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The Indiana State Department of health (ISDH) updated and improved the Indiana Physicians Orders for Scope of Treatment (POST) form in December 2016. The new form is available for download in PDF and Microsoft Word formats at http://www.in.gov/isdh/25880.htm, and it should be available in the offices of most health care service providers. We provide the form to our clients that may be able to use it, and we make it available upon request to whoever requests a copy.
The Indiana legislature enacted an entire chapter of legislation about POST in 2013 (available online at: http://iga.in.gov/legislative/laws/2016/ic/titles/016/articles/036/chapters/006/). An Indiana patient is a “qualified person” to establish a POST form under Indiana Code § 16-36-6-5 if the patient has at least one of the following conditions:
(1) An advanced chronic progressive illness.
(2) An advanced chronic progressive frailty.
(3) A condition caused by injury, disease, or illness from which, to a reasonable degree of medical certainty:
(A) there can be no recovery; and
(B) death will occur from the condition within a short period without the provision of life prolonging procedures.
(4) A medical condition that, if the person were to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful or within a short period the person would experience repeated cardiac or pulmonary failure resulting in death.
The Indiana General Assembly enacted the 2013 Post legislation in response to a national movement to provide a better way for seriously ill patients to coordinate end-of-life health care with their physicians. The movement began in 1991 with the formation of the Oregon POLST Task Force, which created the original Physician Orders for Life-Sustaining Treatment (POLST) form that Oregon adopted in 1995.
We reported a defect in the original Indiana POST form on December 6, 2014, in our article entitled, “Indiana Physician Orders for Scope of Treatment.” We said in that article:
“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 [POST] 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 ISDH replaced that defective language in the new POST form with clearer instructions and alternative signature provisions for adult patients, the parent of a minor patient, a patient’s health care representative, a patient’s health care attorney-in-fact under a Health Care Power of Attorney, or a patient’s legal guardian. The ISDH has also published advance care directives statutes and POST statutes, forms for POST and several kinds of advance care directives, Information for Health Care Professionals about POST, and Information for Patients about POST on the ISDH website at: http://www.in.gov/isdh/25880.htm.
Jeff R. Hawkins and Jennifer J. Hawkins are Trust & Estate Specialty Board Certified Indiana Trust & Estate Lawyers and active members of the Indiana State Bar Association and National Academy of Elder Law Attorneys. Both lawyers are admitted to practice law in Indiana, and Jeff Hawkins is admitted to practice law in Illinois. Jeff is also a registered civil mediator, a Fellow of the American College of Trust and Estate Counsel and the Indiana Bar Foundation; a member of the Illinois State Bar Association and the Indiana Association of Mediators; and he was the 2014-15 President of the Indiana State Bar Association.
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