In previous articles we have looked at advance directives in general and then at the three most common advance directives: the durable power of attorney, the designation of a health care surrogate, and the living will. Often those are the types of advance directives, by those or other names, that are included as a part of an estate plan by skilled attorneys.

However, there are other documents, some of which may be considered as advance directives by some but not by others. They are worthy of consideration whether classified as advance directives or not. They are:

  • Do Not Resuscitate Order (DNR)
  • Pre-need Guardian Designation
  • Anatomical Donations

A Do Not Resuscitate (“DNR”) Order

A DNR is another document some consider to be an advance directive, a very common one that arises pre-surgery, during hospitalizations or serious medical illnesses. Typically, a DNR is less specific and detailed than a Medical Power of Attorney or Health Care Surrogate designation. For example, a DNR commonly has an instruction not to administer cardiopulmonary resuscitation (CPR) if the signing person’s (“the Maker) heart stops or if the Maker stops breathing. Without a DNR, doctors and nurses will typically try to help any patient whose heart has stopped or who has stopped breathing. A DNR is the clearest way to tell a doctor that resuscitation is not the Maker’s choice. A doctor will put a DNR in the patient’s medical chart. Doctors and hospitals in all states accept DNR orders although the form and content of DNRs can be very different from one medical facility to the next and from one state to the next.

Pre-Need Guardian Designations

A person may state in advance that if a guardian is ever needed, it is desired that the guardian be a spouse, child, or specific friend. For example, if a person becomes incapacitated in an accident, a guardian will be required to maintain a lawsuit and thereafter to manage the person’s care. Florida law allows a person to designate who would be the guardian of choice.  Other desires may also be set out, although ultimately, court approval of those desires may be required.

Anatomical Donations

A person may wish to donate, at death, all or part of his or her body upon death. It may be an organ, tissue and eye donation to persons in need, or a donation of the entire body for training in the medical field.  The donor can indicate his or her choice to be an organ donor by designating it on the driver’s license, signing a uniform donor form, registering with the State of Florida at, or by expressing that wish in a living will.  Over 9 million people have registered in Florida alone. Because time is of the essence to harvest organs, it is best to chose multiple means of expressing that wish.

That’s a Lot.  What Else Should I Know? 

  • The laws governing advance directives and these other essential documents are state laws and they vary from state to state.  Florida’s laws are different from other states. The written laws are interpreted by courts, so a statute may actually work very differently than it reads to a non-lawyer or even a lawyer.
  • While technically a person does not have to have a lawyer to fill out the various advance directive documents, professional assistance is a good idea because many advance directives become legally valid as soon as they are properly executed. Others are invalid and worthless if not executed properly.
  • Because different states’ laws are not the same, one state may not honor an advance directive even if valid in the state where it was executed. There is no easy solution to the problem this creates. The best solution is for persons who are going to spend much time in another state, to consider also completing the advance directives for that state.  Also, if a person moves his or her residence from one state to another, it should be determined if the old documents will be effective in the new home state.

About the Author

John Campbell has retired from a 40-year legal practice as a trial attorney in Tampa. He has served in multiple volunteer roles at Idlewild Baptist Church in Lutz, Florida, where he met Jesus.  He began serving as the Executive Director of the Idlewild Foundation in 2016.  He has been married to the love of his life, Mona Puckett Campbell, since 1972.