To amend sections 1337.12, 2108.23, 2108.231, 2133.01, 2133.03, 2133.07, 2133.21, 2133.22, 2133.23, 2133.24, 2133.25, 2133.26, 4765.35, 4765.37, 4765.38, and 4765.39 and to enact section 2133.151 of the Revised Code to provide for a do-not-intubate order, protocol, and identification separate from a do-not-resuscitate order, protocol, and identification.
HB920 would revise Ohio’s end-of-life and advance-directive laws to create a separate legal framework for do-not-intubate (DNI) orders, protocols, and identification, distinct from the existing do-not-resuscitate (DNR) system. The bill amends the state’s health care power of attorney and declaration statutes so that DNI identification can be recognized alongside DNR identification, and it defines how DNI orders are issued, how they are honored, and how they interact with declarations and durable powers of attorney for health care. It also adds a new transitional provision validating certain DNR orders executed within twelve months after the bill’s effective date under prior law.
The bill also expands organ-donor registration opportunities. It requires the Bureau of Motor Vehicles donor registry process to remain in place for driver’s licenses, state IDs, and vehicle registrations, and it adds a new requirement that people applying in person for hunting or fishing licenses be asked whether they want to register as anatomical gift donors. Mail and online hunting/fishing license applicants would also be given a form or electronic link to the donor registry. These changes are intended to increase donor enrollment through multiple state licensing channels.
In the medical-emergency provisions, HB920 updates immunity, compliance, and transfer rules for physicians, emergency medical services personnel, and health care facilities when they encounter DNI or DNR identification or orders. It directs the Ohio Department of Health to adopt separate standardized protocols for withholding CPR and withholding intubation, and to approve standardized DNI and DNR identification forms. The bill also amends EMS scope-of-practice statutes so first responders, EMTs, and paramedics may comply with DNI or DNR orders issued by physician assistants or advanced practice registered nurses under existing law.
The overall sentiment reflected in the bill text is procedural and supportive of patient autonomy and clearer medical guidance, with the legislation framed as a modernization of end-of-life documentation rather than a substantive change in the right to refuse treatment. Because there are no committee transcripts or recorded votes provided, there is no direct evidence of debate, but the structure of the bill suggests an effort to reduce confusion for clinicians and emergency personnel by separating intubation decisions from resuscitation decisions.
The main points of contention likely concern how a separate DNI system would be implemented in practice, including whether emergency responders and hospitals can reliably identify and honor the correct order in urgent situations, and how the new DNI framework interacts with existing declarations, powers of attorney, and DNR documents. Additional issues may include the administrative burden on the Department of Health, EMS agencies, and licensing offices, as well as concerns about public understanding of the difference between refusing intubation and refusing CPR.
HB920 would amend Ohio’s advance-directive, emergency medical, and organ-donation statutes to recognize a separate do-not-intubate framework and to require state agencies to create corresponding protocols and identification cards/forms. It would affect Revised Code chapters governing health care powers of attorney, declarations for life-sustaining treatment, DNR/DNI identification, EMS compliance, and donor registry enrollment, while also adding a temporary savings clause for certain preexisting DNR orders.
No committee testimony or vote history is provided, so there is no recorded public debate to measure. Based on the bill’s structure and caption, the measure appears aimed at clarifying patient wishes and giving health care providers more precise instructions, which suggests generally favorable or at least administrative support rather than overt controversy in the available record.
The likely areas of disagreement are the practical and legal consequences of splitting DNI from DNR, including whether the new distinction could create confusion in emergencies, how quickly EMS and hospitals can adapt protocols and forms, and how the new orders interact with existing declarations, powers of attorney, and physician-issued directives. There may also be concern about the added administrative work for the Department of Health, the Bureau of Motor Vehicles, and licensing agencies that would be used to expand donor registration.