Overview of Indiana Physician Orders for Scope of Treatment Form

by | Jun 19, 2014 | Estate Planning | 0 comments

In 2013 the Indiana legislature created a new kind of advanced directive form called the Physician Orders for Scope of Treatment form, or POST.  This form is meant to allow chronically ill patients to dictate their end-of-life care on a form that will travel with them from facility to facility and will ensure they receive consistent care.  The form discusses whether cardiopulmonary resuscitation (CPR) may be administered, whether or not to administer life support measures, antibiotics, and artificial nutrition. 

A POST form may be filled out by any “qualified person” including any individual who has any of the following:

  • An advanced chronic progressive illness.
  • An advanced chronic progressive frailty.
  • A condition caused by injury, disease, or illness from which, to a reasonable degree of medical certainty: (1) there can be no recovery; and (2) death will occur from the condition within a short period without the provision of life prolonging procedures.
  • A medical condition that, if the person were to suffer cardiac or pulmonary failure, recitation would be unsuccessful or within a short period the person would experience repeated cardiac or pulmonary failure resulting in death.

I.C. 16-36-6-5.  Essentially, the POST is meant for individuals who are chronically ill and who are not expected to recover. 

The form may be filled out by the individual, if over 18, or his or her representative (health care representative, healthcare power of attorney, or guardian, see I.C. 16-36-6-7(a)).  If an individual is under the age of 18 that individual cannot complete the POST, unless certain requirements are met under I.C. 16-36-1-3(a)(2) (for example, the minor is emancipated or not receiving support from his or her parents). 

The form should be filled out in consultation with a health care provider and it must be signed by a physician.  The POST allows patients to designate a healthcare representative who is authorized to make decisions on behalf of the patient if the patient is no longer competent or well enough to make those decisions for him- or herself.  Note that if an individual appoints a healthcare power of attorney on the POST form, that declaration supersedes any such appointment on any other form.  See I.C. 16-36-6-20.  

A copy of the form should be kept in the patient’s medical records.  The original POST is considered the personal property of the individual and should be kept with the patient at all times.

The POST can be revoked in a variety of ways, including in writing or orally.  The form is meant to be flexible and the statute allows a patient to change the form at any time.  A patient may also change his or her mind during treatment and orally request different treatment than is stated on the POST.  

The POST will likely be very valuable for chronically ill patients, especially for those who frequently move between facilities.  This form, however, should be used in conjunction with a properly tailored estate plan that includes a last will and testament, general durable power of attorney, healthcare power of attorney, and/or advanced healthcare directives. 

For example, if a chronically ill patient no longer has the capacity to fill out the POST, then that patient’s health care representative may complete the form. However, that patient must have first appointed the health care representative through his or her estate planning documents.  Additionally, a healthcare power of attorney will allow your representative broader powers to make healthcare decisions for you, as the POST is limited to the three categories as described on the form.  An advanced healthcare directive (or living will) similarly allows you to broadly describe any medical interventions you wish to or don’t wish to receive.  As such, the POST is another useful tool that should be part of your overall estate plan.

If you need assistance with your estate plan or have questions about the POST, please contact Ken or Sara. 

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