Advance Directives Education Provided by Greene County Medical Center


Advance Directives for health care are important components of future medical treatment. Iowa law provides two types of Advance Directives – a Living Will and a Durable Power of Attorney. Adults are encouraged to complete both of these prior to needing medical treatment. 

The Living Will tells your physician which life-sustaining procedures should be withheld or withdrawn if you are in a terminal condition and unable to decide for yourself. According to Iowa law, life-sustaining procedures do not include withholding or withdrawing food or water unless these are being provided by feeding tube or intravenous feeding.  A terminal condition is defined as one that will result in death relatively soon if life-sustaining procedures are not used. It also includes a permanent state of unconsciousness with no likelihood of recovery. 

Those who made a Living Will prior to 1992 may want to make a new one, as a change in Iowa law in 1992 allowed for withdrawal or withholding of intravenous feeding or feeding tubes during a state of permanent unconsciousness. A living will is solely for medical purposes and has nothing to do with the last will and testament that details how a person wants property or finances to be distributed after death.

A medical Durable Power of Attorney appoints a third party to make medical treatment decisions for a patient who is unable to make them. The designated “agent” is also able to make health care decisions in the best interest of a patient if his or her wishes are unknown. A Durable Power of Attorney is not limited to patients with a terminal condition or decisions about life-sustaining procedures. It allows a third party to make health care decisions in accordance with your wishes.

Advance Directive documents apply only when a person is unable to make health care decisions. It is recommended that copies of the Living Will and medical Durable Power of Attorney should be kept in a safe place and shared with family members, the appointed “agent,” as well as the physician and local hospital for filing with a patient’s medical records. 

Advance Directives require careful considerations and discussions with one’s medical provider. The consequences of withholding or withdrawing treatments should be clear. In addition to discussing treatment alternatives and decisions with one’s primary physician, discussing preferences and options with family is important. One might also choose to discuss with legal counsel.

Effective statewide in July 2012, the Iowa Physician Orders for Scope of Treatment (IPOST) form was implemented. This document is a consolidation and summarization of a patient’s preferences for key life-sustaining treatments. When completed, with input from the patient, the patient’s designated “agent,” and health care provider, the form is signed and then serves as a medical order, not an Advance Directive. This portable order set stays with the patient and may be honored in any Iowa health care setting. The IPOST form does not replace or revoke the Advance Directives.

Greene County Medical Center has updated Advance Directives brochures that explain both types of Iowa’s Advance Directives in detail, and provides information on how to obtain and complete the necessary documents. Information on the IPOST form is also in the brochure. Brochures are available in the main lobby of the Medical Center at the business office registration desk. If you have any questions please call 515-386-2114.


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