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

1. 1

   Coordinating palliative care and specialized medical support

   • Hospital referral care: Specialized symptom management, pain treatment, and multidisciplinary medical follow-up in the Union of the Comoros are primarily coordinated through the El-Maarouf National University Hospital Center (Centre Hospitalier National Universitaire El-Maarouf) in Moroni as well as the regional hospitals on Anjouan and Mohéli [5]. The treating medical team establishes a supportive care protocol tailored to the patient's clinical condition [5].
   • Home care follow-up: When the patient's clinical stability allows home care, ongoing treatment and analgesic prescriptions are coordinated between hospital specialists at the El-Maarouf National University Hospital Center and district health centers [5].
   • Health insurance coverage and medical evacuation: Check coverage terms with the Comoros Generalized Health Insurance scheme or supplemental health insurers, as well as the medical board procedures required if a specialized medical transfer abroad is considered [3][5].
2. 2

   Advance medical directives and designating a healthcare proxy

   • Written statement of medical preferences: Although Comorian health legislation does not operate an automated national registry for advance directives, any adult with full legal capacity may set down in writing their wishes regarding invasive treatments, resuscitation, and comfort care to guide attending physicians [2][5].
   • Designating a trusted family representative: It is advisable to formally designate a family member as the trusted healthcare representative in the medical file maintained by the El-Maarouf National University Hospital Center or treating clinic [5]. This family representative serves as the primary point of contact for doctors if the patient becomes unable to express decisions directly [5].
   • Authentication and safekeeping: To give full evidentiary weight to these written wishes, your family member may execute or countersign the document before a notary affiliated with the National Chamber of Notaries of the Comoros (Chambre Nationale des Notaires des Comores) and provide a copy to the attending physician [4][5].
3. 3

   Banking powers of attorney, notarial mandates, and legal protection

   • Dedicated bank power of attorney: While the patient retains full mental capacity, execute formal banking powers of attorney (procurations bancaires) with their commercial banks and financial institutions in the Comoros [4]. This allows a designated representative to pay medical expenses and household bills without account freezes if physical incapacity develops later [4].
   • Notarial power of attorney for administration: For managing real estate, representing the patient before public administrations, or signing civil contracts, your family member can execute an authentic power of attorney before a notary belonging to the National Chamber of Notaries of the Comoros [4]. The notary personally verifies the principal's identity and mental capacity at the time of signature [4].
   • Judicial protection of adults: If cognitive impairment occurs before a notarial mandate is signed, the family must petition the competent civil court under the Ministry of Justice (Ministère de la Justice) to establish legal administration or guardianship in accordance with the Family Code [1][2].
4. 4

   Disability benefits, social security, and caregiver support

   • Invalidity and social insurance benefits: If the patient is a salaried employee registered with the national scheme and their illness causes a lasting inability to work, a medical and administrative claim may be filed with the National Solidarity and Social Insurance Fund (Caisse Nationale de Solidarité et de Prévoyance Sociale - CNSPS) in Moroni [3]. The National Solidarity and Social Insurance Fund assesses eligibility for incapacity benefits or early retirement on medical grounds [3].
   • Public-sector employees and private insurance: For civil servants of the Union or the autonomous islands, applications for extended sick leave or medical retirement are handled by the civil service administration and the Comoros Retirement Fund [3]. Also review disability coverage under any private insurance or bank loan policies [3][4].
   • Leave arrangements for family caregivers: Salaried relatives caring for a seriously ill family member may request authorized family leave or schedule adjustments from their employer upon presentation of a medical certificate issued by the El-Maarouf National University Hospital Center [3][5].
5. 5

   Will preparation, civil status verification, and estate organization

   • Prior verification of civil status records: Before finalizing estate planning, verify that the patient's birth certificate, marriage certificate, and children's birth certificates are properly recorded in the civil registers under Law No. 84-10 of 15 May 1984 on Civil Status published by the Ministry of Justice [1]. Any clerical error or omission can be corrected more easily during the person's lifetime [1].
   • Testamentary dispositions and the Family Code: Under Law No. 05-012/AU of 3 June 2005 enacting the Family Code, any person of sound mind may organize the distribution of their estate by will or notarial deed in strict compliance with the disposable portion (generally capped at one-third of the estate) and the statutory shares of protected heirs [2][4].
   • Estate inventory and diaspora coordination: Consulting a notary from the National Chamber of Notaries of the Comoros helps secure land titles, update insurance beneficiary clauses, and prepare legalized powers of attorney if heirs reside abroad or assets are held outside the Union of the Comoros [2][4].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Law No. 84-10 of 15 May 1984 on Civil Status in the Union of the Comoros — Ministère de la Justice de l'Union des Comores
2. [2]
   Law No. 05-012/AU of 3 June 2005 Enacting the Family Code — Ministère de la Justice de l'Union des Comores
3. [3]
   National Solidarity and Social Insurance Fund (CNSPS) - Contact Details and Procedures — Portail officiel eRegulations Comores
4. [4]
   Areas of Expertise - Family Law, Authentic Deeds, and Successions — Chambre Nationale des Notaires des Comores
5. [5]
   Official Portal of the El-Maarouf National University Hospital Center in Moroni — CHU El-Maarouf (Union des Comores)