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

1. 1

   Coordinate Palliative Care, Home Hospital Services, and Health Coverage

   • Palliative care plan (palliatiivinen hoitosuunnitelma) and end-of-life care decision (saattohoitopäätös): Ask the treating specialist or physician in your regional wellbeing services county (hyvinvointialue) to draw up an individualized palliative care plan and, when appropriate, a formal end-of-life care decision (saattohoitopäätös) in consultation with the ill person and their family [2] [3].
   • Home hospital (kotisairaala) and hospice care (saattohoitokoti): Through the wellbeing services county, patients can receive specialized 24/7 home hospital nursing (kotisairaala), pain management, and assistive equipment at home, or inpatient care in a palliative ward or hospice, coupled with public health care user-fee caps (maksukatto) and Kela medicine reimbursement ceilings (lääkekatto) [3] [4].
   • Designating next of kin in patient records: Ensure the treating healthcare unit records the primary family contact (lähiomainen) and the patient's explicit consent for sharing medical information with designated family members [2] [3].
2. 2

   Record a Living Will (*Hoitotahto*) and Healthcare Proxy in MyKanta (*OmaKanta*)

   • Drafting and saving a hoitotahto in OmaKanta: Under the Act on the Status and Rights of Patients (laki potilaan asemasta ja oikeuksista 785/1992), a mentally competent adult can record binding advance healthcare instructions (hoitotahto) directly in the national digital health portal MyKanta (OmaKanta) at Kanta.fi using Finnish online banking credentials or a mobile certificate [2] [3].
   • Scope of medical treatment preferences: In the hoitotahto, the ill person specifies which medical interventions they consent to or refuse (such as mechanical ventilation, cardiopulmonary resuscitation, or artificial nutrition when recovery is no longer possible), as well as preferences regarding pain relief and symptom care; physicians and nursing staff across Finland view this entry directly in the Kanta patient data repository and are legally bound to respect it [2] [3].
   • Designating a medical surrogate (hoitotahtoon nimetty edustaja): Within the hoitotahto text in MyKanta (or in a written document signed and witnessed by two impartial witnesses), the ill person can also name a trusted proxy to interpret their treatment wishes and receive medical information if the patient later becomes unable to communicate [1] [3].
3. 3

   Execute a Continuing Power of Attorney (*Edunvalvontavaltuutus*) and Digital Mandates

   • Drafting an edunvalvontavaltuutus while capacity is intact: Under the Act on Continuing Powers of Attorney (laki edunvalvontavaltuutuksesta 648/2007), the ill person (valtuuttaja) can appoint an attorney-in-fact (valtuutettu), plus a substitute attorney (varavaltuutettu) and an impartial substitute (esteetön varavaltuutettu) for conflict-of-interest transactions such as property sales or gifts, to manage both financial affairs (taloudelliset asiat) and personal matters (henkilöä koskevat asiat) [1].
   • Strict witnessing requirements and confirmation by DVV: The edunvalvontavaltuutus must be signed in writing by the grantor in the simultaneous presence of two impartial witnesses (kaksi esteetöntä todistajaa) who are not related to the grantor or the appointed attorneys [1]. The document enters into legal force only when the grantor loses capacity due to illness and the attorney submits the original deed plus a medical certificate (lääkärinlausunto) to the Digital and Population Data Services Agency (Digi- ja väestötietovirasto - DVV) for official confirmation (vahvistaminen) [1].
   • Immediate bank and Suomi.fi mandates (Suomi.fi-valtuudet): Because DVV confirmation of an edunvalvontavaltuutus only occurs after capacity is lost and takes processing time, the ill person should also grant immediate Suomi.fi e-Authorizations (Suomi.fi-valtuudet) for pharmacy, healthcare, and tax transactions, as well as a direct bank account mandate (tilinkäyttöoikeus or pankkivaltakirja) at their Finnish bank while still able to act [1] [2].
4. 4

   Activate Sickness, Care Allowance, and Informal Caregiver Support

   • Kela sickness and care allowances: Apply to Kela for sickness allowance (sairauspäiväraha), pensioners' care allowance (eläkkeensaajan hoitotuki) to help cover extra costs and assistance needs caused by progressive illness, and reimbursement for medical travel expenses and prescription pharmaceuticals [4].
   • Informal care support (omaishoidon tuki) and family caregiver leave: If a family member provides regular care at home, apply to the regional wellbeing services county for informal care support (omaishoidon tuki), which includes a taxable care fee (hoitopalkkio), statutory respite days (lakisääteiset vapaapäivät), and caregiver coaching; employed family members also have statutory rights under the Employment Contracts Act (työsopimuslaki) to negotiate temporary absence or informal care leave (omaishoitovapaa) with their employer [4].
   • Earnings-related disability pension (työkyvyttömyyseläke): If the ill person is of working age, coordinate with their occupational health physician and earnings-related pension provider (työeläkelaitos) or Kela regarding partial or full disability pension benefits [4].
5. 5

   Organize the Will (*Testamentti*), Tax Planning, and Cross-Border Documents

   • Formal requirements for a Finnish will (testamentti): Under the Code of Inheritance (perintökaari), a valid will must be executed in writing while the testator has full testamentary capacity and signed in the simultaneous presence of two impartial witnesses aged 15 or over who know the document is a will [5]. Keep the signed original in a secure, accessible location (such as a bank safe or with a trusted attorney) because Finland does not maintain a central public will registry [5].
   • Reviewing marital property (avio-oikeus), beneficiaries, and tax rules: Review any prenuptial or marital property agreement (avioehtosopimus registered with Digi- ja väestötietovirasto), life insurance beneficiary clauses (edunsaajamääräys), and advance gift or inheritance tax implications published by the Finnish Tax Administration (Verohallinto) [1] [5].
   • Cross-border estates and document legalization: If the ill person owns assets outside Finland or is a foreign citizen, they may include an explicit choice-of-law clause in their will under the EU Succession Regulation (Regulation 650/2012) selecting the law of their nationality, and if powers of attorney or civil documents must be recognized abroad, obtain a Hague Apostille from Digi- ja väestötietovirasto or diplomatic legalization from the Ministry for Foreign Affairs of Finland (Ulkoministeriö) [1] [5] [6].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Continuing power of attorney (Edunvalvontavaltuutus) — Digital and Population Data Services Agency (DVV)
2. [2]
   MyKanta (OmaKanta) - Living will and health data portal — Kanta Services (Kela)
3. [3]
   You can save your living will and organ donation testament in MyKanta — Kanta Services (Kela)
4. [4]
   Sickness and rehabilitation benefits in Finland — Kela (The Social Insurance Institution of Finland)
5. [5]
   Inheritance and wills - guidance for individuals — Finnish Tax Administration (Verohallinto)
6. [6]
   Legalisation of documents for use abroad — Ministry for Foreign Affairs of Finland (Ulkoministeriö)