Iowa law provides processes for hospice and end-of-life decisions

An attorney in fact or guardian may request hospice admission for a patient who cannot communicate. This applies when the patient is comatose, incompetent, or otherwise unable to communicate. The patient must have a terminal condition and must not have expressed a wish about palliative care or hospice. If there is no attorney in fact or guardian, an available, willing, and competent person in the statutory priority order may make the request, guided by the patient’s expressed or implied wishes. If guardians have equal responsibilities, a majority must agree; otherwise, a court order is required. This rule does not apply to guardians appointed under chapter 232D.

A care team and an eligible decision-maker may agree to withhold or stop life-sustaining procedures or resuscitation for a patient who cannot communicate. This applies to a patient who is comatose, incompetent, or otherwise unable to communicate. The patient must have a terminal condition and no applicable declaration or out-of-hospital do-not-resuscitate order. The decision requires consultation and a written agreement with the attending provider and another listed medical professional; a witness must be present during the consultation. If guardians have equal responsibilities, a majority must agree; without a majority, a court order is required. The process for resuscitation without an out-of-hospital order applies only in specified health care or hospice facilities.

Guardians’ reports must cover the protected person’s wishes about hospice placement and life-sustaining procedures. This applies to reports filed by guardians of protected people.