Blank Do Not Resuscitate Order Form for Florida

What is a Florida Do Not Resuscitate Order (DNRO) form?

A Florida Do Not Resuscitate Order (DNRO) form is a legal document that tells health care providers not to perform cardiopulmonary resuscitation (CPR) if a person's breathing stops or if their heart stops beating. It is used by individuals who do not want to receive CPR in cases of cardiac or respiratory arrest. This form must be signed by the individual (or their legally authorized representative) and their physician to be valid.

Who can sign a Florida DNRO form?

The Florida DNRO form must be signed by the patient themselves if they are competent and 18 years of age or older. If the patient is a minor or not competent, a legally authorized representative, such as a healthcare surrogate or a durable power of attorney, may sign on their behalf. Additionally, the form must be signed by a licensed physician, osteopathic physician, or advanced registered nurse practitioner to certify the patient's medical condition and the appropriateness of the DNRO.

Where should I keep my DNRO form so it is recognized in an emergency?

For your DNRO form to be effective, especially in an emergency, it should be kept in a prominent place where emergency responders can easily find it. Ideally, it should be placed on the refrigerator or in another visible place in the home. When outside the home, individuals might carry a wallet card indicating they have a DNRO or wear a special necklace or bracelet that signals their DNRO status to medical professionals.

Is a Florida DNRO form valid in other states?

Since each state has its own laws and regulations regarding Do Not Resuscitate orders, a Florida DNRO form may not be automatically recognized in other states. It's important to check the specific laws of the state you are in or plan to travel to. However, most healthcare providers across the United States respect the wishes of a patient as expressed in a DNRO form, even if it does not meet all the legal requirements of their state.

Can I revoke my Do Not Resuscitate Order?

Yes, a Do Not Resuscitate Order can be revoked at any time by the person who has issued it, regardless of their physical or mental condition. The revocation does not need to be in writing; it can be done verbally or by any action that indicates a desire for resuscitation, such as tearing up the DNRO form. It's crucial to inform family members, healthcare proxies, and physicians if a DNRO has been revoked to ensure the patient's current wishes are known.

What happens if a healthcare provider does not follow my DNRO?

If a healthcare provider fails to follow your DNRO, it can be a deeply distressing experience. Ethically and legally, healthcare providers are expected to respect the wishes expressed in a DNRO. If you believe a provider did not honor your DNRO, you may wish to speak directly with the healthcare provider or the facility's patient advocate. Legal recourse might also be an option, depending on the circumstances. Seeking counsel from an attorney specializing in health law can provide guidance on how to address the situation.

1. Not using the official form: People often mistakenly use their own version of a Do Not Resuscitate (DNR) Order rather than the official Florida form. A valid DNR must be on the form provided by the Florida Department of Health to ensure it is recognized by medical personnel.

2. Incorrect patient information: Filling in the patient information inaccurately is a common error. This includes misspelling names, incorrect date of birth, or providing inaccurate address details. Accurate information is crucial for identifying the individual the DNR applies to.

3. Failure to obtain required signatures: A Florida DNR requires signatures from the patient, or their legally authorized representative, and their physician. Often, individuals forget to obtain one or more of these necessary signatures, rendering the document invalid.

4. Lack of witness or notary public signatures: While the Florida DNR does not require the signature of a witness or notary public, including such a verification can reinforce the validity of the document, especially if the patient's or physician's signature is later questioned.

When preparing for healthcare situations where a Florida Do Not Resuscitate (DNR) Order might apply, individuals often consider other legal forms to ensure their wishes are comprehensively documented. These documents work in conjunction with a DNR to provide clear instructions about a person's preferences for medical treatment and end-of-life care. Here are four other essential forms that are commonly used alongside a Florida DNR Order.

• Living Will: A Living Will is a document that outlines a person’s wishes regarding medical treatments and life-sustaining measures in the event they become unable to communicate their decisions. It covers scenarios beyond those addressed by a DNR, including preferences for procedures like mechanical ventilation or tube feeding.
• Health Care Surrogate Designation: This form allows an individual to appoint another person, known as a health care surrogate, to make medical decisions on their behalf if they are unable to do so. This can include decisions about implementing or refusing certain treatments that are not covered by a Living Will.
• Power of Attorney: A Power of Attorney is a broader document that grants another person the authority to make financial and legal decisions for someone else, not just health-related decisions. This can be essential for managing an individual's affairs if they are incapacitated.
• HIPAA Release Form: The Health Insurance Portability and Accountability Act (HIPAA) release form allows healthcare providers to share an individual's medical information with designated people. This is crucial for the appointed health care surrogate or anyone holding a power of attorney to make informed decisions regarding the individual's health care.

Together, these documents create a comprehensive plan for an individual's health care preferences and administrative needs, ensuring they receive the care they desire and their affairs are managed according to their wishes. It’s important for anyone considering a Florida DNR Order to also explore these additional forms to provide a full scope of instructions and authorizations concerning their health care and personal matters.

• A Living Will is closely related to a Do Not Resuscitate (DNR) Order form as both provide specific instructions on medical treatment preferences in situations where an individual is unable to make decisions on their own. The Living Will outlines various medical procedures and treatments an individual agrees or disagrees to undergo, while a DNR specifically addresses the desire to forgo resuscitative efforts in the event of cardiac or respiratory arrest.

• A Medical Power of Attorney (MPOA) designates a person to make health care decisions on an individual's behalf when they are incapacitated. Similar to a DNR, it activates under specific medical conditions where the individual cannot express their wishes. However, while a DNR strictly limits instruction to not resuscitate, an MPOA encompasses broader decision-making authority over healthcare treatments and interventions.

• A Physician Orders for Life-Sustaining Treatment (POLST) form also parallels the purpose of a DNR by providing detailed instructions regarding life-sustaining treatments. Unlike a DNR, which explicitly denies the use of CPR or other resuscitative measures, a POLST can include guidelines for various other medical interventions, such as the use of antibiotics, intubation, and artificial nutrition, based on the patient's wishes.

• The Advance Directive is an umbrella term that often encompasses the DNR order, living wills, and other health care instructions. It allows individuals to outline their medical care preferences and appoint a health care proxy. While it shares similarities with a DNR in allowing individuals to express their wishes for medical treatment, an Advance Directive covers a broader range of healthcare decisions and scenarios beyond resuscitation.

Filling out a Florida Do Not Resuscitate (DNR) Order form requires careful attention to detail and an understanding of its legal implications. This document is crucial in ensuring your wishes regarding resuscitation are respected by healthcare professionals. Below are guidelines to follow and pitfalls to avoid when completing this form.

Do:

• Ensure the form is the current version approved by the Florida Department of Health. Laws and regulations change, and using an outdated form could invalidate your DNR Order.
• Complete the form with accurate personal information, ensuring your name, date of birth, and other identifying details are correct and match other identification documents.
• Discuss your decision with a physician and have them review the DNR Order. Their signature is required for the document to be valid.
• Inform family members or your healthcare proxy about your decision to have a DNR Order. This can help avoid confusion or disputes in emergency situations.
• Make multiple copies of the signed DNR Order. Keep the original in a readily accessible place at home, provide copies to family members or a healthcare proxy, and submit a copy to your primary care physician to be included in your medical records.
• Review and update the DNR Order as necessary. Changes in health status or personal wishes should be reflected in a new form, signed and dated accordingly.

Don't:

• Sign the form without fully understanding the implications of a DNR Order. It is important to comprehend that in the event of a cardiac or respiratory arrest, resuscitation will not be attempted if this form is presented.
• Leave any sections of the form incomplete, as this could lead to misunderstandings or the DNR Order being considered invalid in a critical moment.
• Forget to get the physician’s signature. A Florida DNR Order is not legally valid without a licensed physician's signature, attesting to the discussion and agreement of the DNR terms.
• Fail to communicate your decision to have a DNR Order in place with key healthcare providers besides your primary care physician. Ensure that any specialists or other healthcare professionals involved in your care are aware of your DNR status.
• Store the DNR Order where it cannot be easily found in an emergency, such as a safe deposit box. First responders need immediate access to this document to honor your wishes.
• Assume the DNR Order is permanently fixed. Your wishes regarding resuscitation can change, and it's important to revisit and possibly revise the DNR Order to reflect your current healthcare preferences.

When it comes to the Florida Do Not Resuscitate (DNR) Order form, misconceptions abound, leading to misunderstandings about its purpose, legality, and effect. Here, we dispel some of the most common myths to provide clarity on this important medical directive.

• It’s only for the elderly. The DNR order is not limited by age. It can be appropriate for individuals at any stage of life who wish to decline resuscitation efforts in the event of cardiac or respiratory arrest, based on their health condition and personal preferences.

• A DNR is a verbal agreement. In Florida, a DNR must be formally documented through the state's specific form (DH Form 1896) to be legally valid. Verbal agreements are not enforceable for this purpose.

• It covers all forms of medical treatment. A DNR specifically addresses cardiopulmonary resuscitation (CPR) and does not apply to other forms of medical treatment such as pain relief, antibiotic therapy, or nutrition.

• It’s the same as a Living Will. A Living Will is a broader document that can outline wishes for various medical treatments in the event of incapacitation. A DNR solely focuses on the absence of resuscitation efforts.

• Healthcare professionals can ignore it. In Florida, healthcare professionals are legally obligated to honor a valid DNR. Ignoring it can lead to legal repercussions, assuming they are aware of its existence.

• A DNR order can be applied by anyone. Only the patient, their legally authorized representative, or a healthcare surrogate with explicit authority can consent to a DNR order.

• It’s permanent and can’t be revoked. A DNR order can be revoked at any time by the individual or their authorized representative, allowing for changes in patient wishes or medical conditions.

• Signing a DNR means giving up on life. Choosing a DNR is a personal decision often made to avoid unnecessary suffering and aggressive medical interventions that do not improve the quality of life.

• It must be notarized to be valid. Though formal documentation is required for a DNR in Florida, notarization is not necessary. The form must be completed accurately and signed by the appropriate parties.

• A DNR is only valid in the state of Florida. While it's true that DNR orders are state-specific, many states have reciprocity agreements or procedures that allow them to recognize DNR orders from other states. However, it's advisable to check with healthcare providers when traveling or relocating.

Understanding these key points about the Florida DNR Order can help individuals and their families make informed decisions that reflect their values and medical preferences.

When considering the use of a Do Not Resuscitate (DNR) Order form in Florida, it's imperative to understand key aspects that ensure its proper completion and application. These takeaways guide individuals through the process, highlighting legal considerations and practical steps to follow.

• The Florida Do Not Resuscitate Order form must be completed accurately to be legally valid. Ensure all information provided is current and correct.
• This form is designed for individuals who choose not to receive cardiopulmonary resuscitation (CPR) in the event their heart stops or they stop breathing.
• A licensed physician must sign the form for it to be effective. Their signature indicates they have discussed the DNR order with the patient (or their legally authorized representative) and agree with the patient’s wishes.
• The form should be readily accessible to emergency medical services (EMS) personnel; consider keeping it in a visible location within the home or on your person if you are frequently out.
• Discuss your decision with family members, close friends, and healthcare providers to ensure they understand your wishes and the existence of your DNR order.
• The DNR order can be revoked at any time by the patient or their legally authorized representative. Destruction of the form or a verbal indication of intent to revoke should be clearly communicated to the healthcare provider.
• Make multiple copies of the signed form. Give one to your physician, keep one for yourself, and consider giving copies to family members or caregivers who are likely to be present in an emergency.
• Despite having a DNR order, patients still have the right to receive all other forms of medical care if desired. The DNR specifically relates to CPR and does not affect other treatments.
• It's important to review and update the DNR order periodically, especially if there is a significant change in health status or if the patient wishes to change their decision regarding resuscitation.

Understanding and following these key points can ensure that your wishes concerning resuscitation are both respected and legally recognized in Florida.