You may have heard about a new kind of health care directive in Indiana, called a Physician Orders for Scope of Treatment (POST) form. Here, we discuss what a POST form is and when you might need one.
A POST form is a doctor’s order that helps you keep control over medical care at the end of life. Like a Do Not Resuscitate (DNR) order, the form tells emergency medical personnel and other health care providers whether or not to administer cardiopulmonary resuscitation (CPR) in the event of a medical emergency. A POST form may be used in addition to -- or instead of -- a DNR order. The POST form may also provide other information about your wishes for end-of-life health care, as explained just below.
A health care professional can help you create a POST form if you have an advanced, progressive medical condition and you enter a medical facility or health care setting -- such as a hospital, nursing home, or hospice care in a facility or at home. To be legally valid, a POST form must be dated and signed by your doctor, advanced practice nurse, or physicians assistant. (Indiana Code § 16-36-6-8.) You or your legally appointed health care decisionmaker must sign the POST form. If a member of the medical staff does not ask you whether you want to create a POST form, you may ask for one.
A POST form is usually printed on brightly colored paper so it will easily stand out in your medical records. The form travels with you if you move from one health care setting to another. You can change it or cancel it at any time.
A POST form differs from a DNR order in one important way: A POST form also includes directions about life-sustaining measures in addition to CPR, such as intubation, antibiotic use, and feeding tubes. The POST form helps medical providers understand your wishes at a glance, but it is not a substitute for a properly prepared living will and durable power of attorney for health care.
Taken together, a living will and durable power of attorney for health care provide more information than a POST form, including details about your chosen attorney-in-fact and health care representative, more complete health care wishes, and your preferences for organ donation. Therefore, if you have a POST form, you do not need a DNR order, but you should still complete these two additional health care directives to provide a full set of wishes about your care.
You need to consider a POST only if you're facing a life-threatening medical condition. If you're healthy, you need only a living will and durable power of attorney for health care to provide a full set of wishes for your treatment in the event of an unexpected accident or medical crisis.
On the other hand, a patient diagnosed with a terminal illness or frailty that requires care in a medical setting -- or ongoing care at home -- may need a POST in addition to traditional health care directives. That’s because a living will and durable power of attorney for health care may not be enough to prevent medical personnel from resuscitating a patient in an emergency. For that, it's important to have a medical order such as a POST or DNR order. If you feel strongly that you don’t want emergency measures at the end of life -- or if you’re caring for someone who feels that way -- find out about making a POST in addition to traditional health care directives.
For details about preparing essential health care directives, see Indiana Living Wills and Powers of Attorney for Health Care: What You Need to Know.
For general information about how to document your health care wishes, see the Living Wills & Medical Power of Attorney section of Nolo.com.