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

1. 1

   Coordinate Hospital Care, Household Doctor Support, and Medical Coverage

   • State healthcare system and household doctor system: Under the Public Health Law and the Law on Medical Care of the DPRK, medical services are administered by the Ministry of Public Health (with country health indicators and technical programmes monitored alongside the World Health Organization (DPRK Country Office) and UNICEF) [1][5]. Every residential district (dong or ri) is assigned a household doctor (hojdong uisa) from the local clinic or polyclinic who coordinates referrals to county, provincial, or central tertiary hospitals in Pyongyang [1][5].
   • Home symptom management and hospital referrals: Because formal standalone hospice institutions are rare in the DPRK and hospitals often face shortages of specialised medications and medical supplies, supportive care for an advanced illness is commonly coordinated between the provincial hospital specialist team and the local hojdong uisa, with family members providing daily bedside nursing and nutritional care [1][4][5].
   • Care and medical evacuation for foreign nationals: Foreign residents or visitors in Pyongyang are normally treated at the Pyongyang Friendship Hospital [2][3]. For serious or life-limiting conditions affecting a foreign national, consular authorities - including the Foreign, Commonwealth & Development Office (Consular Services for North Korea) and the U.S. Department of State (Protecting Power Consular Guidance for North Korea) - advise arranging early medical evacuation to Beijing or another regional medical hub [2][3].
2. 2

   Record Medical Treatment Preferences and Family Healthcare Representation

   • Role of the family in clinical decision-making: North Korean law does not establish a statutory electronic registry for living wills or advance directives comparable to Western or South Korean systems [4]. Instead, under the Law on Medical Care of the DPRK, attending physicians at Ministry of Public Health hospitals consult directly with the patient and the head of household or immediate adult family members regarding major surgical procedures, intensive interventions, and discharge to home care [1][4].
   • Designating a primary family spokesperson: While your family member retains full mental capacity, they should clearly inform both their attending hospital physician and their local hojdong uisa which immediate family member (such as a spouse or adult child listed on the same household register) is authorised to speak with medical staff and make care decisions if their condition worsens [1][4].
   • Obtaining official clinical documentation: Request written medical diagnosis certificates (Jindanso) from the hospital administration while treatment is ongoing, as official medical certificates are required for workplace leave, social security disability assessments, and ration adjustments [1][4].
3. 3

   Execute Legal Representation Mandates and Manage Household Records

   • Representation under DPRK Civil Law: Under the Civil Law of the DPRK, a citizen with legal capacity may authorise a representative (taeri-in) via a written letter of representation (Wiimjang) to handle specific civil and administrative matters on their behalf [4].
   • Certification at the State Notary Office (Kukga Kongjungso): For a representation mandate or property declaration to be recognised by state administrative organs, local People's Committees (Inmin Wiwonhoe), or state savings banks, the document should be executed and certified before the local State Notary Office (Kukga Kongjungso) while the ill person is still able to appear or confirm their intent [4].
   • Organising personal savings and household affairs: Where the ill person holds personal savings in a state bank branch or manages household assets, adding an immediate cohabiting family member or transferring funds while capacity is intact avoids administrative freezes later [4].
4. 4

   Activate Temporary Incapacity, Disability, and Workplace Support

   • Medical assessment for loss of working capacity: Under DPRK labour and social insurance regulations, a worker who becomes unable to work due to severe illness must be evaluated by a hospital medical assessment committee under the Ministry of Public Health to certify temporary or permanent loss of working capacity (rodong nungryok sangsil) [1][4].
   • Workplace social insurance and sick allowances: Present the hospital medical certificate to the administration and trade union committee of the ill person's state enterprise, cooperative farm, or institution (kikwan) to activate temporary incapacity subsidies (ilsi pojogum) or transition to a state disability pension (nyonrodongja mit yugongja nyongum) administered through the local People's Committee labour department [4][5].
   • Caregiver leave and ration book coordination: Family members employed at state work units must submit the hospital's certificate of severe illness to their workplace supervisor and local inminban leader to request authorised family caregiving leave and ensure uninterrupted household allocations under the Public Distribution System [4][5].
5. 5

   Organize Wills, Personal Property, and State Housing Occupancy Rights

   • Written will for personal property (kaein soyu): Under the DPRK Law on Succession, citizens have the right to dispose of their personal property - including personal funds, household furnishings, utensils, and personal effects - by will (yuon) to family members or other individuals [4]. To prevent disputes before the People's Court (Inmin Jaepanso), a written will should be witnessed and notarised at the State Notary Office (Kukga Kongjungso) while the person has full mental capacity [4].
   • Securing the State Housing Occupancy Permit (Ibsajung): Because residential housing and land in the DPRK are owned by the state or cooperatives rather than private individuals, housing cannot be bequeathed by will [4]. Instead, ensure that the spouse, adult children, or other caregiving relatives who live with the ill person are formally registered as cohabiting household members with the Ministry of Social Security (Sahoe Anjonbu) and the Housing Management Department of the local People's Committee so the State Housing Occupancy Permit (Ibsajung) can remain with the family [4].
   • Verifying Citizen Registration Certificates (Kongminjung): Confirm that all family relationship entries and Citizen Registration Certificates are consistent across the household register, and note that any cross-border legal documents for foreign or overseas relatives require consular authentication through the DPRK Ministry of Foreign Affairs and a resident embassy in Pyongyang [2][3][4].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Democratic People's Republic of Korea - Country Health and Public Health System Profile — World Health Organization (WHO)
2. [2]
   Foreign Travel Advice: North Korea (Healthcare, Legal Rules, and Consular Assistance) — Foreign, Commonwealth & Development Office (GOV.UK)
3. [3]
   Democratic People's Republic of Korea International Travel and Consular Information — U.S. Department of State - Bureau of Consular Affairs
4. [4]
   Democratic People's Republic of Korea - UN Human Rights and Legal System Reports — Office of the United Nations High Commissioner for Human Rights (OHCHR)
5. [5]
   UNICEF Democratic People's Republic of Korea - Health and Social Services Overview — United Nations Children's Fund (UNICEF)