Default Health-Care Surrogate Priority in Ohio
At a glance
| When the default route opens | Adult terminal or unconscious for at least 12 months; two-physician findings, no effective declaration/health care POA (§ 2133.08(A)). |
|---|---|
| Care or setting covered | Withholding or withdrawal of life-sustaining treatment under § 2133.08; nutrition/hydration has separate § 2133.09 process. |
| Guardian or appointed agent | Guardian first; effective declaration or health care POA prevents this family-consent route (§ 2133.08(A)(1)(b),(B)(1)). |
| Family and partner order | Spouse → adult child/majority of children → parents → adult sibling/majority of siblings → nearest adult blood/adoptive relative (§ 2133.08(B)). |
| Friend or other nonfamily person | No friend class in the § 2133.08(B) list; final class is an adult blood/adoptive relative. |
| Decision within one class | Majority of available adult children or siblings; an equal division in any priority class yields no consent (§ 2133.08(B)(3),(5),(C)(1)). |
| Who is available and eligible | Available in reasonable time, competent, sound mind, voluntary; pending marital case, protection order, or specified assault charge can bar (§ 2133.08(A),(C)). |
| Decisions limited or excluded | Written consent with two eligible witnesses; patient wishes govern; pregnancy restriction; nutrition/hydration needs added findings and probate order (§§ 2133.08, 2133.09). |
| No surrogate or disputed authority | Unavailable/declining class yields to next; a tie does not. Qualifying relatives may object and seek probate reversal on strict deadlines (§ 2133.08(C),(E)). |
Requirements one by one
When the default route opens
Ohio Rev. Code § 2133.08(A)(1) permits the family-consent process only for an adult whose attending physician and another examining physician find a terminal condition or permanent unconsciousness lasting at least the immediately preceding twelve months. The attending physician must also find that the patient cannot make informed life-sustaining treatment decisions and is unlikely to regain that ability. An effective declaration or durable health care power of attorney addressing the situation prevents this route under § 2133.08(A)(1)(b).
Care or setting covered
Section 2133.08 addresses written consent to withhold or withdraw life-sustaining treatment. Section 2133.09 imposes a separate process for nutrition and hydration for an adult permanently unconscious for at least twelve months. These sections do not themselves supply a general family ladder for ordinary treatment decisions.
Family and partner order
Section 2133.08(B) ranks the guardian, spouse, adult child or majority of available adult children, parents, adult sibling or majority of available adult siblings, then the nearest adult blood or adoptive relative who can consult within a reasonable time. The list ends with relatives; it does not include a close friend.
Decision within one class
Under § 2133.08(C)(1), an unavailable, incompetent, or declining class yields to the next. An equal division within a priority class is different: it blocks written consent under this section and does not authorize the next class to decide.
Who is available and eligible
Section 2133.08(A)(1)(c)–(e) requires consultation and informed-consent information, sound mind, voluntary consent, and a diligent effort to notify available adult children before a child-class consent. Under § 2133.08(C)(2), a pending divorce or similar marital proceeding, a protection order naming the patient as alleged victim, or specified assault charges tied to the terminal condition can disqualify a candidate.
Decisions limited or excluded
Section 2133.08(A)(1) requires written consent to the attending physician, witnessed by two eligible individuals; subsection (D) requires good faith and consistency with known patient wishes. Subsection (G) restricts withdrawal during pregnancy when it would terminate the pregnancy unless the two-physician live-birth finding is made. Under § 2133.09(A), withholding nutrition or hydration from a permanently unconscious adult requires added comfort and pain findings, separate written witnessed consent, and a probate court order.
No surrogate or disputed authority
Section 2133.08(C)(1) passes authority to the next class only when the higher class is unavailable, incompetent, or declines. Under § 2133.08(E)(1), an eligible objector must notify the attending physician within 48 hours of the consent and file a probate complaint within two business days after notice to seek reversal.
What trips people up
The § 2133.09 nutrition-and-hydration order is mandatory under that section's conditions; the family consent alone does not authorize withdrawal. Likewise, § 2133.08(B) is an end-of-life consent ladder, so it should not be used as a blanket answer to who may authorize routine care.
Common questions
Can a close friend serve under this statute? Section 2133.08(B) ends its ranked list with the nearest available adult related by blood or adoption.
Can a relative object after written consent? Yes. Section 2133.08(E)(1) gives specified relatives a short notice and probate-complaint window; the court can confirm or reverse the consent.
Statutes and sources
- Ohio Rev. Code §§ 2133.08–.09. Verbatim current official text, section links, and access dates appear in the source fields above.
Source links
Every statute quoted above, linked, with the date we checked it.
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