	351

(3) The attending physician of the patient and one other	352
physician as described in division (A)(2) of section 2133.08 of	353
the Revised Code who examines the patient determine, in good	354
faith, to a reasonable degree of medical certainty, and in	355
accordance with reasonable medical standards, that nutrition and	356
hydration will not or no longer will provide comfort or alleviate	357
pain in connection with the patient.	358

(4) Written consent to the withholding or withdrawal of	359
nutrition and hydration in connection with the patient, witnessed	360
by two individuals who satisfy the witness eligibility criteria	361
set forth in division (B)(1) of section 2133.02 of the Revised	362
Code, is given to the attending physician of the patient by an	363
appropriate individual or individuals as specifieddescribed in	364
divisiondivisions (B)(1) to (6) of section 2133.08 of the Revised	365
Code.	366

(5) The written consent to the withholding or withdrawal of	367
the nutrition and hydration in connection with the patient is	368
given in accordance with division (B) of this section.	369

(6) The probate court of the county in which the patient is	370
located issues an order to withhold or withdraw the nutrition and	371
hydration in connection with the patient pursuant to division (C)	372
of this section.	373

(B)(1) A decision to consent pursuant to this section to the	374
withholding or withdrawal of nutrition and hydration in connection	375
with a patient shall be made in good faith.	376

(2) Except as provided in division (B)(4) of this section, if	377
the patient previously expressed an intention with respect to the	378
use or continuation, or the withholding or withdrawal, of	379
nutrition and hydration should the patient subsequently be in a	380
permanently unconscious state and no longer able to make informed	381
decisions regarding the administration of nutrition and hydration,	382
a consent given pursuant to this section shall be valid only if it	383
is consistent with that previously expressed intention.	384

(3) Except as provided in division (B)(4) of this section, if	385
the patient did not previously express an intention with respect	386
to the use or continuation, or the withholding or withdrawal, of	387
nutrition and hydration should the patient subsequently be in a	388
permanently unconscious state and no longer able to make informed	389
decisions regarding the administration of nutrition and hydration,	390
a consent given pursuant to this section shall be valid only if it	391
is consistent with the type of informed consent decision that the	392
patient would have made if the patient previously had expressed an	393
intention with respect to the use or continuation, or the	394
withholding or withdrawal, of nutrition and hydration should the	395
patient subsequently be in a permanently unconscious state and no	396
longer able to make informed decisions regarding the	397
administration of nutrition and hydration, as inferred from the	398
lifestyle and character of the patient, and from any other	399
evidence of the desires of the patient, prior to the patient's	400
becoming no longer able to make informed decisions regarding the	401
administration of nutrition and hydration. The Rules of Evidence	402
shall not be binding for purposes of this division.	403

(4)(a) The attending physician of the patient, and other	404
health care personnel acting under the direction of the attending	405
physician, who do not have actual knowledge of a previously	406
expressed intention as described in division (B)(2) of this	407
section or who do not have actual knowledge that the patient would	408
have made a different type of informed consent decision under the	409
circumstances described in division (B)(3) of this section, may	410
rely on a consent given in accordance with this section unless a	411
probate court decides differently under division (C) of this	412
section.	413

(b) The immunity conferred by division (C)(2) of section	414
2133.11 of the Revised Code is not forfeited by an individual who	415
gives a consent to the withholding or withdrawal of nutrition and	416
hydration in connection with a patient under division (A)(4) of	417
this section if the individual gives the consent in good faith and	418
without actual knowledge, at the time of giving the consent, of	419
either a contrary previously expressed intention of the patient,	420
or a previously expressed intention of the patient, as described	421
in division (B)(2) of this section, that is revealed to the	422
individual subsequent to the time of giving the consent.	423

(C)(1) Prior to the withholding or withdrawal of nutrition	424
and hydration in connection with a patient pursuant to this	425
section, the priority individual or class of individuals that	426
consented to the withholding or withdrawal of the nutrition and	427
hydration shall apply to the probate court of the county in which	428
the patient is located for the issuance of an order that	429
authorizes the attending physician of the patient to commence the	430
withholding or withdrawal of the nutrition and hydration in	431
connection with the patient. Upon the filing of the application,	432
the clerk of the probate court shall schedule a hearing on it and	433
cause a copy of it and a notice of the hearing to be served in	434
accordance with the Rules of Civil Procedure upon the applicant,	435
the attending physician, the consulting physician associated with	436
the determination that nutrition and hydration will not or no	437
longer will provide comfort or alleviate pain in connection with	438
the patient, and the individuals described in divisions (B)(1) to	439
(5) of section 2133.08 of the Revised Code who are not applicants,	440
which service shall be made, if possible, within three days after	441
the filing of the application. The hearing shall be conducted at	442
the earliest possible time, but no sooner than the thirtieth	443
business day, and no later than the sixtieth business day, after	444
the service has been completed.	445

At the hearing, any individual described in divisions (B)(1)	446
to (5) of section 2133.08 of the Revised Code who is not an	447
applicant and who disagrees with the decision of the priority	448
individual or class of individuals to consent to the withholding	449
or withdrawal of nutrition and hydration in connection with the	450
patient shall be permitted to testify and present evidence	451
relative to the use or continuation of nutrition and hydration in	452
connection with the patient. Immediately following the hearing,	453
the court shall enter on its journal its determination whether the	454
requested order will be issued.	455

(2) The court shall issue an order that authorizes the	456
patient's attending physician to commence the withholding or	457
withdrawal of nutrition and hydration in connection with the	458
patient only if the applicants establish, by clear and convincing	459
evidence, to a reasonable degree of medical certainty, and in	460
accordance with reasonable medical standards, all of the	461
following:	462

(a) The patient currently is and for at least the immediately	463
preceding twelve months has been in a permanently unconscious	464
state.	465

(b) The patient no longer is able to make informed decisions	466
regarding the administration of life-sustaining treatment.	467

(c) There is no reasonable possibility that the patient will	468
regain the capacity to make informed decisions regarding the	469
administration of life-sustaining treatment.	470

(d) The conditions specified in divisions (A)(1) to (4) of	471
this section have been satisfied.	472

(e) The decision to withhold or withdraw nutrition and	473
hydration in connection with the patient is consistent with the	474
previously expressed intention of the patient as described in	475
division (B)(2) of this section or is consistent with the type of	476
informed consent decision that the patient would have made if the	477
patient previously had expressed an intention with respect to the	478
use or continuation, or the withholding or withdrawal, of	479
nutrition and hydration should the patient subsequently be in a	480
permanently unconscious state and no longer able to make informed	481
decisions regarding the administration of nutrition and hydration	482
as described in division (B)(3) of this section.	483

(3) Notwithstanding any contrary provision of the Revised	484
Code or of the Rules of Civil Procedure, the state and persons	485
other than individuals described in division (A)(4) of this	486
section or in divisions (B)(1) to (5) of section 2133.08 of the	487
Revised Code and other than the attending physician and consulting	488
physician associated with the determination that nutrition and	489
hydration will not or no longer will provide comfort or alleviate	490
pain in connection with the patient are prohibited from filing an	491
application under this division and from joining or being joined	492
as parties to a hearing conducted under this division, including	493
joining by way of intervention.	494

(D) A valid consent given in accordance with this section	495
supersedes any general consent to treatment form signed by or on	496
behalf of the patient prior to, upon, or after the patient's	497
admission to a health care facility to the extent there is a	498
conflict between the consent and the form.	499

Sec. 2133.12.  (A) The death of a qualified patient or other	500
patient resulting from the withholding or withdrawal of	501
life-sustaining treatment in accordance with sections 2133.01 to	502
2133.15 of the Revised Code does not constitute for any purpose a	503
suicide, aggravated murder, murder, or any other homicide offense.	504

(B)(1) The execution of a declaration shall not do either of	505
the following:	506

(a) Affect the sale, procurement, issuance, or renewal of any	507
policy of life insurance or annuity, notwithstanding any term of a	508
policy or annuity to the contrary;	509

(b) Be deemed to modify or invalidate the terms of any policy	510
of life insurance or annuity that is in effect on October 10,	511
1991.	512

(2) Notwithstanding any term of a policy of life insurance or	513
annuity to the contrary, the withholding or withdrawal of	514
life-sustaining treatment from an insured, qualified patient or	515
other patient in accordance with sections 2133.01 to 2133.15 of	516
the Revised Code shall not impair or invalidate any policy of life	517
insurance or annuity.	518

(3) Notwithstanding any term of a policy or plan to the	519
contrary, the use or continuation, or the withholding or	520
withdrawal, of life-sustaining treatment from an insured,	521
qualified patient or other patient in accordance with sections	522
2133.01 to 2133.15 of the Revised Code shall not impair or	523
invalidate any policy of health insurance or any health care	524
benefit plan.	525

(4) No physician, health care facility, other health care	526
provider, person authorized to engage in the business of insurance	527
in this state under Title XXXIX of the Revised Code, health	528
insuring corporation, other health care plan, legal entity that is	529
self-insured and provides benefits to its employees or members, or	530
other person shall require any individual to execute or refrain	531
from executing a declaration, or shall require an individual to	532
revoke or refrain from revoking a declaration, as a condition of	533
being insured or of receiving health care benefits or services.	534

(C)(1) Sections 2133.01 to 2133.15 of the Revised Code do not	535
create any presumption concerning the intention of an individual	536
who has revoked or has not executed a declaration with respect to	537
the use or continuation, or the withholding or withdrawal, of	538
life-sustaining treatment if the individual should be in a	539
terminal condition or in a permanently unconscious state at any	540
time.	541

(2) Sections 2133.01 to 2133.15 of the Revised Code do not	542
affect the right of a qualified patient or other patient to make	543
informed decisions regarding the use or continuation, or the	544
withholding or withdrawal, of life-sustaining treatment as long as	545
the qualified patient or other patient is able to make those	546
decisions.	547

(3) Sections 2133.01 to 2133.15 of the Revised Code do not	548
require a physician, other health care personnel, or a health care	549
facility to take action that is contrary to reasonable medical	550
standards.	551

(4) Sections 2133.01 to 2133.15 of the Revised Code and, if	552
applicable, a declaration do not affect or limit the authority of	553
a physician or a health care facility to provide or not to provide	554
life-sustaining treatment to a person in accordance with	555
reasonable medical standards applicable in an emergency situation.	556

(D) Nothing in sections 2133.01 to 2133.15 of the Revised	557
Code condones, authorizes, or approves of mercy killing, assisted	558
suicide, or euthanasia.	559

(E)(1) Sections 2133.01 to 2133.15 of the Revised Code do not	560
affect the responsibility of the attending physician of a	561
qualified patient or other patient, or other health care personnel	562
acting under the direction of the patient's attending physician,	563
to provide comfort care to the patient. Nothing in sections	564
2133.01 to 2133.15 of the Revised Code precludes the attending	565
physician of a qualified patient or other patient who carries out	566
the responsibility to provide comfort care to the patient in good	567
faith and while acting within the scope of the attending	568
physician's authority from prescribing, dispensing, administering,	569
or causing to be administered any particular medical procedure,	570
treatment, intervention, or other measure to the patient,	571
including, but not limited to, prescribing, personally furnishing,	572
administering, or causing to be administered by judicious	573
titration or in another manner any form of medication, for the	574
purpose of diminishing the qualified patient's or other patient's	575
pain or discomfort and not for the purpose of postponing or	576
causing the qualified patient's or other patient's death, even	577
though the medical procedure, treatment, intervention, or other	578
measure may appear to hasten or increase the risk of the patient's	579
death. Nothing in sections 2133.01 to 2133.15 of the Revised Code	580
precludes health care personnel acting under the direction of the	581
patient's attending physician who carry out the responsibility to	582
provide comfort care to the patient in good faith and while acting	583
within the scope of their authority from dispensing,	584
administering, or causing to be administered any particular	585
medical procedure, treatment, intervention, or other measure to	586
the patient, including, but not limited to, personally furnishing,	587
administering, or causing to be administered by judicious	588
titration or in another manner any form of medication, for the	589
purpose of diminishing the qualified patient's or other patient's	590
pain or discomfort and not for the purpose of postponing or	591
causing the qualified patient's or other patient's death, even	592
though the medical procedure, treatment, intervention, or other	593
measure may appear to hasten or increase the risk of the patient's	594
death.	595

(2)(a) If, at any time, a person described in division	596
(A)(2)(a)(i) of section 2133.05 of the Revised Code or the	597
individual or a majority of the individuals in either of the first	598
two classes of individuals that pertain to a declarant in the	599
descending order of priority set forth in division (A)(2)(a)(ii)	600
of section 2133.05 of the Revised Code believes in good faith that	601
both of the following circumstances apply, the person or the	602
individual or majority of individuals in either of the first two	603
classes of individuals may commence an action in the probate court	604
of the county in which a declarant who is in a terminal condition	605
or permanently unconscious state is located for the issuance of an	606
order mandating the use or continuation of comfort care in	607
connection with the declarant in a manner that is consistent with	608
division (E)(1) of this section:	609

(i) Comfort care is not being used or continued in connection	610
with the declarant.	611

(ii) The withholding or withdrawal of the comfort care is	612
contrary to division (E)(1) of this section.	613

(b) If a declarant did not designate in the declarant's	614
declaration a person as described in division (A)(2)(a)(i) of	615
section 2133.05 of the Revised Code and if, at any time, a	616
priority individual or any member of a priority class of	617
individuals under division (A)(2)(a)(ii) of section 2133.05 of the	618
Revised Code or, at any time, the individual or a majority of the	619
individuals in the next class of individuals that pertains to the	620
declarant in the descending order of priority set forth in that	621
division believes in good faith that both of the following	622
circumstances apply, the priority individual, the member of the	623
priority class of individuals, or the individual or majority of	624
individuals in the next class of individuals that pertains to the	625
declarant may commence an action in the probate court of the	626
county in which a declarant who is in a terminal condition or	627
permanently unconscious state is located for the issuance of an	628
order mandating the use or continuation of comfort care in	629
connection with the declarant in a manner that is consistent with	630
division (E)(1) of this section:	631

(i) Comfort care is not being used or continued in connection	632
with the declarant.	633

(ii) The withholding or withdrawal of the comfort care is	634
contrary to division (E)(1) of this section.	635

(c) If, at any time, a priority individual or any member of a	636
priority class of individuals under divisiondescribed in	637
divisions (B)(1) to (5) of section 2133.08 of the Revised Code or,	638
at any time, the individual or a majority of the individuals in	639
the next class of individuals that pertains to the patient in the	640
descending order of priority set forth in that divisionthose	641
divisions believes in good faith that both of the following	642
circumstances apply, the priority individual, the member of the	643
priority class of individuals, or the individual or majority of	644
individuals in the next class of individuals that pertains to the	645
patient may commence an action in the probate court of the county	646
in which a patient as described in division (A) of section 2133.08	647
of the Revised Code is located for the issuance of an order	648
mandating the use or continuation of comfort care in connection	649
with the patient in a manner that is consistent with division	650
(E)(1) of this section:	651

(i) Comfort care is not being used or continued in connection	652
with the patient.	653

(ii) The withholding or withdrawal of the comfort care is	654
contrary to division (E)(1) of this section.	655

Section 2. That existing sections 2133.08, 2133.09, and	656
2133.12 of the Revised Code are hereby repealed.	657

Section 3.  Section 2133.12 of the Revised Code is presented	658
in this act as a composite of the section as amended by both Sub.	659
H.B. 354 and Am. Sub. S.B. 66 of the 122nd General Assembly. The	660
General Assembly, applying the principle stated in division (B) of	661
section 1.52 of the Revised Code that amendments are to be	662
harmonized if reasonably capable of simultaneous operation, finds	663
that the composite is the resulting version of the section in	664
effect prior to the effective date of the section as presented in	665
this act.	666