Terminal Illness & End-of-Life Planning in Colombia: 5-Step Official Checklist

1. 1

   Activate Home or Hospital Palliative Care and Health System (EPS) Coverage

   Colombian legislation guarantees the right of every person with a chronic, degenerative, irreversible, or terminal illness to receive comprehensive palliative care and effective pain management [1][2]:

   • Mandatory coverage under the Consuelo Devis Saavedra Law (Law 1733 of 2014): Pursuant to Law 1733 of 2014 and the regulations of the Ministerio de Salud y Protección Social, all Health Promoting Entities (EPS in both the contributory and subsidized regimes) and Healthcare Provider Institutions (IPS) must guarantee comprehensive palliative care in inpatient, outpatient, and home care (atención domiciliaria) settings (including care by pain and palliative care specialists, nursing, nutritional support, psychology, and social work) [1][2]. Ask the treating physician or specialist for a formal referral to your EPS's Home Palliative Care Program and an updated copy of the medical record [1].
   • Supply of opioid medications, copayment exemptions, and Supersalud protection: EPS insurers and departmental narcotics funds are required to ensure continuous availability of opioid analgesics and special-control medications for severe pain relief [1]. Furthermore, patients diagnosed with catastrophic or high-cost illnesses are exempt from copayments and moderating fees (copagos y cuotas moderadoras) for services related to their condition; if any delay or barrier arises in delivering medications or home care supplies, the family can file an urgent life-risk complaint with the National Health Superintendency (Superintendencia Nacional de Salud - Supersalud) or file a constitutional protection action (acción de tutela) to enforce the fundamental right to health.
2. 2

   Execute the Advance Directive Document (DVA) and Designate a Healthcare Proxy

   While the ill person retains full legal and mental capacity, they can formally record their decisions regarding future medical treatments and end-of-life care [1][2]:

   • Scope of the Advance Directive Document (Resolution 2665 of 2018): Under Law 1733 of 2014 and Resolution 2665 of 2018 issued by the Ministerio de Salud y Protección Social, any capable adult - whether healthy or ill - may execute an Advance Directive Document (Documento de Voluntad Anticipada - DVA) freely and consciously stating their specific preferences regarding healthcare, acceptance or refusal of disproportionate medical treatments or life-support measures (redirection of therapeutic effort), palliative accompaniment, and decisions relating to the right to die with dignity or organ donation [1][2].
   • Three valid formalization methods and incorporation into the medical record: In Colombia, Resolution 2665 of 2018 allows formalizing the Advance Directive Document through any of three fully valid methods without requiring a lawyer: 1) before the attending physician (who records it in the clinical chart), 2) in writing before two (2) witnesses (attaching copies of the identity documents of the declarant and both witnesses), or 3) by public deed before a Notary (Notaría) [1][2]. In the same document, your family member can designate a trusted relative or representative to ensure their decisions are honored by the medical team, and should request that the DVA be incorporated into their clinical history and reported to their EPS [1][2].
3. 3

   Execute Notarial Powers of Attorney, Advance Support Directives, and Bank Mandates

   Under Law 1996 of 2019 (which strengthened the legal capacity framework in Colombia), establishing representation and support instruments while the person can unequivocally express their wishes avoids subsequent judicial proceedings [2][5]:

   • General Power of Attorney by public deed before a Notary or special power of attorney: To manage bank accounts, collect pension payments, file tax returns with DIAN, or administer real estate, it is advisable for the ill person to execute a General Power of Attorney by public deed (Poder General por escritura pública) before a Colombian Notary (or special powers of attorney with personal appearance and biometric signature/fingerprint verification) [5]. If your family member has mobility limitations or is hospitalized, you can request mobile notary service (notaría a domicilio) so the notary attends the residence or hospital room in person to verify full mental lucidity and take the biometric signature and fingerprint.
   • Support agreements or Advance Directives (Law 1996 of 2019) and bank requirements: Additionally, an advance directive or formal support agreement (acuerdo de apoyo) for future legal and financial acts can be executed before a notary or authorized conciliation center. Check directly with each Colombian commercial bank (such as Bancolombia, Davivienda, Banco de Bogotá, or BBVA) regarding any internal forms or specific clauses required in a general or special power of attorney to authorize withdrawals, CDT management, and financial transactions without operational holds.
4. 4

   Apply for Sick Leave Pay, Disability Pension, and Caregiver Leave

   A serious or advanced illness activates health-related wage replacements, disability pensions, and protected workplace leave in Colombia [3][4]:

   • Temporary sick pay and Disability Pension with Colpensiones or private pension funds (AFP): During the first 180 days of continuous temporary work incapacity, sick pay is covered by the EPS; from day 181 for up to an additional 360 days, while rehabilitation or loss-of-working-capacity assessment proceeds, the pension administrator pays the incapacity subsidy [3]. If the medical assessment issued by the EPS, Colpensiones, the insurer, or the Regional Disability Qualification Boards certifies a loss of working capacity of 50% or more (pérdida de capacidad laboral igual o superior al 50%), an affiliated person who meets the statutory contribution-week requirement is entitled to apply for a Common-Risk Disability Pension (Pensión de Invalidez por riesgo común) with Colpensiones (or with their private pension fund under the Individual Savings Regime), or for a substitute indemnity / balance refund via the electronic portal if minimum weeks were not reached [3][4].
   • Disability Certificate and workplace leave for family caregivers: Apply to the municipal or district health secretariat for multidisciplinary assessment for the official Disability Certificate (Resolution 113 of 2020 and updated regulations of the Ministerio de Salud y Protección Social) [1]. Likewise, working family members caring for a close relative with a terminal illness or severe medical condition are entitled to request paid leave for serious domestic calamity (grave calamidad doméstica) (protected under Article 57(6) of the Substantive Labor Code and Constitutional Court case law) as well as flexible hours or remote-work arrangements for caregivers.
5. 5

   Review the Notarial Will, Insurance Beneficiaries, and Property Records in Advance

   Organizing the will, insurance policies, and property records in advance prevents succession disputes and simplifies future procedures for the family [4][5]:

   • Open or closed will before a Notary and forced heirship rules (Law 1934 of 2018): Under the Colombian Civil Code (as amended by Law 1934 of 2018), an estate is divided into the compulsory legitimate half (mitad legitimaria - 50%) reserved for forced heirs (legitimarios, such as descendants or ascendants) and the free disposal half (mitad de libre disposición - 50%) that the testator may leave freely to any person. Executing an open will by public deed (testamento abierto por escritura pública) before a notary and three competent witnesses (or a closed will before a notary and five witnesses) while retaining full mental capacity provides complete legal certainty and is registered with the Superintendency of Notaries and Registry (Superintendencia de Notariado y Registro).
   • Life insurance beneficiaries, pension records, and cross-border coordination: Review and update in writing the named beneficiaries on individual or group life insurance policies and mortgage debtor insurance, as life insurance payouts do not enter the probate estate and are paid directly to named beneficiaries. Gather copies of the Civil Registry of Birth and Marriage (or notarial deed/conciliation record declaring a unión marital de hecho), real estate title certificates (certificados de tradición y libertad), and bank records; if assets or family members are located abroad, obtain the online Hague Apostille for Colombian powers of attorney or public deeds through the portal of the Ministerio de Relaciones Exteriores [5].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Advance Directive Document (DVA) and Palliative Care (Law 1733 of 2014 and Resolution 2665 of 2018) — Ministerio de Salud y Protección Social
2. [2]
   FAQ Guide (ABECÉ) on the Advance Directive Document (DVA) and End-of-Life Rights — Ministerio de Salud y Protección Social
3. [3]
   Economic Benefits and Common-Risk Disability Pension (Pensión de Invalidez) — Colpensiones
4. [4]
   Online Economic Benefits and Grant Filings Portal — Colpensiones
5. [5]
   Online Apostille and Legalization of Public Documents — Ministerio de Relaciones Exteriores de Colombia (Cancillería)