Healthcare Surrogates and Advance Directives

Every adult has the right to make decisions concerning his or her own health, including the right to choose or refuse medical treatment.

When a person becomes unable to make decisions due to a physical or mental change, such as being in a coma or developing dementia (like Alzheimer’ disease), they are considered incapacitated. To make sure that an incapacitated person’s decisions about health care will still be respected, the Florida legislature enacted legislation pertaining to health care advance directives (Chapter 765, Florida Statutes). The law recognizes the right of a capacitated adult to make an advance directive instructing his or her physician to provide, withhold, or withdraw life-prolonging procedures; to designate another individual to make treatment decisions if the person becomes unable to make his or her own decisions; and/or to indicate the desire to make an anatomical donation after death.

What is an advance directive? It is a written or oral statement about how you want medical decisions made should you not be able to make them yourself and/or it can express your wish to make an anatomical donation after death. Some people make advance directives when they are diagnosed with a life-threatening illness. Others put their wishes into writing while they are healthy, often as part of their estate planning.

Four types of advance directives are:

You might choose to complete one, two, or all three of these forms. 

What is a living will? It is a written or oral statement of the kind of medical care you want or do not want if you become unable to make your own decisions. It is called a living will because it takes effect while you are still living. You may wish to speak to your health care provider or attorney to be certain you have completed the living will in a way that your wishes will be understood.

What is a health care surrogate designation? It is a document naming another person as your representative to make medical decisions for you if you are unable to make them yourself. You can include instructions about any treatment you want or do not want, similar to a living will. You can also designate an alternate surrogate.

What is the difference in a Healthcare Surrogate and Power of Attorney? The main difference between a medical power of attorney and a healthcare surrogate is that you appoint a medical power of attorney representative to make healthcare decisions for you when you become unable to make them for yourself. You can specify what healthcare decisions your medical power of attorney can make.

What is an anatomical donation? It is a document that indicates your wish to donate, at death, all or part of your body. This can be an organ and tissue donation to persons in need, or donation of your body for training of health care workers. You can indicate your choice to be an organ donor by designating it on your driver’s license or state identification card (at your nearest driver’s license office), signing a uniform donor form (seen elsewhere in this pamphlet), or expressing your wish in a living will.

What is the Florida Do Not Resuscitate?The Florida do not resuscitate order form (DNR or DNRO) is a document that is used by citizens of the State who suffer from incurable or irreversible medical conditions. This form states that the requester does not wish to be resuscitated in the event of respiratory or cardiac arrest. Although not always reserved for patients with terminal illnesses, it is the most common reason for a physician to sign off on a DNR order. A DNR must be honored in any health care setting by all medical personnel, including EMTs and paramedics outside of a medical facility. For a Florida DNR to be legally valid, the form must be printed on yellow paper before it is filled out by the patient/authorized representative and physician.

Am I required to have an advance directive under Florida law? No, there is no legal requirement to complete an advance directive. However, if you have not completed a written advance directive, your medical decision maker will be determined according to Florida Law.

Must an attorney prepare the advance directive? No, the procedures are simple and do not require an attorney, though you may choose to consult one. However, an advance directive, whether it is a written document or an oral statement, needs to be witnessed by two individuals. At least one of the witnesses cannot be a spouse or a blood relative.

Who can witness a designation of healthcare surrogate? The person making decisions for you may or may not be aware of your wishes. When you make an advance directive, and discuss it with the significant people in your life, it will better assure that your wishes will be carried out the way you want.

Can I change my mind after I write an advance directive? Yes, you may change or cancel an advance directive at any time. Any changes should be written, signed and dated. However, you can also change an advance directive by oral statement; physical destruction of the advance directive; or by writing a new advance directive.

If your driver’s license or state identification card indicates you are an organ donor, but you no longer want this designation, contact the nearest driver’s license office to cancel the donor designation and a new license or card will be issued to you.

What if I have filled out an advance directive in another state and need treatment in Florida?
An advance directive completed in another state, as described in that state's law, can be honored in Florida.
What should I do with my advance directive if I choose to have one?

  • If you designate a health care surrogate and an alternate surrogate be sure to ask them if they agree to take this responsibility, discuss how you would like matters handled, and give them a copy of the document.
  • Make sure that your health care provider, attorney, and the significant persons in your life know that you have an advance directive and where it is located. You also may want to give them a copy.
  • Set up a file where you can keep a copy of your advance directive (and other important paperwork). Some people keep original papers in a bank safety deposit box. If you do, you may want to keep copies at your house or information concerning the location of your safety deposit box.
  • Keep a card or note in your purse or wallet that states that you have an advance directive and where it is located.
  • If you change your advance directive, make sure your health care provider, attorney and the significant persons in your life have the latest copy.

If you have questions about your advance directive you may want to discuss these with your health care provider, attorney, or the significant persons in your life.

Planning ahead is crucial for the well-being, both emotionally and financially, of yourself and your family.

Click Here to download a Designation of Healthcare Surrogate

Click Here to download a Living Will