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THE BILL ITSELF

SB 312

Patient-directed Medical Orders

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underlined language is being added; struck language is being deleted. Line numbers are the Legislature's own — the same ones amendments cite.

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.
27 Be It Enacted by the Legislature of the State of Florida:
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 , or 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.