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

1. 1

   Activating Home or Hospital Palliative Care and Health Coverage

   • Access to the National Palliative Care Plan: In Paraguay, comprehensive pain relief and complex symptom management are organized under the National Palliative Care Plan (2024-2030) and Law No. 7340, coordinated by the Ministry of Public Health and Social Welfare (MSPyBS) [1] [2]. The attending specialist physician should refer the patient to the multidisciplinary palliative care units at specialized hospitals (such as the National Cancer Institute - INCAN or regional hospitals) or coordinate follow-up with Family Health Units (USF) for home support [1] [2].
   • Social Security Institute coverage and private health plans: If your family member is an active contributor, retiree, or beneficiary of the Social Security Institute (IPS), they are entitled to inpatient coverage, controlled analgesic medication, oncology care, and home medical visits for bedridden patients or those with severely reduced mobility [3] [4]. If covered by private health insurance or prepaid medicine in Paraguay, you should submit the updated medical report to the insurer to coordinate home supplies, oxygen therapy, or home nursing care according to the policy terms [1] [2].
2. 2

   Advance Directives and Appointing a Healthcare Proxy

   • Informed consent and advance medical directives: Under the healthcare regulations of the Ministry of Public Health and Social Welfare (MSPyBS) and the provisions protecting human dignity in palliative care in Paraguay, every competent adult patient has the right to receive accurate clinical information, to grant or revoke informed consent, and to express in advance their wishes regarding medical treatments they accept or refuse in advanced stages of illness [1] [2].
   • Formalization before a public notary and inclusion in the medical record: To give full evidentiary force to advance medical directives and the appointment of a trusted family member or representative as healthcare proxy (valid interlocutor before the medical team should the patient become temporarily or permanently unable to express their wishes), it is advisable to execute this declaration by public deed or notarial record before a licensed Public Notary (Escribano Público) [1] [5]. An authenticated copy should be delivered to the attending physician for mandatory inclusion in the clinical record at the Ministry of Public Health and Social Welfare (MSPyBS), the Social Security Institute (IPS), or the private hospital [1] [3].
3. 3

   Executing Notarial Powers of Attorney and Bank Authorizations

   • Granting a general or special power of attorney before a Public Notary: While the person who is ill retains intact decision-making capacity under the Paraguayan Civil Code, it is a priority to visit a Public Notary (or request their attendance at the home or hospital) to execute by public deed a General Power of Attorney for administration or detailed special powers of attorney [5] [6]. These powers allow the trusted representative to collect payments, represent the principal before public bodies, and manage or dispose of registrable assets, and must be registered in the Powers of Attorney section of the General Directorate of Public Registries under the Judiciary of Paraguay (Supreme Court of Justice) [5].
   • Operational authorizations with banks, finance companies, and cooperatives: Because commercial banks and savings and credit cooperatives in Paraguay normally require in-person or notarized registration of authorized signatures on their own internal forms, it is advisable to arrange co-signatories or banking representatives as early as possible [3] [5]. Likewise, retirees and pensioners of the Social Security Institute (IPS) with mobility limitations can use the biometric proof-of-life tool inside the MI IPS mobile application or register authorized representatives to collect pension payments [3] [4].
4. 4

   Disability Benefits, Dependency Support, and Workplace Leave

   • Extended medical leave allowances and disability pension with IPS: If the person who is ill is an employed contributor under the general social security scheme, they can apply to the Social Security Institute (IPS) for monetary sickness allowances during extended medical leave and, when the condition causes permanent incapacity for work, request an evaluation by the Medical Board to qualify for a Disability Pension (Jubilación por Invalidez) [3] [4]. Updated diagnostic certificates and the contribution history recorded in the social security system must be submitted [3] [4].
   • Disability certification and workplace leave for family caregivers: When the illness results in severe physical or functional dependency, a Disability Certificate can be requested from the National Secretariat for the Human Rights of Persons with Disabilities (SENADIS), which facilitates access to support programs and rehabilitative or palliative services in Paraguay [1] [2]. At the same time, working family members can coordinate with their employers for justified leave, special permissions, or flexible scheduling provided under Paraguayan labor and civil service rules to accompany close relatives undergoing serious medical treatment [1] [3].
5. 5

   Preventive Will Preparation, Insurance Review, and Documentation

   • Executing a will before a Public Notary: To ensure respect for the patrimonial wishes of the person who is ill within the mandatory forced-heirship shares (legítima) established by the Paraguayan Civil Code, it is advisable to execute a will by public act (public deed before a Public Notary and three resident witnesses) or a closed will while retaining full mental clarity [5] [6]. The will is recorded in the Registry of Wills of the Judiciary of Paraguay (Supreme Court of Justice), greatly simplifying future succession proceedings [5] [6].
   • Reviewing beneficiaries, civil status certificates, and international coordination: It is helpful to gather and verify updated birth and marriage certificates issued by the General Directorate of the Civil Registry (REC), registered property titles, and life insurance policies or cooperative funds, expressly updating beneficiary designations [5] [6]. If the person who is ill holds assets abroad or has family members residing outside Paraguay, notarial powers of attorney or public documents intended for foreign legal effect must be legalized before the Judiciary of Paraguay (Supreme Court of Justice) and apostilled by the Ministry of Foreign Affairs of Paraguay [5] [6].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   National Palliative Care Plan of Paraguay 2024-2030 — Ministerio de Salud Pública y Bienestar Social (MSPyBS)
2. [2]
   Technical Guide of the National Palliative Care Plan — INCAN / Ministerio de Salud Pública y Bienestar Social (MSPyBS)
3. [3]
   Economic Benefits, Retirements, and Pensions of the Social Security Scheme — Instituto de Previsión Social (IPS)
4. [4]
   Retirement and Benefit Procedures for Insured Members — Instituto de Previsión Social (IPS)
5. [5]
   Legalizations and Services of the General Directorate of Public Registries — Poder Judicial de Paraguay (Corte Suprema de Justicia)
6. [6]
   Certificates and Fee Schedule for Civil Status Records — Dirección General del Registro del Estado Civil (REC)