What Is a Florida DNR Order and Who Actually Needs One
A do not resuscitate order (commonly referred to as a DNR or DNRO) is governed by FAC 64J-2.018, which provides the procedure for instructing paramedics and emergency room doctors to refrain from conducting CPR in the event of cardiac arrest or respiratory arrest. DNRs are typically utilized by someone with an end-stage disease, terminal condition, or persistent vegetative state.
A DNRO is just one of several important incapacity planning documents that Florida families should have in place. Understanding what it does, and what it does not do, is essential before deciding whether one is appropriate for your loved one.
The DNRO is useless unless it is available. Emergency medical personnel do not have time to ask where a DNR may be located, so it should be placed in an easily identifiable area. If the DNRO patient is in an institution such as an ALF, nursing home, or extended stay in a hospital, the DNR should be presented to the facility's risk management or legal office so the DNR can be prominently placed in the medical file. If the DNR patient is at home, the do not resuscitate order should be placed somewhere prominently where paramedics or other EMS personnel would easily see the yellow DNRO document. Some suggest taping it at the foot of the patient's bed or on the wall closest to the patient's bed. The bottom half of the DNR form can be detached (more on that below), laminated, and attached to a necklace.
Requirements for a Florida Do Not Resuscitate Order
A DNR order is a single-page form document that has been approved by the Florida Department of Health. A link to the printable DNR form is in the resources section below.
The DNRO will list the patient's full legal name. Underneath are the words: "Based upon informed consent, I, the undersigned, hereby direct that CPR be withheld or withdrawn." There is then space to check whether the DNR form is being signed by the patient him or herself, or a health care surrogate, court-appointed guardian, health care proxy, or durable power of attorney.
Beneath this statement is a place for the patient's physician to also sign and indicate that the doctor agrees with the patient's decision to withhold or withdraw CPR, artificial ventilation, cardiac compression, endotracheal intubation, and defibrillation in the event of cardiac or respiratory arrest.
The do not resuscitate order form then has a dotted line. Underneath the dotted line is the same information as above, but is meant to be cut off and placed in a wallet.
Both the patient (or their surrogate, durable power of attorney, etc.) AND the patient's doctor must sign.
The DNR Form Must Be Printed on Yellow Paper
Some people find it odd that the DNRO must be printed on yellow paper, but this is in fact a requirement that must be respected. DNRs printed on plain white paper (or any other color but yellow), even if utilizing the exact Florida Department of Health form, need not be honored by paramedics or emergency medical personnel.
The yellow form is actually an advantage. Because there is no specifically designated place to record the Do Not Resuscitate Order, the point is for the DNRO to be easily identifiable by EMS, paramedics, or emergency room doctors. The yellow allows this form to stand out from a volume of other paperwork.
Copies of this form can be made as long as copies are also on yellow paper.
Difference Between a DNR and a Living Will in Florida
The Do Not Resuscitate Order is a doctor's order that is very limited in its scope. A DNR only concerns refusing emergency CPR. Living wills address a host of other end-of-life issues and decisions that our elder law clients wish to make while they have the capacity to do so.
A DNRO requires a doctor's signature to have any effect. Living wills do not require a doctor's signature. They only require that the client have the capacity to make their end-of-life wishes known and must be signed in the presence of two witnesses.
A DNR is a one-page yellow piece of paper provided by the Florida Department of Health. Living wills can be longer, personalized documents that get into significantly more detail. The color of paper a living will is printed on is unimportant.
Living wills should also be presented to institutions and medical doctors to be made part of the patient's medical records.
A durable medical power of attorney is another closely related document. While a living will records your personal healthcare wishes, a durable medical POA designates someone you trust to make healthcare decisions on your behalf if you become unable to communicate. Neither a DNR nor a living will replace the need for a properly drafted medical POA.
For a full picture of how these documents work together, see our guide on advance care planning in Florida
Who Needs a Florida DNR Order
Most people want to leave this world as peacefully as possible. The primary job of emergency medical personnel and paramedics is to do whatever they can to keep their patient alive. But the harsh reality is that most of these emergency life-saving procedures are incredibly painful. CPR, artificial ventilation, cardiac chest compressions, endotracheal intubation, and defibrillation are all physically traumatic interventions.
Chest compressions regularly result in cracked or broken ribs. Intubation forces a tube down one's throat or through their nostrils. It has been described as very painful, and some people regularly vomit as a result. Defibrillation delivers a sudden electric current jolted into the chest, which has been described as being kicked by a mule in the chest or akin to a bomb going off inside.
For those younger and in generally good health, this pain is worth enduring in exchange for a significantly longer life to live.
A DNR is really only appropriate for those who are already near the end of their life and do not wish for it to be prolonged in a manner that is painful. If you are unsure whether a DNR is the right document for your loved one's situation, talking through the full set of Florida end-of-life planning documents with an elder law attorney will give you clarity on what each document does and which combination is right for your family.
To learn more about Do Not Resuscitate Orders, talk to your treating physician or a local Florida elder law attorney.
Frequently Asked Questions
Q. What is a DNR order in Florida?
A. A do not resuscitate order (DNRO) is a physician-signed document that instructs paramedics and emergency room doctors to refrain from performing CPR, chest compressions, artificial ventilation, intubation, and defibrillation in the event of cardiac or respiratory arrest. It is governed by Florida Administrative Code FAC 64J-2.018 and must be printed on yellow paper to be legally recognized by emergency medical personnel.
Q. Who can sign a DNR form in Florida?
A. The DNR form must be signed by both the patient's physician and the patient themselves, or by an authorized representative acting on the patient's behalf. Authorized representatives include a health care surrogate, a court-appointed guardian, a health care proxy, or the holder of a durable power of attorney. Without both signatures, the form has no legal effect.
Q. Does a DNR have to be on yellow paper in Florida?
A. Yes, and this is a hard requirement. A DNR printed on white paper or any other color, even if it uses the exact official Florida Department of Health form, does not have to be honored by paramedics or emergency medical personnel. The yellow color exists so the document is instantly visible and identifiable in an emergency. Copies are permitted as long as they are also printed on yellow paper.
Q. What is the difference between a DNR and a living will in Florida?
A. A DNR is a narrow, physician-signed order that only addresses CPR in an emergency. A living will is a broader document that records a person's wishes about a range of end-of-life medical decisions, including the use of life-prolonging treatments, artificial nutrition, and hydration. A living will does not require a doctor's signature. The two documents serve different purposes and are not interchangeable. Many people benefit from having both.
Q. Does a DNR override a durable power of attorney in Florida?
A. Not exactly. A durable medical power of attorney designates someone to make healthcare decisions on your behalf if you are incapacitated. A DNR is a specific standing order about CPR. If both documents are in place, they work together. The DNR tells medical personnel not to perform CPR. The durable medical POA gives your designated agent authority to make broader medical decisions beyond what the DNR addresses. Neither document replaces the other.
Q. When is a DNR appropriate for a Florida resident?
A. A DNR is generally appropriate for individuals who are near the end of life due to a terminal illness, end-stage disease, or persistent vegetative state, and who do not wish for emergency resuscitation procedures to prolong their life in a painful way. It is not typically appropriate for younger individuals in good health. A Florida elder law attorney or the patient's treating physician can help families evaluate whether a DNR is the right decision given their specific circumstances.
Q. Where should a DNR be kept in Florida?
A. The DNR must be readily accessible to emergency personnel at all times. If the patient lives at home, it should be displayed prominently near their bed or in a location where paramedics would easily see it. In a nursing home, ALF, or hospital, it should be filed with the facility's risk management or legal office and placed prominently in the medical record. The bottom portion of the form can be detached, laminated, and worn as a necklace for additional visibility.
Ready to Put the Right Documents in Place
A DNR is one piece of a larger set of incapacity planning documents that every Florida family should have in order. The others, including a living will, health care surrogate designation, and durable power of attorney, work alongside the DNR to ensure your wishes are honored in any medical situation, not just a cardiac emergency.
At Elder Needs Law, we help Florida families put all of these documents in place correctly, so that nothing is left to chance. Schedule a consultation today or call us at (305) 931-0478.
Free Florida DNR Form and Resources
Free DNR Form: Florida Department of Health Form 1896 — Do Not Resuscitate Order printable form (print on yellow paper only).
Florida Administrative Code: Do Not Resuscitate Orders (FAC 64J-2.018)
Related Reading:
- Types of advanced health care directives in Florida
- Summary of Florida Statutes Chapter 765 — living wills and health care surrogates
- The importance of incapacity planning
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