By Jon Carroll
There are two documents related to medical decisions that often get confused.
Imagine you are home with a loved one when you collapse. Your loved one calls 911. The paramedics arrive to find that your heart has stopped.
Your loved one knows you have always said, “I don’t want to be kept alive by machines.” And there is a living will along with your estate-planning documents.
But the paramedics have arrived to deal with the fact that your heart has stopped. Should they perform CPR despite your Living Will?
This scenario illustrates an often misunderstood distinction: a Living Will and a Do Not Resuscitate Order (DNR) are not the same thing. What are the differences between the two documents?
A Living Will (also known as an Advance Directive) is a legal document that communicates your wishes about life-prolonging medical treatment if you become unable to make or communicate your own health care decisions and are in circumstances covered by the document and Florida law.
It can address treatments such as mechanical ventilation and other life-prolonging procedures. It provides guidance to your physicians, family, and health care surrogate about the treatment you would want.
In other words, a living will answers the questions of: “If I am in certain end-of-life circumstances and cannot speak for myself, what medical treatment do I want?”
Over thirty years ago, the concept of a living will became especially familiar to many Floridians because of the highly publicized case of Terri Schiavo.
Schiavo was a Florida woman who suffered cardiac arrest in 1990 and was left with severe brain damage. Eight years later, a legal battle developed between her husband, who sought to have life-prolonging measures withdrawn, and her parents, who opposed that decision. The dispute continued through multiple court proceedings and ultimately became a national political and legal controversy before Schiavo died in 2005.
While Florida enacted a statutory living will framework before the Schiavo case, her tragic situation brought the practical importance of advance directives into the public spotlight. It demonstrated what can happen when a person becomes unable to communicate and family members, physicians, and courts must determine what that person would have wanted.
Today, Florida law allows a competent adult to make a living will directing the withholding or withdrawal of life-prolonging procedures if the person becomes incapacitated and has a terminal condition, an end-stage condition, or is in a persistent vegetative state, subject to the requirements of the statute.
But a living will is not necessarily an instruction to emergency personnel about what to do when your heart suddenly stops. In such circumstances, a Florida Do Not Resuscitate Order (DNR) addresses what should happen.
A properly completed DNR directs health care providers and emergency medical personnel not to perform CPR in that situation.
That distinction is particularly important during an emergency at home. Paramedics need to know immediately whether a valid DNR exists. This is why people will keep a DNR in a visible place, such as taped to their refrigerator. A living will in an estate-planning binder may communicate your wishes about end-of-life treatment, but it is not the same thing as having a DNR available for emergency personnel.
Not everyone makes the same medical choices. Someone may have a living will expressing wishes about treatment at the end of life and also have a DNR so emergency personnel know not to attempt CPR. Another person may have a living will but still want CPR attempted in an emergency. The important thing is that both documents allow you to express your wishes and to ensure those wishes have been clearly communicated before a crisis occurs.
Jon Carroll is a licensed attorney. The information in this column is provided for educational and informational purposes only, and does not constitute legal advice, nor establish an attorney client relationship. Consult a qualified attorney in your jurisdiction for legal advice specific to your situation.
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