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SB0312 • 2026

Patient-directed Medical Orders

Patient-directed Medical Orders

Healthcare
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Rodriguez
Last action
2026-03-13
Official status
Senate - Died in Appropriations Committee on Health and Human Services
Effective date
2026-07-01

Plain English Breakdown

The bill did not pass and died in committee on Health and Human Services.

Patient-Directed Medical Orders

This bill updates the definitions and requirements for patient-directed medical orders, which are instructions given by patients to healthcare providers about their treatment preferences.

What This Bill Does

  • Updates definitions related to advance directives and patient-directed medical orders.
  • Requires that certain health care services be provided regardless of decisions to withhold or withdraw life-prolonging procedures.
  • Authorizes physicians, physician assistants, and advanced practice registered nurses to withhold or withdraw life-prolonging procedures without facing penalties under specific circumstances.
  • Creates a new section for patient-directed medical orders detailing how they should be executed and what information must be included.
  • Requires the Agency for Health Care Administration to create and maintain an online database for storing these orders.

Who It Names or Affects

  • Patients who want to give instructions about their treatment preferences.
  • Healthcare providers such as physicians, physician assistants, and advanced practice registered nurses.
  • The Agency for Health Care Administration which will manage the database of patient-directed medical orders.

Terms To Know

Advance directive
A document where a person gives instructions about their health care or designates someone to make decisions on their behalf if they cannot do so themselves.
Patient-directed medical order
An instruction given by a patient, in collaboration with a healthcare provider, that directs how the patient's treatment should be handled.

Limits and Unknowns

  • The bill did not pass and died in committee.
  • It is unclear if or when similar legislation will be reintroduced.

Bill History

  1. 2026-03-13 Senate

    • Died in Appropriations Committee on Health and Human Services

  2. 2026-01-13 Senate

    • Introduced

  3. 2025-12-10 Senate

    • Now in Appropriations Committee on Health and Human Services

  4. 2025-12-09 Senate

    • Favorable by Health Policy; YEAS 7 NAYS 0

  5. 2025-12-01 Senate

    • On Committee agenda-- Health Policy, 12/09/25, 10:00 am, 412 Knott Building

  6. 2025-11-17 Senate

    • Referred to Health Policy; Appropriations Committee on Health and Human Services; Fiscal Policy

  7. 2025-10-31 Senate

    • Filed

Official Summary Text

Patient-directed Medical Orders; Revising definitions and defining the term “patient-directed medical order”; authorizing the execution of a patient-directed medical order for a specified purpose; requiring that certain health care services be provided to the principal regardless of the decision to withhold or withdraw life-prolonging procedures; authorizing physicians, physician assistants, and advanced practice registered nurses to withhold or withdraw life-prolonging procedures under certain circumstances without penalty; requiring the Agency for Health Care Administration to create and update a database for the storage of patient-directed medical orders, etc.

Current Bill Text

Read the full stored bill text
Florida Senate
-
2026

SB 312

By
Senator Rodriguez

40-00411-26 2026312__
1 A bill to be entitled
2 An act relating to patient-directed medical orders;
3 amending s. 765.101, F.S.; revising definitions and
4 defining the term “patient-directed medical order”;
5 amending s. 765.102, F.S.; revising legislative
6 findings and intent; creating s. 765.3041, F.S.;
7 authorizing the execution of a patient-directed
8 medical order for a specified purpose; providing
9 requirements for valid patient-directed medical
10 orders; authorizing the use of telehealth for a
11 specified purpose; requiring that certain health care
12 services be provided to the principal regardless of
13 the decision to withhold or withdraw life-prolonging
14 procedures; authorizing physicians, physician
15 assistants, and advanced practice registered nurses to
16 withhold or withdraw life-prolonging procedures under
17 certain circumstances without penalty; providing
18 construction; amending ss. 395.1041, 400.142, 400.487,
19 400.605, 400.6095, 400.611, 401.35, 401.45, 429.255,
20 429.73, 744.4431, 752.001, 765.110, 765.204, 765.205,
21 and 765.305, F.S.; conforming cross-references and
22 provisions to changes made by the act; requiring the
23 Agency for Health Care Administration to create and
24 update a database for the storage of patient-directed
25 medical orders; providing an effective date.
26
27 Be It Enacted by the Legislature of the State of Florida:
28
29 Section 1. Present subsections (15) through (22) of section
30 765.101, Florida Statutes, are redesignated as subsections (16)
31 through (23), respectively, a new subsection (15) is added to
32 that section, and subsections (1) and (7) of that section are
33 amended, to read:
34 765.101 Definitions.—As used in this chapter:
35 (1) “Advance directive” means a witnessed written document
36 or oral statement in which instructions are given by a principal
37 or in which the principal’s desires are expressed concerning any
38 aspect of the principal’s health care or health information, and
39 includes, but is not limited to, the designation of a health
40 care surrogate, a living will, or an anatomical gift made
41 pursuant to part V of this chapter.
An advance directive may

42
also include a patient-directed medical order.

43 (7) “Health care facility” means a hospital, nursing home,
44 hospice, home health agency, or health maintenance organization
45 licensed in this state
; a
,
o
r any
facility subject to part I of
46 chapter 394
; or an assisted living facility or adult family-care

47
home licensed under chapter 429
.
48
(15)

“Patient-directed medical order” means a medical order

49
created by the principal in collaboration with a physician, a

50
physician assistant, or an advanced practice registered nurse

51
registered under s. 464.0123 which is portable across health

52
care settings and accessible in a voluntary online registry.

53 Section 2. Subsection (6) of section 765.102, Florida
54 Statutes, is amended to read:
55 765.102 Legislative findings and intent.—
56 (6) For purposes of this chapter:
57 (a) Palliative care is the comprehensive management of the
58 physical, psychological, social, spiritual, and existential
59 needs of patients. Palliative care is especially suited to the
60 care of persons who have incurable
or
,
progressive illnesses.
61 (b) Palliative care
may

must
include:
62 1. An opportunity to discuss and plan for end-of-life care.
63 2. Assurance that physical and mental suffering will be
64 carefully attended to.
65 3. Assurance that preferences for withholding and
66 withdrawing life-sustaining interventions will be honored.
67 4. Assurance that the personal goals of the dying person
68 will be addressed.
69 5. Assurance that the dignity of the dying person will be a
70 priority.
71 6. Assurance that health care providers will not abandon
72 the dying person.
73 7. Assurance that the burden to family and others will be
74 addressed.
75 8. Assurance that advance directives for care
, orders not

76
to resuscitate executed pursuant to s. 401.45, and patient

77
directed medical orders executed pursuant to s. 765.3041
will be
78 respected regardless of the location of care.
79 9. Assurance that organizational mechanisms are in place to
80 evaluate the availability and quality of end-of-life,
81 palliative, and hospice care services, including the evaluation
82 of administrative and regulatory barriers.
83 10. Assurance that necessary health care services will be
84 provided and that relevant reimbursement policies are available.
85 11. Assurance that the goals expressed in subparagraphs 1.
86 10. will be accomplished in a culturally appropriate manner.
87 Section 3. Section 765.3041, Florida Statutes, is created
88 to read:
89
765.3041

Patient-directed medical orders.—

90
(1)

To facilitate a principal’s instructions concerning

91
treatment preferences, a patient-directed medical order may be

92
executed in advance to direct the actions of health care

93
providers and health care facilities.

94
(2)

A valid patient-directed medical order must:

95
(a)

Be on a form adopted by rule of the Department of

96
Health and may be combined with an order not to resuscitate

97
executed pursuant to s. 401.45. The form must:

98
1.

Address medical interventions to be withheld or

99
withdrawn when the application of life-prolonging procedures

100
would serve only to prolong artificially the process of dying.

101
2.

Be signed by the principal and the principal’s

102
physician, physician assistant, or advanced practice registered

103
nurse registered under s. 464.0123.

104
a.

If the principal is physically unable to sign the form,

105
the physician, physician assistant, or advanced practice

106
registered nurse present at the discussion as required by

107
subparagraph (b)1. may subscribe the principal’s signature in

108
the principal’s presence and at the principal’s direction. If

109
telehealth is used, the physician, physician assistant, or

110
advanced practice registered nurse may be present at either

111
location where telehealth is being administered.

112
b.

If the principal is incapacitated, the form may be

113
signed by the principal’s health care surrogate or proxy, court

114
appointed guardian as provided in chapter 744, or attorney in

115
fact under a durable power of attorney as provided in chapter

116
709. The court-appointed guardian or attorney in fact must be

117
delegated authority to make health care decisions on behalf of

118
the principal.

119
c.

All signatures may be electronic signatures.

120
(b)

Clearly express the principal’s preferences and

121
instructions for care, which may include all treatments

122
available, modified treatments that are not prolonged or

123
burdensome, or comfort measures that do not pursue or continue

124
interventions.

125
1.

The principal and a physician, a physician assistant, or

126
an advanced practice registered nurse registered under s.

127
464.0123 must discuss the principal’s medical treatment wishes

128
relating to medical interventions to be withheld or withdrawn

129
based on the principal’s values and preferences in the event the

130
principal becomes unable to make her or his own decisions.

131
2.

The discussion must be in person and may be conducted

132
using telehealth.

133
(3)

Regardless of the decision to withhold or withdraw

134
life-prolonging procedures, necessary health care services must

135
be provided for the care and comfort of the principal or to

136
alleviate pain.

137
(4)

A physician, a physician assistant, or an advanced

138
practice registered nurse registered under s. 464.0123 may

139
withhold or withdraw cardiopulmonary resuscitation or other

140
life-prolonging procedures if presented with an order not to

141
resuscitate executed pursuant to s. 401.45 or a patient-directed

142
medical order executed pursuant to this section which contains

143
an order not to resuscitate or an order to withhold or withdraw

144
life-prolonging procedures. A physician, a physician assistant,

145
or an advanced practice registered nurse registered under s.

146
464.0123 is not subject to any disciplinary action under s.

147
456.072 or criminal prosecution or civil liability, or

148
considered to have engaged in negligent or unprofessional

149
conduct, for withholding or withdrawing cardiopulmonary

150
resuscitation or other life-prolonging procedures pursuant to

151
such orders. The absence of an order not to resuscitate executed

152
pursuant to s. 401.45 or a patient-directed medical order

153
executed pursuant to this section does not preclude a physician,

154
a physician assistant, or an advanced practice registered nurse

155
registered under s. 464.0123 from withholding or withdrawing

156
cardiopulmonary resuscitation or other life-prolonging

157
procedures as otherwise authorized by law.

158 Section 4. Paragraph (l) of subsection (3) of section
159 395.1041, Florida Statutes, is amended to read:
160 395.1041 Access to and ensurance of emergency services;
161 transfers; patient rights; diversion programs; reports of
162 controlled substance overdoses.—
163 (3) EMERGENCY SERVICES; DISCRIMINATION; LIABILITY OF
164 FACILITY OR HEALTH CARE PERSONNEL.—
165 (l) Hospital personnel may withhold or withdraw
166 cardiopulmonary resuscitation
or other life-prolonging

167
procedures
if presented with an order not to resuscitate
168 executed pursuant to s. 401.45
or a patient-directed medical

169
order executed pursuant to s. 765.3041 which contains an order

170
not to resuscitate or an order to withhold or withdraw life

171
prolonging procedures
. Facility staff and facilities
are

shall

172 not
be
subject to criminal prosecution or civil liability,
or

173
nor be
considered to have engaged in negligent or unprofessional
174 conduct, for withholding or withdrawing cardiopulmonary
175 resuscitation
or other life-prolonging procedures
pursuant to
176 such
orders

an order
. The absence of an order not to resuscitate
177 executed pursuant to s. 401.45
or a patient-directed medical

178
order executed pursuant to s. 765.3041
does not preclude a
179 physician from withholding or withdrawing cardiopulmonary
180 resuscitation
or other life-prolonging procedures
as otherwise
181
authorized

permitted
by law.
182 Section 5. Subsection (3) of section 400.142, Florida
183 Statutes, is amended to read:
184 400.142 Emergency medication kits; orders not to
185 resuscitate
and patient-directed medical orders
.—
186 (3) Facility staff may withhold or withdraw cardiopulmonary
187 resuscitation
or other life-prolonging procedures
if presented
188 with an order not to resuscitate executed pursuant to s. 401.45
189
or a patient-directed medical order executed pursuant to s.

190
765.3041 which contains an order not to resuscitate or an order

191
to withhold or withdraw life-prolonging procedures
. Facility
192 staff and facilities are not subject to criminal prosecution or
193 civil liability, or considered to have engaged in negligent or
194 unprofessional conduct, for withholding or withdrawing
195 cardiopulmonary resuscitation
or other life-prolonging

196
procedures
pursuant to such
orders

order
. The absence of an
197 order not to resuscitate executed pursuant to s. 401.45
or a

198
patient-directed medical order executed pursuant to s. 765.3041

199 does not preclude a physician from withholding or withdrawing
200 cardiopulmonary resuscitation
or other life-prolonging

201
procedures
as otherwise
authorized

permitted
by law.
202 Section 6. Subsection (7) of section 400.487, Florida
203 Statutes, is amended to read:
204 400.487 Home health service agreements; physician’s,
205 physician assistant’s, and advanced practice registered nurse’s
206 treatment orders; patient assessment; establishment and review
207 of plan of care; provision of services; orders not to
208 resuscitate
and patient-directed medical orders
.—
209 (7) Home health agency personnel may withhold or withdraw
210 cardiopulmonary resuscitation
or other life-prolonging

211
procedures
if presented with an order not to resuscitate
212 executed pursuant to s. 401.45
or a patient-directed medical

213
order executed pursuant to s. 765.3041 which contains an order

214
not to resuscitate or an order to withhold or withdraw life

215
prolonging procedures
. The agency shall adopt rules providing
216 for the implementation of such orders. Home health personnel and
217 agencies
are

shall
not
be
subject to criminal prosecution or
218 civil liability,
or

nor be
considered to have engaged in
219 negligent or unprofessional conduct, for withholding or
220 withdrawing cardiopulmonary resuscitation
or other life

221
prolonging procedures
pursuant to such
orders

an order
and rules
222 adopted by the agency.
The absence of an order not to

223
resuscitate executed pursuant to s. 401.45 or a patient-directed

224
medical order executed pursuant to s. 765.3041 does not preclude

225
a physician from withholding or withdrawing cardiopulmonary

226
resuscitation or other life-prolonging procedures as otherwise

227
authorized by law.

228 Section 7. Paragraph (e) of subsection (1) of section
229 400.605, Florida Statutes, is amended to read:
230 400.605 Administration; forms; fees; rules; inspections;
231 fines.—
232 (1) The agency shall by rule establish minimum standards
233 and procedures for a hospice pursuant to this part. The rules
234 must include:
235 (e) Procedures relating to the implementation of
advance

236
advanced
directives
, patient-directed medical orders executed

237
pursuant to s. 765.3041,
and
do-not-resuscitate
orders
not to

238
resuscitate executed pursuant to s. 401.45
.
239 Section 8. Subsection (8) of section 400.6095, Florida
240 Statutes, is amended to read:
241 400.6095 Patient admission; assessment; plan of care;
242 discharge; death.—
243 (8) The hospice care team may withhold or withdraw
244 cardiopulmonary resuscitation
or other life-prolonging

245
procedures
if presented with an order not to resuscitate
246 executed pursuant to s. 401.45
or a patient-directed medical

247
order executed pursuant to s. 765.3041 which contains an order

248
not to resuscitate or an order to withhold or withdraw life

249
prolonging procedures
. The agency shall adopt rules providing
250 for the implementation of such orders. Hospice staff
are

shall

251 not
be
subject to criminal prosecution or civil liability,
or

252
nor be
considered to have engaged in negligent or unprofessional
253 conduct, for withholding or withdrawing cardiopulmonary
254 resuscitation
or other life-prolonging procedures
pursuant to
255 such
orders

an order
and applicable rules. The absence of an
256 order
not
to resuscitate executed pursuant to s. 401.45
or a

257
patient-directed medical order executed pursuant to s. 765.3041

258 does not preclude a physician from withholding or withdrawing
259 cardiopulmonary resuscitation
or other life-prolonging

260
procedures
as otherwise
authorized

permitted
by law.
261 Section 9. Paragraph (b) of subsection (4) of section
262 400.611, Florida Statutes, is amended to read:
263 400.611 Interdisciplinary records of care; confidentiality;
264 release of records.—
265 (4) A hospice may not release a patient’s interdisciplinary
266 record or any portion thereof, unless the person requesting the
267 information provides to the hospice:
268 (b) In the case of an incapacitated patient, a patient
269 authorization executed
before

prior to
the patient’s death by
270 the patient’s then acting legal guardian, health care surrogate
271 as defined in
s. 765.101

s. 765.101(21)
, health care proxy as
272 defined in
s. 765.101

s. 765.101(19)
, or agent under power of
273 attorney;
274 Section 10. Subsection (4) of section 401.35, Florida
275 Statutes, is amended to read:
276 401.35 Rules.—The department shall adopt rules, including
277 definitions of terms, necessary to carry out the purposes of
278 this part.
279 (4) The rules must establish circumstances and procedures
280 under which emergency medical technicians and paramedics may
281 honor orders
not to resuscitate executed pursuant to s. 401.45

282
or patient-directed medical orders executed pursuant to s.

283
765.3041 which contain an order not to resuscitate or an order

284
to withhold or withdraw life-prolonging procedures
by the
285 patient’s physician
, physician assistant, or advanced practice

286
registered nurse registered under s. 464.0123

not to resuscitate

287 and the documentation and reporting requirements for handling
288 such
orders

requests
.
289 Section 11. Paragraphs (a) and (b) of subsection (3) of
290 section 401.45, Florida Statutes, are amended to read:
291 401.45 Denial of emergency treatment; civil liability.—
292 (3)(a)
Resuscitation may be withheld or withdrawn from a

293
patient by
An emergency medical technician or paramedic
may

294
withhold or withdraw cardiopulmonary resuscitation or other

295
life-prolonging procedures
if
presented with

evidence of
an
296 order not to resuscitate
executed pursuant to this subsection or

297
a patient-directed medical order executed pursuant to s.

298
765.3041 which contains an order not to resuscitate or an order

299
to withhold or withdraw life-prolonging procedures

by the

300
patient’s physician or physician assistant is presented to the

301
emergency medical technician or paramedic
. An order not to
302 resuscitate
executed pursuant to this subsection or a patient

303
directed medical order executed pursuant to s. 765.3041 which

304
contains an order not to resuscitate or an order to withhold or

305
withdraw life-prolonging procedures
, to be valid, must be on the
306 form adopted by rule of the department. The form must be signed
307 by the patient’s physician
,

or
physician assistant
, or advanced

308
practice registered nurse registered under s. 464.0123
and by
309 the patient or, if the patient is incapacitated, the patient’s
310 health care surrogate or proxy as provided in chapter 765,
311 court-appointed guardian as provided in chapter 744, or attorney
312 in fact under a durable power of attorney as provided in chapter
313 709. The court-appointed guardian or attorney in fact must have
314 been delegated authority to make health care decisions on behalf
315 of the patient.
316 (b) Any licensee, physician, medical director, or emergency
317 medical technician or paramedic who acts under the direction of
318 a medical director is not subject to criminal prosecution or
319 civil liability, and has not engaged in negligent or
320 unprofessional conduct, as a result of the withholding or
321 withdrawal of
cardiopulmonary
resuscitation
or other life

322
prolonging procedures
from a patient pursuant to this subsection
323 and rules adopted by the department.
324 Section 12. Subsection (4) of section 429.255, Florida
325 Statutes, is amended to read:
326 429.255 Use of personnel; emergency care.—
327 (4) Facility staff may withhold or withdraw cardiopulmonary
328 resuscitation
,

or
the use of an automated external
329 defibrillator
, or other life-prolonging procedures
if presented
330 with an order not to resuscitate executed pursuant to s. 401.45
331
or a patient-directed medical order executed pursuant to s.

332
765.3041 which contains an order not to resuscitate or an order

333
to withhold or withdraw life-prolonging procedures
. The agency
334 shall adopt rules providing for the implementation of such
335 orders. Facility staff and facilities
are

may
not
be
subject to
336 criminal prosecution or civil liability,
or

nor be
considered to
337 have engaged in negligent or unprofessional conduct, for
338 withholding or withdrawing cardiopulmonary resuscitation
, the

or

339 use of an automated external defibrillator
, or other life

340
prolonging procedures
pursuant to such
orders

an order
and rules
341 adopted by the agency. The absence of an order not to
342 resuscitate executed pursuant to s. 401.45
or a patient-directed

343
medical order executed pursuant to s. 765.3041
does not preclude
344 a physician from withholding or withdrawing cardiopulmonary
345 resuscitation
, the

or
use of an automated external
346 defibrillator
, or other life-prolonging procedures
as otherwise
347
authorized

permitted
by law.
348 Section 13. Subsection (3) of section 429.73, Florida
349 Statutes, is amended to read:
350 429.73 Rules and standards relating to adult family-care
351 homes.—
352 (3) The agency shall adopt rules providing for the
353 implementation of orders not to resuscitate
and patient-directed

354
medical orders
. The provider may withhold or withdraw
355 cardiopulmonary resuscitation
or other life-prolonging

356
procedures
if presented with an order not to resuscitate
357 executed pursuant to s. 401.45
or a patient-directed medical

358
order executed pursuant to s. 765.3041 which contains an order

359
not to resuscitate or an order to withhold or withdraw life

360
prolonging procedures
. The provider
is

shall
not
be
subject to
361 criminal prosecution or civil liability,
or

nor be
considered to
362 have engaged in negligent or unprofessional conduct, for
363 withholding or withdrawing cardiopulmonary resuscitation
or

364
other life-prolonging procedures
pursuant to such
orders

an

365
order
and applicable rules.
The absence of an order not to

366
resuscitate executed pursuant to s. 401.45 or a patient-directed

367
medical order executed pursuant to s. 765.3041 does not preclude

368
a physician from withholding or withdrawing cardiopulmonary

369
resuscitation or other life-prolonging procedures as otherwise

370
authorized by law.

371 Section 14. Subsections (1), (7), and (8) of section
372 744.4431, Florida Statutes, are amended to read:
373 744.4431 Guardianship power regarding life-prolonging
374 procedures.—
375 (1) Except as provided in this section, decisions by a
376 professional guardian, as defined in s. 744.102, to withhold or
377 withdraw life-prolonging procedures from, or to execute an order
378 not to resuscitate
pursuant to s. 401.45 or a patient-directed

379
medical order pursuant to s. 765.3041 which contains an order

380
not to resuscitate or an order to withhold or withdraw life

381
prolonging procedures
for, a ward must be approved by the court.
382 A professional guardian appointed to act on behalf of a ward’s
383 person must petition the court pursuant to the Florida Probate
384 Rules for authority to consent to withhold or withdraw life
385 prolonging procedures or to execute an order not to resuscitate
386
pursuant to s. 401.45 or a patient-directed medical order

387
pursuant to s. 765.3041. Court approval must be obtained
before
388 taking such action, except as provided in subsection (7).
389 (7) Court approval is not required for the following
390 decisions:
391 (a) A decision to withhold or withdraw life-prolonging
392 procedures made by a professional guardian to whom authority has
393 been granted by the court under s. 744.3115 to carry out the
394 instructions in or to take actions consistent with the ward’s
395 advance directive
, order not to resuscitate executed pursuant to

396
s. 401.45, or patient-directed medical order executed pursuant

397
to s. 765.3041 which contains an order not to resuscitate or an

398
order to withhold or withdraw life-prolonging procedures
, as
399 long as there are no known objections from the ward; the ward’s
400 attorney; the ward’s next of kin, if known; and any other
401 interested persons as the court may direct based on s.
402 765.105(1).
403 (b) A decision by a professional guardian who has been
404 delegated health care decisionmaking authority to execute an
405 order not to resuscitate
pursuant to s. 401.45 or a patient

406
directed medical order pursuant to s. 765.3041
, as described in

407
s. 401.45(3)(a)
, if the ward is in a hospital and the following
408 conditions are met:
409 1. The ward’s primary treating physician and at least one
410 other consulting physician document in the ward’s medical record
411 that:
412 a. There is no reasonable medical probability for recovery
413 from or a cure of the ward’s underlying medical condition;
414 b. The ward is in an end-stage condition, a terminal
415 condition, or a persistent vegetative state as those terms are
416 defined in s. 765.101, and that the ward’s death is imminent;
417 and
418 c. Resuscitation will cause the ward physical harm or
419 additional pain.
420 2. The professional guardian has notified the ward’s next
421 of kin, if known, and any interested persons as the court may
422 direct and the decision is not contrary to the ward’s expressed
423 wishes and there are no known objections from the ward; the
424 ward’s attorney; the ward’s next of kin, if known; or any other
425 interested persons as the court may direct on the basis of s.
426 765.105(1).
427 (8) Within 2 business days after executing an order not to
428 resuscitate
pursuant to s. 401.45 or a patient-directed medical

429
order pursuant to s. 765.3041 which contains an order not to

430
resuscitate or an order to withhold or withdraw life-prolonging

431
procedures

under paragraph (7)(b)
, a professional guardian must
432 notify the court in writing of all of the following:
433 (a) The date the order not to resuscitate
or patient

434
directed medical order
was executed.
435 (b) The location of the ward when the order not to
436 resuscitate
or patient-directed medical order
was executed.
437 (c) The names of the physicians who documented the ward’s
438 condition in the ward’s medical record.
439 Section 15. Subsection (3) of section 752.001, Florida
440 Statutes, is amended to read:
441 752.001 Definitions.—As used in this chapter, the term:
442 (3) “Persistent vegetative state” has the same meaning as
443
provided
in
s. 765.101

s. 765.101(15)
.
444 Section 16. Subsections (1) and (4) of section 765.110,
445 Florida Statutes, are amended to read:
446 765.110 Health care facilities and providers; discipline.—
447 (1) A health care facility
, pursuant to Pub. L. No. 101

448
508, ss. 4206 and 4751,
shall provide to each patient written
449 information concerning the individual’s rights concerning
450 advance directives
, orders not to resuscitate executed pursuant

451
to s. 401.45, or patient-directed medical orders executed

452
pursuant to s. 765.3041 which contain an order not to

453
resuscitate or an order to withhold or withdraw life-prolonging

454
procedures
and the health care facility’s policies respecting
455 the implementation of such rights, and shall document in the
456 patient’s medical records whether
or not
the individual has
457 executed an advance directive
, an order not to resuscitate

458
pursuant to s. 401.45, or a patient-directed medical order

459
pursuant to s. 765.3041 which contains an order not to

460
resuscitate or an order to withhold or withdraw life-prolonging

461
procedures
.
462 (4) The Department of Health, in consultation with the
463 Department of Elderly Affairs, for health care providers; the
464 Agency for Health Care Administration for hospitals, hospices,
465 nursing homes, home health agencies,
assisted living facilities,

466
adult family-care homes,
and health maintenance organizations;
467 and the Department of Children and Families for facilities
468 subject to part I of chapter 394 shall adopt rules to implement
469 this section.
470 Section 17. Subsection (3) of section 765.204, Florida
471 Statutes, is amended to read:
472 765.204 Capacity of principal; procedure.—
473 (3) The surrogate’s authority commences either upon a
474 determination under subsection (2) that the principal lacks
475 capacity or upon a stipulation of such authority pursuant to
s.

476
765.101

s. 765.101(21)
. Such authority remains in effect until a
477 determination that the principal has regained such capacity, if
478 the authority commenced as a result of incapacity, or until the
479 authority is revoked, if the authority commenced immediately
480 pursuant to
s. 765.101

s. 765.101(21)
. Upon commencement of the
481 surrogate’s authority, a surrogate who is not the principal’s
482 spouse shall notify the principal’s spouse or adult children of
483 the principal’s designation of the surrogate. Except if the
484 principal provided immediately exercisable authority to the
485 surrogate pursuant to
s. 765.101

s. 765.101(21)
, in the event
486 that the primary or attending physician determines that the
487 principal has regained capacity, the authority of the surrogate
488 shall cease, but recommences if the principal subsequently loses
489 capacity as determined pursuant to this section. A health care
490 provider is not liable for relying upon health care decisions
491 made by a surrogate while the principal lacks capacity. At any
492 time when a principal lacks capacity, a health care decision
493 made on the principal’s behalf by a surrogate is effective to
494 the same extent as a decision made by the principal. If a
495 principal possesses capacity, health care decisions of the
496 principal take precedence over decisions made by the surrogate
497 that present a material conflict.
498 Section 18. Paragraph (c) of subsection (1) of section
499 765.205, Florida Statutes, is amended to read:
500 765.205 Responsibility of the surrogate.—
501 (1) The surrogate, in accordance with the principal’s
502 instructions, unless such authority has been expressly limited
503 by the principal, shall:
504 (c) Provide written consent using an appropriate form
505 whenever consent is required, including
the execution of an

a

506
physician’s
order not to resuscitate
pursuant to s. 401.45 or a

507
patient-directed medical order pursuant to s. 765.3041 which

508
contains an order not to resuscitate or an order to withhold or

509
withdraw life-prolonging procedures
.
510 Section 19. Subsection (2) of section 765.305, Florida
511 Statutes, is amended to read:
512 765.305 Procedure in absence of a living will.—
513 (2) Before exercising the incompetent patient’s right to
514 forego treatment,
including the execution of an order not to

515
resuscitate pursuant to s. 401.45 or a patient-directed medical

516
order pursuant to s. 765.3041 which contains an order not to

517
resuscitate or an order to withhold or withdraw life-prolonging

518
procedures,
the surrogate must be satisfied that:
519 (a) The patient does not have a reasonable medical
520 probability of recovering capacity so that the right could be
521 exercised by the patient.
522 (b) The patient has an end-stage condition, the patient is
523 in a persistent vegetative state, or the patient’s physical
524 condition is terminal.
525 Section 20.
The Agency for Health Care Administration shall

526
create and update a database for the storage of patient-directed

527
medical orders, which shall be stored solely at the option of

528
the patient in electronic form by the agency.

529 Section 21. This act shall take effect July 1, 2026.