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

1. 1

   Coordinate Palliative Care, Hospital Support, and Public Health Coverage

   • Public healthcare and inpatient palliative support: Public hospital and primary care services in Kiribati are delivered through the Ministry of Health and Medical Services, with specialist inpatient care concentrated at Tungaru Central Hospital in Nawerewere (South Tarawa) and regional care at Betio Hospital, Southern Kiribati Hospital, and London Hospital on Kiritimati [1][5]. Public healthcare services and essential pain-relief medications provided at government facilities are publicly funded for citizens of Kiribati [1][5].
   • Home nursing and outer-island community care: For patients wishing to remain at home on South Tarawa or on an outer island, care is coordinated between the hospital medical team and local medical assistants or public health nurses at the nearest Island Health Centre operated by the Ministry of Health and Medical Services [1][5].
   • Overseas Medical Referral Scheme: Where specialised oncology or palliative interventions are unavailable domestically, the clinical committee at Tungaru Central Hospital under the Ministry of Health and Medical Services evaluates eligibility under the Government of Kiribati Overseas Medical Referral program [1].
2. 2

   Record Advance Medical Preferences and Designate a Healthcare Representative

   • Documenting medical treatment preferences: Kiribati does not have a standalone living will statute, so medical consent and treatment refusal are governed by common-law principles of patient autonomy and clinical protocols administered by the Ministry of Health and Medical Services [1][4]. While your family member has full mental capacity, they can sign a written statement of treatment preferences setting out their wishes regarding cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition, and pain management [1].
   • Naming a healthcare spokesperson: Your family member should formally name a trusted family representative in their clinical file at Tungaru Central Hospital or their local health centre so attending physicians under the Ministry of Health and Medical Services know whom to consult if your family member becomes unable to communicate [1][5].
   • Mental health and capacity safeguards: Ensure the attending physician records a contemporaneous note in the medical chart confirming that your family member understood the nature and effect of their care instructions at the time of signing [1][4].
3. 3

   Execute Financial and Legal Powers of Attorney and Bank Mandates

   • General Power of Attorney while capacity is intact: Under the common-law and statutory framework overseen by the Ministry of Justice and the courts of Kiribati, a person with full mental capacity may execute a written Power of Attorney authorising a trusted representative to manage financial affairs, sign official documents, and administer personal property [2][4].
   • Witnessing and registration formalities: To ensure acceptance by government agencies and courts under the Magistrates' Courts Ordinance (Cap. 52), the Power of Attorney should be signed in the presence of a Magistrate, a commissioner for oaths, a legal practitioner, or an authorised officer of the Ministry of Justice [2][4].
   • Direct bank mandates: Commercial and state financial institutions in Kiribati - including ANZ Kiribati and the Development Bank of Kiribati - frequently require their own account mandate forms. Your family member should visit the bank branch (or arrange an authorised officer visit) while still able to sign in person to add a joint signatory or register the Power of Attorney [2].
4. 4

   Activate Incapacity, Provident Fund, and Social Support Benefits

   • Kiribati Provident Fund medical and incapacity withdrawals: Under the National Provident Fund Ordinance (Cap. 64), a member who becomes permanently incapacitated from employment due to physical or mental illness may apply to withdraw their accumulated retirement savings early from the Kiribati Provident Fund [3][6]. The application requires a formal medical board certificate issued through the Ministry of Health and Medical Services confirming permanent medical incapacity [1][3][6].
   • Updating Provident Fund beneficiary nominations: While your family member has capacity, they should review and update their official nomination form on file with the Kiribati Provident Fund in Bairiki so that any remaining account balance is paid directly to the intended family beneficiaries without delay [3][6].
   • Disability and social welfare allowances: For individuals meeting national disability or age thresholds, inquire with the Ministry of Women, Youth, Sport and Social Affairs or the local Island Council welfare officer regarding the Disability Support Allowance or the Elderly Fund (Kara) allowance, as well as workplace sick leave entitlements under Kiribati employment law [2].
5. 5

   Organize Wills, Customary Land Records, and Civil Status Documents

   • Drafting a valid will and customary land rules: While personal bank accounts, chattels, and non-customary leases can be bequeathed by a written will signed before two independent witnesses, the succession and transfer of native customary land in Kiribati are strictly regulated by the Gilbert and Phoenix Islands Lands Code and adjudicated by the Magistrates' Court (Lands Division) under the Magistrates' Courts Ordinance (Cap. 52) [4]. Any lifetime gift or arrangement involving customary land requires approval and registration before the Lands Court [2][4].
   • Verifying civil registration records: Check that your family member's birth certificate, marriage certificate, and children's birth certificates are accurately recorded with the Civil Registration Office at the Ministry of Justice under the Births, Deaths and Marriages Registration Ordinance (Cap. 5), as name discrepancies can delay future Kiribati Provident Fund or Lands Court applications [2][3].
   • Cross-border documents and consular authentication: Because Kiribati is not a member of the Hague Apostille Convention, any foreign powers of attorney or overseas property documents must be authenticated through the Ministry of Justice and the relevant diplomatic mission [2].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Ministry of Health and Medical Services - Clinical and Referral Services — Ministry of Health and Medical Services, Republic of Kiribati
2. [2]
   Ministry of Justice - Civil Registration and Judicial Services — Ministry of Justice, Republic of Kiribati
3. [3]
   Kiribati Provident Fund - Member Services, Nominations, and Incapacity Withdrawals — Kiribati Provident Fund (KPF)
4. [4]
   Magistrates' Courts Ordinance (Cap. 52) - Civil and Lands Jurisdiction — Pacific Islands Legal Information Institute (PacLII)
5. [5]
   World Health Organization - Kiribati Country Health Profile — World Health Organization (WHO)
6. [6]
   National Provident Fund Ordinance (Cap. 64) — Pacific Islands Legal Information Institute (PacLII)