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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to patient -directed doctor's orders; 2
amending ss. 395.1041, 400.142, and 400.487, F.S.; 3
authorizing specified personnel to withhold or 4
withdraw cardiopulmonary resuscitation if presented 5
with a patient-directed doctor's order (PDDO) form 6
that contains an order not to resuscitate; providing 7
such personnel with immunity from criminal prosecution 8
or civil liability for such actions; providing that 9
the absence of such form does not preclude physicians 10
or home health agency personnel from withhol ding or 11
withdrawing cardiopulmonary resuscitation under 12
certain conditions; amending s. 400.605, F.S.; 13
requiring the Agency for Health Care Administration to 14
adopt by rule procedures for the implementation of 15
PDDO forms in hospice care; amending s. 400.609 5, 16
F.S.; authorizing hospice care teams to withhold or 17
withdraw cardiopulmonary resuscitation if presented 18
with a PDDO form; providing hospice staff with 19
immunity from criminal prosecution or civil liability 20
for such actions; providing that the absence of such 21
form does not preclude physicians from withholding or 22
withdrawing cardiopulmonary resuscitation; amending s. 23
401.35, F.S.; requiring the Department of Health to 24
establish circumstances and procedures for honoring 25
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
PDDO forms; amending s. 401.45, F.S.; authorizing 26
emergency medical personnel to withhold or withdraw 27
other forms of medical interventions if presented with 28
a PDDO form; prohibiting physician assistants from 29
signing such form; creating s. 401.451, F.S.; 30
establishing the Patient -directed Doctor's Order 31
(PDDO) Program within the department; providing 32
requirements for a PDDO form; providing duties of the 33
department; providing a restriction on the use of such 34
form; providing for the revocation of such form under 35
certain circumstances; specifying wh ich document takes 36
precedence when directives in such form conflict with 37
other advance directives; providing limited immunity 38
for legal representatives and specified health care 39
providers relying in good faith on such form; 40
requiring the review of such for m upon transfer of a 41
patient; prohibiting such form from being required as 42
a condition for treatment or admission to a health 43
care facility; providing that the presence or absence 44
of such form does not affect, impair, or modify 45
certain insurance contracts; declaring such form 46
invalid if executed in exchange for payment or other 47
remuneration; requiring the agency to create and 48
update a database for the storage, solely at the 49
option of the patient, of a PDDO form by the 50
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
department; providing construction; ame nding s. 51
429.255, F.S.; authorizing assisted living facility 52
personnel to withhold or withdraw cardiopulmonary 53
resuscitation or the use of an automated external 54
defibrillator if presented with a PDDO form; providing 55
facility staff and facilities with immun ity from 56
criminal prosecution or civil liability for such 57
actions; providing that the absence of such form does 58
not preclude physicians from withholding or 59
withdrawing cardiopulmonary resuscitation or the use 60
of an automated external defibrillator; amendin g s. 61
429.73, F.S.; requiring the agency to adopt rules for 62
the implementation of PDDO forms in adult family -care 63
homes; authorizing providers of such homes to withhold 64
or withdraw cardiopulmonary resuscitation if presented 65
with such form; providing such pr oviders with immunity 66
from criminal prosecution or civil liability for such 67
actions; amending s. 456.072, F.S.; authorizing 68
licensees to withhold or withdraw cardiopulmonary 69
resuscitation or the use of an automated external 70
defibrillator if presented with an order not to 71
resuscitate or a PDDO form; requiring the department 72
to adopt rules providing for the implementation of 73
such order and form; providing licensees with immunity 74
from criminal prosecution or civil liability for 75
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
withholding or withdrawing cardi opulmonary 76
resuscitation or the use of an automated external 77
defibrillator if presented with such order or form; 78
providing that the absence of such order or form does 79
not preclude licensees from withholding or withdrawing 80
cardiopulmonary resuscitation or t he use of an 81
automated external defibrillator; amending s. 765.205, 82
F.S.; requiring health care surrogates to provide 83
written consent for a PDDO form under certain 84
circumstances; providing an effective date. 85
86
Be It Enacted by the Legislature of the Sta te of Florida: 87
88
Section 1. Paragraph (l) of subsection (3) of section 89
395.1041, Florida Statutes, is amended to read: 90
395.1041 Access to and ensurance of emergency services; 91
transfers; patient rights; diversion programs; reports of 92
controlled substance overdoses.— 93
(3) EMERGENCY SERVICES; DISCRIMINATION; LIABILITY OF 94
FACILITY OR HEALTH CARE PERSONNEL. — 95
(l) Hospital personnel may withhold or withdraw 96
cardiopulmonary resuscitation if presented with an order not to 97
resuscitate executed pursuant to s. 401.45 or a patient-directed 98
doctor's order (PDDO) form executed pursuant to s. 401.451 that 99
contains an order not to resuscitate . Facility staff and 100
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facilities are shall not be subject to criminal prosecution or 101
civil liability, and are not nor be considered to have engaged 102
in negligent or unprofessional conduct, for withholding or 103
withdrawing cardiopulmonary resuscitation pursuant to such an 104
order or PDDO form. The absence of an order not to resuscitate 105
executed pursuant to s. 401.45 or a PDDO form execut ed pursuant 106
to s. 401.451 that contains an order not to resuscitate does not 107
preclude a physician from withholding or withdrawing 108
cardiopulmonary resuscitation as otherwise authorized permitted 109
by law. 110
Section 2. Subsection (3) of section 400.142, Flor ida 111
Statutes, is amended to read: 112
400.142 Emergency medication kits; orders not to 113
resuscitate.— 114
(3) Facility staff may withhold or withdraw 115
cardiopulmonary resuscitation if presented with an order not to 116
resuscitate executed pursuant to s. 401.45 or a patient-directed 117
doctor's order (PDDO) form executed pursuant to s. 401.451 that 118
contains an order not to resuscitate . Facility staff and 119
facilities are not subject to criminal prosecution or civil 120
liability, or considered to have engaged in negligent or 121
unprofessional conduct, for withholding or withdrawing 122
cardiopulmonary resuscitation pursuant to such an order or PDDO 123
form. The absence of an order not to resuscitate executed 124
pursuant to s. 401.45 or a PDDO form executed pursuant to s. 125
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
401.451 that contains an order not to resuscitate does not 126
preclude a physician from withholding or withdrawing 127
cardiopulmonary resuscitation as otherwise authorized permitted 128
by law. 129
Section 3. Subsection (7) of section 400.487, Florida 130
Statutes, is amended to read: 131
400.487 Home health service agreements; physician's, 132
physician assistant's, and advanced practice registered nurse's 133
treatment orders; patient assessment; establishment and review 134
of plan of care; provision of services; orders not to 135
resuscitate; patient-directed doctor's orders for life -136
sustaining treatment .— 137
(7) Home health agency personnel may withhold or withdraw 138
cardiopulmonary resuscitation if presented with an order not to 139
resuscitate executed pursuant to s. 401.45 or a patient-directed 140
doctor's order (PDDO) form executed pursuant to s. 401.451 that 141
contains an order not to resuscitate . The agency shall adopt 142
rules providing for the implementation of such orders. Home 143
health personnel and agencies are shall not be subject to 144
criminal prosecution or civil liability, and are not nor be 145
considered to have engaged in negligent or unprofessional 146
conduct, for withholding or withdrawing cardiopulmonary 147
resuscitation pursuant to such an order or PDDO form and rules 148
adopted by the agency. 149
Section 4. Paragraph (e) of subsection (1) of section 150
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400.605, Florida Statutes, is amended to read: 151
400.605 Administration; forms; fees; rules; inspections; 152
fines.— 153
(1) The agency shall by rule establish minimum standards 154
and procedures for a hospice pursuant to this part. The rules 155
must include: 156
(e) Procedures relating to the implementation of advance 157
advanced directives; patient-directed doctor's order (PDDO) 158
forms executed pursuant to s. 401.451 that contain orders not to 159
resuscitate; and orders not to resuscitate do-not-resuscitate 160
orders. 161
Section 5. Subsection (8) of section 400.6095, Florida 162
Statutes, is amended to read: 163
400.6095 Patient admission; assessment; plan of care; 164
discharge; death.— 165
(8) The hospice care team may withhold or withdraw 166
cardiopulmonary resuscitation if presented with an order not to 167
resuscitate executed pursuant to s. 401.45 or a patient-directed 168
doctor's order (PDDO) form executed pursuant to s. 401.451 that 169
contains an order not to resusci tate. The agency shall adopt 170
rules providing for the implementation of such orders. Hospice 171
staff are shall not be subject to criminal prosecution or civil 172
liability, and are not nor be considered to have engaged in 173
negligent or unprofessional conduct, for withholding or 174
withdrawing cardiopulmonary resuscitation pursuant to such an 175
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
order or PDDO form and applicable rules. The absence of an order 176
to resuscitate executed pursuant to s. 401.45 or a PDDO form 177
executed pursuant to s. 401.451 that contains an ord er not to 178
resuscitate does not preclude a physician from withholding or 179
withdrawing cardiopulmonary resuscitation as otherwise 180
authorized permitted by law. 181
Section 6. Subsection (4) of section 401.35, Florida 182
Statutes, is amended to read: 183
401.35 Rules.—The department shall adopt rules, including 184
definitions of terms, necessary to carry out the purposes of 185
this part. 186
(4) The rules must establish circumstances and procedures 187
under which emergency medical technicians and paramedics may 188
honor orders by the patient's physician not to resuscitate 189
executed pursuant to s. 401.45 or patient -directed doctor's 190
order (PDDO) forms executed pursuant to s. 401.451 that contain 191
orders not to resuscitate and the documentation and reporting 192
requirements for handling s uch requests. 193
Section 7. Paragraph (a) of subsection (3) of section 194
401.45, Florida Statutes, is amended to read: 195
401.45 Denial of emergency treatment; civil liability. — 196
(3)(a) Resuscitation or other forms of medical 197
intervention may be withheld or withdrawn from a patient by an 198
emergency medical technician , a or paramedic, or another health 199
care professional if evidence of an order not to resuscitate by 200
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
the patient's physician or physician assistant or a patient-201
directed doctor's order (PDDO) form executed pursuant to s. 202
401.451 that contains an order not to resuscitate is presented 203
to the emergency medical technician , or paramedic, or other 204
health care professional . To be valid, an order not to 205
resuscitate or not to perform other medical interventi on, to be 206
valid, must be on the form adopted by rule of the department. 207
The form must be signed by the patient's physician or physician 208
assistant and by the patient or, if the patient is 209
incapacitated, the patient's health care surrogate or proxy as 210
provided in chapter 765, court -appointed guardian as provided in 211
chapter 744, or attorney in fact under a durable power of 212
attorney as provided in chapter 709 ; however, a physician 213
assistant may not sign a patient -directed doctor's order form 214
executed pursuant to s. 401.451 that contains an order not to 215
resuscitate. The court-appointed guardian or attorney in fact 216
must have been delegated authority to make health care decisions 217
on behalf of the patient. 218
Section 8. Section 401.451, Florida Statutes, is created 219
to read: 220
401.451 Patient-directed Doctor's Order Program. — 221
(1) PATIENT-DIRECTED DOCTOR'S ORDER FORM. —A patient-222
directed doctor's order (PDDO) must be on a form adopted by rule 223
of the department which must include the statutory requirements 224
specified in this section and must be executed as required by 225
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this section. 226
(a) A PDDO form may only be completed by or for a patient 227
determined by the patient's physician to have an end -stage 228
condition as defined in s. 765.101 or a patient who, in the good 229
faith clinical judgment of his or her physician, is suffering 230
from at least one terminal medical condition that will likely 231
result in the death of the patient within 1 year. 232
(b) A PDDO form must be signed by the patient's physician. 233
The form must contain a cert ification by the physician signing 234
the PDDO form that the physician consulted with the patient 235
signing the form or, if the patient is incapable of making 236
health care decisions for himself or herself or is 237
incapacitated, the patient's health care surrogate, proxy, 238
court-appointed guardian, or attorney in fact permitted to 239
execute a PDDO form on behalf of the patient as provided in 240
paragraph (c) and include information about the patient's care 241
goals and preferences selected as reflected on the PDDO form, 242
specifically relating to the use of and the effect of removal or 243
refusal of life-sustaining medical treatment. The physician 244
signing the PDDO form must further indicate the medical 245
circumstance justifying the execution of the PDDO. 246
(c) A PDDO form must also be signed by the patient or, if 247
the patient is incapable of making health care decisions for 248
himself or herself or is incapacitated, the patient's health 249
care surrogate or proxy as provided in chapter 765, court -250
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appointed guardian as provided in chapter 74 4, or attorney in 251
fact as provided in chapter 709. If a PDDO form is signed by a 252
health care surrogate, proxy, court -appointed guardian, or 253
attorney in fact, the patient's physician must certify the basis 254
for the authority of the appropriate individual to execute the 255
PDDO form on behalf of the patient, including compliance with 256
chapter 765, chapter 744, or chapter 709. 257
(d) The execution of a PDDO form by the patient 258
automatically revokes all PDDO forms previously executed by the 259
patient. 260
(e) A patient's health care surrogate, proxy, court -261
appointed guardian, or attorney in fact permitted to execute a 262
PDDO form on behalf of a patient as provided in paragraph (c) 263
may subsequently revoke a PDDO form for a patient, unless a 264
valid advance directive or prior P DDO form executed by the 265
patient expressly forbids changes by a surrogate, proxy, 266
guardian, or attorney in fact. 267
(f) An individual acting in good faith as a surrogate, 268
proxy, court-appointed guardian, or attorney in fact who 269
executes a PDDO form on behal f of an incapacitated patient in 270
accordance with this section and rules adopted by the department 271
is not subject to criminal prosecution or civil liability for 272
executing the PDDO form. 273
(g) If a family member of the patient, the health care 274
facility providing services to the patient, or the patient's 275
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physician who may reasonably be expected to be affected by the 276
patient's PDDO form directives believes that directives executed 277
by the patient's legal representative are in conflict with the 278
patient's prior expressed desires regarding end -of-life care, 279
the family member, facility, or physician may seek expedited 280
judicial intervention pursuant to the Florida Probate Rules if: 281
1. The PDDO form regarding the patient's wishes regarding 282
life-sustaining treatment i s ambiguous or the patient has 283
changed his or her mind after execution of the advance directive 284
or PDDO form; 285
2. The PDDO form was executed by a surrogate, proxy, 286
court-appointed guardian, or attorney in fact permitted to 287
execute a PDDO form on behalf of a patient as provided in 288
paragraph (c) and the PDDO form is not in accord with the 289
patient's known desires or chapter 765, chapter 744, or chapter 290
709; 291
3. The PDDO form was executed by a surrogate, proxy, 292
court-appointed guardian, or attorney in fact on behalf of a 293
patient as provided in paragraph (c) and the surrogate, proxy, 294
court-appointed guardian, or attorney in fact was improperly 295
designated or appointed, or the designation of the surrogate, 296
proxy, court-appointed guardian, or attorney in fact is n o 297
longer effective or has been removed; 298
4. The surrogate, proxy, court -appointed guardian, or 299
attorney in fact who executed the PDDO form on behalf of the 300
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patient as provided in paragraph (c) has failed to discharge his 301
or her duties, or incapacity or il lness renders him or her 302
incapable of discharging those duties; 303
5. The PDDO was executed by a surrogate, proxy, court -304
appointed guardian, or attorney in fact permitted to execute a 305
PDDO form on behalf of a patient as provided in paragraph (c) 306
who has abused his or her powers; or 307
6. The patient has sufficient capacity to make his or her 308
own health care decisions. 309
(h) A PDDO form may not include a directive regarding 310
hydration or the preselection of any decision or directive. A 311
PDDO form must be voluntarily executed by the patient or, if the 312
patient is incapacitated, the patient's legal representative, 313
and all directives included in the form must be made by the 314
patient or, if the patient is incapacitated, the patient's legal 315
representative at the time of signing the form. A PDDO form is 316
not valid and may not be included in a patient's medical records 317
or submitted to the database as provided in subsection (10) 318
unless the form: 319
1. Is clearly printed on one or both sides of a single 320
piece of paper as determined by department rule; 321
2. Includes the signatures of the patient and the 322
patient's examining physician or, if the patient is 323
incapacitated, the patient's legal representative and the 324
patient's examining physician. The PDDO form may be executed 325
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only after the examining physician consults with the patient or 326
the patient's legal representative, as appropriate; 327
3. Prominently states that completion of a PDDO form is 328
voluntary, that the execution or use of a PDDO form may not be 329
required as a condition for medical treatment, and that a PDDO 330
form may not be given effect if the patient is conscious and 331
competent to make health care decisions; 332
4. Prominently provides in a conspicuous location on the 333
form a space for the patient's examining physician to attest 334
that, in his or her clinical judgment and with good faith, at 335
the time the PDDO form is completed and signed, the patient has 336
the ability to make and communicate health care decisions or, if 337
the patient is incapacitated, that the patient's legal 338
representative has such ability; 339
5. Includes an expiration date, provided by the patient's 340
examining physician, that is within 1 year after the patient or 341
the patient's legal representative signs the form or that is 342
contingent on completion of the course of treatment addressed in 343
the PDDO form, whichever occurs first; and 344
6. Identifies the medical condition or conditions, 345
provided by the patient's examining physician, that necessitate 346
the PDDO form. 347
(2) DUTIES OF THE DEPARTMENT. —The department shall: 348
(a) Adopt rules to implement and administer the PDDO 349
program. 350
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(b) Prescribe a standardized PDDO form. 351
(c) Provide the PDDO form in an electronic format on the 352
department's website and prominently state on the website the 353
requirements for a PDDO form as specified under paragraph 354
(3)(a). 355
(d) Consult with health care professional licensing 356
groups, provider advocacy groups, medical ethicists, and other 357
appropriate stakeholders on the development of rules and forms 358
to implement and administer the PDDO pr ogram. 359
(e) Recommend a uniform method of identifying persons who 360
have executed a PDDO form and providing health care providers 361
with contact information regarding the person's primary health 362
care provider. 363
(f) Oversee the education of health care provid ers 364
licensed by the department regarding implementation of the PDDO 365
program. 366
(g) Develop a process for collecting provider feedback to 367
enable periodic redesign of the PDDO form in accordance with 368
current health care best practices. 369
(3) DUTY TO COMPLY W ITH PDDO; OUT-OF-STATE PDDO; LIMITED 370
IMMUNITY.— 371
(a) Emergency medical service personnel, health care 372
providers, physicians, and health care facilities, absent actual 373
notice of revocation or termination of a PDDO form, may comply 374
with the orders on a pers on's PDDO form, without regard to 375
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whether the PDDO ordering provider is on the medical staff of 376
the treating health care facility. If the PDDO ordering provider 377
is not on the medical staff of the treating health care 378
facility, the PDDO form shall be review ed by the treating health 379
care professional at the receiving facility with the patient or 380
the patient's health care surrogate, proxy, court -appointed 381
guardian, or attorney in fact permitted to execute a PDDO form 382
on behalf of a patient as provided in parag raph (1)(c) and made 383
into a medical order at the receiving facility, unless the PDDO 384
form is replaced or voided as provided in this act. 385
(b) A PDDO form from another state, absent actual notice 386
of revocation or termination, shall be presumed valid and sh all 387
be effective in this state and shall be complied with to the 388
same extent as a PDDO form executed in this state. 389
(c) Any licensee, physician, medical director, or 390
emergency medical technician or paramedic who acts in good faith 391
on a PDDO is not subjec t to criminal prosecution or civil 392
liability, and has not engaged in negligent or unprofessional 393
conduct, as a result of carrying out the directives of the PDDO 394
made in accordance with this section and rules adopted by the 395
department. 396
(4) PATIENT TRANSFE R; PDDO FORM REVIEW REQUIRED. —If a 397
patient whose goals and preferences for care have been entered 398
in a valid PDDO form is transferred from one health care 399
facility or level of care to another, the health care facility 400
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or level of care initiating the transf er must communicate the 401
existence of the PDDO form to the receiving facility or level of 402
care before the transfer. Upon the patient's transfer, the 403
treating health care provider at the receiving facility or level 404
of care must review the PDDO form with the patient or, if the 405
patient is incapacitated, the patient's health care surrogate, 406
proxy, court-appointed guardian, or attorney in fact . 407
(5) CONFLICTS WITH ADVANCE DIRECTIVES. —To the extent that 408
a directive made on a patient's PDDO form conflicts with ano ther 409
advance directive of the patient which addresses a substantially 410
similar health care condition or treatment, the document most 411
recently signed by the patient takes precedence. Such directives 412
may include, but are not limited to: 413
(a) A living will. 414
(b) A health care power of attorney. 415
(c) A PDDO form for the specific medical condition or 416
treatment. 417
(d) An order not to resuscitate. 418
(6) PDDO FORM NOT A PREREQUISITE. —A PDDO form may not be a 419
prerequisite for receiving medical services or for admi ssion to 420
a health care facility. A health care facility or health care 421
provider may not require an individual to complete, revise, or 422
revoke a PDDO form as a condition of receiving medical services 423
or treatment or as a condition of admission. The execution , 424
revision, or revocation of a PDDO form must be a voluntary 425
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decision of the patient or, if the patient is incapacitated, the 426
patient's legal representative. 427
(7) REVOCATION OF A PDDO FORM. — 428
(a) A PDDO form may be revoked at any time by a patient 429
deemed to have capacity by means of: 430
1. A signed, dated writing; 431
2. The physical cancellation or destruction of the PDDO 432
form by the patient or by another in the patient's presence and 433
at the patient's direction; 434
3. An oral expression of intent to revoke; or 435
4. A subsequently executed PDDO form or advance directive 436
that is materially different from a previously executed PDDO 437
form or advance directive. 438
(b) A surrogate, proxy, court -appointed guardian, or 439
attorney in fact permitted to execute a PDDO form on behalf of a 440
patient as provided in paragraph (1)(c) who created a PDDO form 441
for a patient may revoke a PDDO form at any time in a writing 442
signed by such surrogate, proxy, court -appointed guardian, or 443
attorney in fact. 444
(c) Any revocation of a PDDO form shall be promptly 445
communicated to the patient's primary health care provider, 446
primary physician, any health care facility at which the patient 447
is receiving care, and the Agency for Health Care Administration 448
for purposes of updating the database. Further, a health care 449
professional, surrogate, proxy, court -appointed guardian, or 450
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
attorney in fact who is informed of the revocation of a PDDO 451
form shall promptly communicate the fact of the revocation to 452
the patient's primary care physician, the current supervi sing 453
health care professional, and any health care facility at which 454
the patient is receiving care, to the extent known to the 455
surrogate, proxy, court -appointed guardian, or attorney in fact. 456
(d) Upon revocation, a PDDO form shall be void. A PDDO 457
form may only be revoked in its entirety. A partial revocation 458
of a PDDO form renders the entirety of the PDDO form void. 459
(8) INSURANCE NOT AFFECTED. —The presence or absence of a 460
PDDO form does not affect, impair, or modify a contract of life 461
or health insurance or an annuity to which an individual is a 462
party and may not serve as the basis for a delay in issuing or 463
refusing to issue a policy of life or health insurance or an 464
annuity or for an increase or decrease in premiums charged to 465
the individual. 466
(9) INVALIDITY.—A PDDO form is invalid if payment or other 467
remuneration was offered or made in exchange for execution of 468
the form. 469
(10) DATABASE.—The Agency for Health Care Administration 470
shall create and update a database for the storage of PDDO 471
forms, which shall be stored solely at the option of the patient 472
in electronic form by the department. 473
(11) CONSTRUCTION.—This section may not be construed to 474
condone, authorize, or approve mercy killing or euthanasia. The 475
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Legislature does not intend that this act be c onstrued as 476
authorizing an affirmative or deliberate act to end an 477
individual's life, except to allow the natural process of dying. 478
Section 9. Subsection (4) of section 429.255, Florida 479
Statutes, is amended to read: 480
429.255 Use of personnel; emergenc y care.— 481
(4) Facility staff may withhold or withdraw 482
cardiopulmonary resuscitation or the use of an automated 483
external defibrillator if presented with an order not to 484
resuscitate executed pursuant to s. 401.45 or a patient-directed 485
doctor's order (PDDO) form executed pursuant to s. 401.451 that 486
contains an order not to resuscitate . The agency shall adopt 487
rules providing for the implementation of such an order or PDDO 488
form orders. Facility staff and facilities are may not be 489
subject to criminal prosecution or civil liability, and are not 490
nor be considered to have engaged in negligent or unprofessional 491
conduct, for withholding or withdrawing cardiopulmonary 492
resuscitation or the use of an automated external defibrillator 493
pursuant to such an order or PDDO form and rules adopted by the 494
agency. The absence of an order not to resuscitate executed 495
pursuant to s. 401.45 or a PDDO form executed pursuant to s. 496
401.451 that contains an order not to resuscitate does not 497
preclude a physician from withholding or withdrawi ng 498
cardiopulmonary resuscitation or the use of an automated 499
external defibrillator as otherwise authorized permitted by law. 500
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Section 10. Subsection (3) of section 429.73, Florida 501
Statutes, is amended to read: 502
429.73 Rules and standards relating to ad ult family-care 503
homes.— 504
(3) The agency shall adopt rules providing for the 505
implementation of orders not to resuscitate and patient-directed 506
doctor's order (PDDO) forms executed pursuant to s. 401.451 that 507
contain orders not to resuscitate . The provider may withhold or 508
withdraw cardiopulmonary resuscitation if presented with an 509
order not to resuscitate executed pursuant to s. 401.45 or a 510
PDDO form executed pursuant to s. 401.451 that contains an order 511
not to resuscitate. The provider is shall not be subject to 512
criminal prosecution or civil liability, and is not nor be 513
considered to have engaged in negligent or unprofessional 514
conduct, for withholding or withdrawing cardiopulmonary 515
resuscitation pursuant to such an order or PDDO form and 516
applicable rules. 517
Section 11. Subsections (7) and (8) of section 456.072, 518
Florida Statutes, are renumbered as subsections (8) and (9), 519
respectively, and a new subsection (7) is added to that section 520
to read: 521
456.072 Grounds for discipline; penalties; enforcement. — 522
(7) A licensee may withhold or withdraw cardiopulmonary 523
resuscitation or the use of an automated external defibrillator 524
if presented with an order not to resuscitate executed pursuant 525
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to s. 401.45 or a patient -directed doctor's order (PDDO) form 526
executed pursuant to s. 401.451 that contains an order not to 527
resuscitate. The department shall adopt rules providing for the 528
implementation of such order or form. A licensee is not subject 529
to criminal prosecution or civil liability, and is not 530
considered to have engaged in negligent or unprofessional 531
conduct, for withholding or withdrawing cardiopulmonary 532
resuscitation or the use of an automated external defibrillator 533
if presented with such an order or PDDO form. The absence of 534
such an order or PDDO form does not preclude a licensee from 535
withholding or withdrawing cardiopulmonary resuscitation or the 536
use of an automated external defibrillator as otherwise 537
authorized by law. 538
Section 12. Paragraph (c) of subsection (1) of section 539
765.205, Florida Statutes, is am ended to read: 540
765.205 Responsibility of the surrogate. — 541
(1) The surrogate, in accordance with the principal's 542
instructions, unless such authority has been expressly limited 543
by the principal, shall: 544
(c) Provide written consent using an appropriate fo rm 545
whenever consent is required, including a physician's order not 546
to resuscitate or a patient-directed doctor's order (PDDO) form 547
executed pursuant to s. 401.451 that contains an order not to 548
resuscitate. 549
Section 13. This act shall take effect July 1, 2024. 550