Indiana Physician Orders for Scope of Treatment

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What scares you most about growing old and dying? Everyone may answer the question differently, but a common theme we find among clients is the fear of being so disabled at the end of life that a person cannot participate in his or her final healthcare choices. Most solutions to this problem fell short on some level (such as living wills, appointments of healthcare representative, health care powers of attorney, and do not resuscitate orders). No single solution prevents that nightmare from becoming a reality, but some Indiana patients have a relatively effective new solution. That solution is the Indiana Physician Orders for Scope of Treatment, known by its acronym “POST.”

Living wills have disappointed doctors and lawyers over the last 20 years because healthcare providers almost never fulfill the statutory requirement of a physician’s written certification that a patient has (1) an incurable injury disease or illness, (2) death will occur in a short time, and (3) life-prolonging procedures were merely artificially prolonging the dying process. The lack of that written physician’s certification makes a living will a worthless piece of paper in the hospital records.

Appointments of healthcare representatives and health care powers of attorney offer wonderful solutions to empower trusted family members and friends to make healthcare decisions. Unfortunately, some people do not have family members or friends they can trust to make critical end-of-life healthcare decisions.

Do not resuscitate orders are great tools for terminally ill patients, but they operate like a light switch – they tend to direct healthcare providers to either resuscitate a patient or withhold care altogether. There is no room for a custom-designed care plan for a terminally ill patient under a do not resuscitate order.

A POST document allows a chronically ill or terminally ill patient and the doctor to make a customized care plan for end-of-life decisions. The POST statute provides predefined terms that doctors can use in the form to describe various kinds of pain management and comfort care that modern medicine has made possible. Patients that have appointed healthcare representatives with an appointment healthcare representative or a healthcare power of attorney should avoid completing the section of the back side of the form that mentions healthcare representatives because a patient can accidentally terminate his or her previous appointment of healthcare representative and thereby prevent an intended healthcare representative from helping with healthcare decisions other than end-of-life choices. The POST form and information about advance care directives appear on the Indiana State Department of Health website at: .

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Jeff R. Hawkins and Jennifer J. Hawkins are Trust & Estate Specialty Board Certified Indiana Trust & Estate Lawyers. Jeff is a Fellow of the American College of Trust and Estate Counsel  and the 2014-15 Indiana State Bar Association President . © Copyright 2014 Hawkins Law PC.

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