Iowa Physician Orders for Scope of Treatment (POST)

There is a health care form in Iowa for patients making decisions about end of life health care treatment. The form is called Iowa PHYSICIAN ORDERS FOR SCOPE OF TREATMENT (IPOST).  It is based on a 2012 Iowa law. 

The form is to make clear the full range of a patient’s end of life health care wishes through a physician’s order.  It is to be available to all of a patient’s health care providers in all medical settings.  The form is to make sure your wishes are carried out no matter where you are getting care or treatment.   The new form is especially important for out of hospital care by non-physicians such as paramedics and first responders. If emergency care providers do not have access to your instructions for treatment they may in good faith provide treatment against your wishes. 

IPOST is for use by persons who are frail and elderly or have chronic, critical medical condition or a terminal illness.

• It does not replace power of attorney for health care, living will or out-of hospital do-not-resuscitate orders which you may already have. It puts all of this information in one form that is also a physician’s order.
• The form is completed through a physician, nurse practitioner, or physician’s assistant with your help.  
• The form may also be executed with the help of your legal representative if you are not competent to do so.   

The completed form contains medical orders to carry out your wishes for end of life medical care.  The areas addressed include but are not limited to:

• The administration of cardiopulmonary resuscitation (for example, the form could indicate a “Do Not Resuscitate” order)
• The level of medical interventions in the event of an emergency (for example, the form could indicate that you want full treatment in emergency or only measures for comfort)
• The use of medically administered nutrition by tube (for example, you could indicate that you do not want the use of nutrition by tube)
• The reason for the orders (the reason could be based on your health care power of attorney document and living will or your known wishes)
• The patient or a patient’s legal representative may revoke the form at any time. 

The form is not yet used statewide.  The development of a system for recording and use of the form requires local community initiative with all county health care providers agreeing to participate.  Ask your doctor or care provider about use of the form in your county. 

The IPOST formand more information about IPOST can be found through the Iowa Department of Public Health website:   https://idph.iowa.gov/ipost. 

• Iowa Legal Aid provides help to low-income Iowans.