Advance Directives FAQs

1. Who is a health care surrogate?How should I choose my health care surrogate?
2. Who is a health care proxy?
3. What is the difference between a health care surrogate and a health care proxy?
4. When does my living will take effect?
5. How often should I revise my designated health care surrogate form and living will?
6. Will my designated health care surrogate form and living will be honored if I become ill in another state?
7. How can I make sure that my wishes are followed?
8. Do I need to have my Designated Health Care Surrogate form and Living Will notarized or witnessed by a lawyer?
9. Is there a cost to create a Designated Health Care Surrogate form or Living Will?
10. What if I change my mind or need to make changes on my Designated Health Care form or Living Will?
11. How will having a Designated Health Care Surrogate form or Living Will affect my medical treatment?
12. Is an Advance Directive the same thing as a Do Not Resuscitate Order (DNRO)?
13. I’d like to know what my religion says about these important health care matters. Whom should I talk to for clarification?
14. Things to remember: Power of Attorney vs. Advance Directive

Who is a health care surrogate?

The person you ask to make your health care decisions if you cannot speak for yourself. Your health care surrogate can:

• Accept, refuse or withdraw medical treatments
• Authorize admission to/transfer from a health care facility
• Speak with your health care team regarding your condition and treatment options
• Review your medical record and authorize its release, if needed

How should I choose my health care surrogate?

You want to be sure your health care surrogate is willing to speak on your behalf when needed. He or she should be someone you can count on to honor and communicate your personal wishes even if they do not agree with them. Most people choose a close relative or friend who knows them best.

Who is a health care proxy? 

A person appointed to make health care decisions for you when you are:

• unable to make decisions
• have not chosen a health care surrogate

According to Florida Statute 765.401, a health care proxy is appointed based on the following "order of priority" to a patient:

• Judicially appointed patient guardian
• Patient's spouse
• Majority of patient's adult children who are reasonably available for consultation
• Patient's parent
• Adult sibling or majority of adult siblings who are reasonably available for consultation
• Patient's adult relative who has exhibited special care and concern and has regular contact
• Patient's close friend
• Licensed Clinical Social Worker

What is the difference between a health care surrogate and a health care proxy?

A health care surrogate is chosen by you prior to becoming unable to make decisions. A proxy is appointed based on the relationship to the patient according to the order designated by Florida law.

When does my living will take effect?

Your living will only goes into effect when there is little to no chance of recovery. In the state of Florida, two physicians must determine your condition cannot be made any better before life-prolonging procedures may be withheld or withdrawn in accordance with your wishes as written in your living will form.

How often should I revise my designated health care surrogate form and living will?

Advances in medical science happen all the time, and the laws about advance care plans can change within the state and across the nation. It is wise to discuss your plan with your primary doctor every few years, after major life events (marriage/divorce, birth/death, retirement or major illness) or whenever you have questions.

Will my designated health care surrogate form and living will be honored if I become ill in another state?

Most states will honor another state's advance directive. Every state has its own laws governing living wills, health care surrogates and do not resuscitate orders (DNROs.)To help ensure your wishes are honored, it is important you check the laws of states where you spend time.

How can I make sure that my wishes are followed? 

Your designated health care surrogate form and living will should be part of your medical record. It should be readily available to doctors and other health care providers. It is important to include your health care surrogate and your family in your planning, keeping them informed of your wishes, and providing them with copies of your advance directives. If you are planning any procedures that may require hospitalization, bring a copy of your forms with you.

Do I need to have my Designated Health Care Surrogate form and Living Will notarized or witnessed by a lawyer?

If you are a Florida resident, it is not necessary to notarize your Designated Health Care Surrogate form or Living Will or have a lawyer involved to complete the documents. It is required that the document signatures be witnessed by two competent adults other than your designated surrogate, and one witness must not be your spouse or a blood relative. It is best to have someone witness the document signatures who is neither your heir, your family member nor your health care provider(s).

Is there a cost to create a Designated Health Care Surrogate form or Living Will?

There is no cost to obtain or complete a Designated Health Care Surrogate form or Living Will. Included in this booklet, please find a copy of a Designated Health Care Surrogate form and Living Will. You can complete these forms without the assistance of an attorney as long as your signature is witnessed as mentioned above.

What if I change my mind or need to make changes on my Designated Health Care form or Living Will?

You have the right to change your document at any time. Simply complete a new document and destroy the old. Make sure you replace all the old versions with the new one and that your loved ones, health care surrogate, clergy and doctor(s) have a copy of the new version. Health care providers will always honor the most recent dated document.

How will having a Designated Health Care Surrogate form or Living Will affect my medical treatment?

These forms make it easier for your health care team to give you the type of care that you want.  Knowing your choices in advance is also a gift to your loved ones.

Is an Advance Directive the same thing as a Do Not Resuscitate Order (DNRO)?

No, an advance directive like a designation of health care surrogate form or living will and a DNRO order are not the same item. An advance directive is a form that details a person’s choices for health care and treatment, should he or she become unable to talk with doctors or make health care decisions, due to being sick or hurt.

A DNRO is a form jointly created by a doctor and a person that shows he or she has decided not to have cardiopulmonary resuscitation (CPR) in the event his or her heart or breathing stops. This form is considered a doctor’s order as part of medical treatment plan, and must have a doctor’s signature and the signature of the patient or the patient’s healthcare surrogate or proxy. While an advance directive can be updated by a person independent of a doctor, a DRNO cannot; it must be created with and contain a doctor’s signature.

I’d like to know what my religion says about these important health care matters. Whom should I talk to for clarification?

For many individuals, it is important to follow the teachings of their faith tradition when making end of life decisions. It is best to consult with a trusted clergy person or spiritual leader for a clear understanding of what beliefs a particular religion might hold. Some religious denominations (e.g. Roman Catholic) have forms available that incorporate the teachings of that faith with regard to end-of-life care. Check with a representative of your denomination about this option, if preferred.

Things to remember: Power of Attorney vs. Advance Directive

A power of attorney (POA) is not the same as an advance directive. The POA typically does NOT give any authority to the designee to make health care decisions. A POA delegates a person to act for specific reasons such as financial transactions or other legal matters.

A Durable Power of Attorney (DPOA), similar to a POA, gives authority for legal and/or financial decisions but a DPOA may include health care decision making authority depending on how the document is drafted. A DPOA stays in effect if the person becomes incapacitated.

These documents should be read carefully.

For more information visit the Florida Bar Association at: Floridabar.org