The State of Iowa, with the help of the Iowa Department of Public Health and certain local medical centers, passed a new law which is applicable to every person. Despite the law’s significance and relevance to humankind, I find in my practice that very few people know about it. The law, known as the Iowa Physician Orders for Scope of Treatment (“IPOST”), is a two-page document which permits a person to communicate his or her preference for significant life-sustaining treatments like resuscitation (when the patient has no pulse and is not breathing), general scope of treatment (comfort measures only, limited interventions, or full treatment), and artificial nutrition.
The availability of IPOST is significant given that modern healthcare makes it difficult to guarantee a person’s end-of-life treatment choices are honored from one health care center to another. This is an area that has gained national attention as of late, especially with a few states passing the controversial Death With Dignity Act, which takes end-of-life treatment options to another level and allows terminally ill patients to choose when and how they will die. IPOST is not nearly as extreme as other states’ Death With Dignity Acts. Under current state law, Iowa patients cannot choose how or when to die, but they can utilize IPOST to control how they will be cared for under certain circumstances.
In my practice, I have seen numerous instances where IPOST would be beneficial for people who do not want to be resuscitated if they have no pulse and stop breathing. Several clients have a living will, which says if a doctor declares them permanently unconscious, they wish to withdraw life sustaining support. However, if that person does not have an IPOST or “do not resuscitate” order on them when they become pulseless and breathless, medical personnel are required to try and bring that person back to life. IPOST was a four-year initiative that is intended to address complex issues such as this. Medical personnel across the State of Iowa are being trained to look for IPOST directions on people’s fridges, purses, and wallets.
Unlike a living will and health care power of attorney which I commonly prepare for clients, IPOST must be signed by the patient’s health care professional. IPOST provides consistency in a patient’s treatment across different healthcare settings – such as a patient moving from home, to a hospital, to a nursing home, and finally to hospice services. The patient’s health care professional may facilitate a dialogue with the patient and family to create an understanding of the patient’s values and desire of care.
IPOST is intended for elderly patients or those with a critical illness which requires frequent contact with healthcare professionals. Please do not hesitate to contact our office for a complimentary IPOST form.
The information contained herein is for informational purposes only, and is not legal advice or a substitute for legal counsel. You should not act or rely on any information herein.