Ana Maria Rodriguez files a bill to better ensure patient choices are honored in end-of-life care

Sen. Ana Maria Rodriguez wants to make sure physicians follow directives from Florida patients who communicate and preauthorize end-of-life care preferences.

Those can include pain management choices and interventions that artificially prolong the process of dying.

The Doral Republican filed a bill (SB 312) that aims to establish and regulate “patient-directed medical orders” within Florida law, ensuring that patient preferences, such as withholding or withdrawing life-sustaining interventions, are honored and respected across health care settings.

Patient-directed medical orders — defined as medical directives created between the patient and their licensed physicians, physician assistants, or advanced practice registered nurse — would facilitate a patient’s instructions on whether they want to continue with medical treatments such as pain management, breathing support, nutritional support, medications such as antibiotics, or CPR. 

Patient orders could be combined with a do not resuscitate (DNR) order. Incapacitated patients could have a surrogate, proxy, guardian, or attorney-in-fact sign on their behalf, and electronic signatures would be recognized as valid.

The orders would be portable and stored in a voluntary online registry.

The bill would further clarify that palliative care must include respect for the patient’s orders and any other end-of-life directives, as well as emphasizing the need for patients to be treated with dignity, comfort and culturally appropriate care at the end of their lives.

Medical professionals and facilities would be shielded from liability or disciplinary action if they follow a patient-directed order or DNR orders. The absence of an order would also not prevent providers from withholding any life-prolonging procedures if authorized by law.

Multiple statutes would be amended to ensure orders are recognized in hospitals, nursing homes, hospices, home health agencies, emergency medical services, adult-family care homes and assisted living facilities.

Patient guardians would be authorized to execute or honor a patient-directed order with court approval, or without approval if death is imminent, there are no known objections, or if it is in a hospital setting.

Patient-directed orders would be required to be on a standardized form that would be adopted by the Florida Department of Health and signed by both the patient and a licensed medical professional.

The definition of “advance directive” would be broadened to include patient orders alongside living wills and health care surrogate designations.

According to a study from Florida TaxWatch, Florida’s aging population drives a need for patient-centered hospice care. In 2024, the state had 166,116 hospice patients across 94 licensed programs.

Florida providers currently operate under a Certificate of Need (CON) program, ranking sixth in the nation on the Hospice & Palliative Care Composite Process Measure, and second on the Hospice Care Index. 

The Agency for Health Care administration would be responsible for creating and maintaining a secure, electronic database for storing patient orders.

Rodriguez introduced a similar measure (SB 566) during the 2025 Legislative Session. However, the bill died during its passage through committee.

If passed, the bill would take effect July 1, 2026.