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

1. 1

   Activating Home or Hospital Palliative Care and Health Coverage

   • National Palliative Care Plan under MINSA and EsSalud: In Peru, Law No. 30846 establishes the National Palliative Care Plan for Oncological and Non-Oncological Diseases, coordinated by the Ministry of Health of Peru (MINSA) (through specialized institutions such as the National Institute of Neoplastic Diseases - INEN, national hospitals, and the ADAMO home-care program covered by the Comprehensive Health Insurance - SIS) and by the Social Health Insurance of Peru (EsSalud) [1] [2]. The attending specialist physician must issue a clinical referral to enroll the patient in the corresponding pain therapy and palliative care unit [1].
   • Home care (PADOMI / COPHOES) and private insurance: If your family member is insured under the Social Health Insurance of Peru (EsSalud) and has severe mobility limitations, they can enroll in the Home Care Program (PADOMI) or specialized palliative support units to receive home medical and nursing visits, opioid analgesic management, and psychological support [1]. If covered by a Health Care Provider Entity (EPS) or private oncology or medical insurance in Peru, you should promptly contact the insurer to activate home hospitalization coverage and high-cost medication supply [1] [2].
2. 2

   Advance Directives and Appointing a Healthcare Proxy

   • Patient rights and advance medical directives: Under Law No. 29414 (Law Establishing the Rights of Users of Health Services) and its regulations supervised by the Ministry of Health of Peru (MINSA) and SUSALUD, every competent person has the right to prior, free, and express informed consent, as well as the right to accept or refuse to receive or continue medical treatment (except in public health emergencies) and to record in writing their preferences regarding clinical management and pain relief in advanced stages [1] [2].
   • Appointing a healthcare representative and notarial formalization: While the person who is ill retains full decision-making capacity (recognized and protected by Legislative Decree No. 1384 reforming the Peruvian Civil Code), it is advisable to execute in writing -preferably with a notarized signature or by public deed before a Public Notary- an advance directive and appointment of a healthcare support person or representative to act as a valid interlocutor before the medical team if they later become unable to express their wishes [1] [4]. A legalized copy should be formally added to the clinical record at the facility of the Ministry of Health of Peru (MINSA), the Social Health Insurance of Peru (EsSalud), or the private clinic [1] [2].
3. 3

   Executing Notarial Powers of Attorney and Bank Authorizations

   • Granting a power of attorney by public deed and registering with SUNARP: To prevent future financial or administrative freezes, it is a priority for the person who is ill, while retaining full mental clarity, to grant a broad general power of attorney or specific special powers by public deed before a Public Notary in Peru (who can travel to the home or hospital if the patient cannot move, verifying capacity and biometric fingerprint identity connected with the National Registry of Identification and Civil Status (RENIEC)) [4] [5]. This power of attorney must be registered in the Registry of Mandates and Powers of the National Superintendency of Public Registries (SUNARP) to be fully enforceable before third parties, banks, and state agencies [4] [5].
   • Advance designation of support persons and bank validation: In addition to an ordinary power of attorney, Peruvian civil law allows any adult to preventively designate before a Public Notary the person or persons who will act as their future support and safeguards (apoyos y salvaguardias), recording this act in the Personal Registry of the National Superintendency of Public Registries (SUNARP) [4]. Once registered, a certificate of validity of power of attorney (vigencia de poder) issued by the National Superintendency of Public Registries (SUNARP) should be submitted to commercial banks for internal legal validation (bastanteo de poderes) to ensure smooth operation of accounts used to cover medical expenses [4] [5].
4. 4

   Disability Benefits, Dependency Support, and Caregiver Leave

   • Temporary incapacity allowance and disability pension: If the person who is ill is an active worker insured with the Social Health Insurance of Peru (EsSalud), they are entitled to a monetary allowance for temporary incapacity for work starting from the 21st day of certified medical leave (the first 20 days are paid by the employer) [1]. When the Medical Evaluation Commission certifies permanent incapacity for work, the member can apply for a Disability Pension before the Pension Standardization Office (ONP) (under Decree-Law No. 19990) or before their Private Pension Fund Administrator (AFP), which also allows extraordinary withdrawal of up to 50% of pension funds in cases of accredited terminal illness or cancer diagnosis [3].
   • Paid workplace leave for family caregivers (Law No. 30012): In Peru, Law No. 30012 grants public and private sector workers the right to paid leave of up to seven calendar days (extendable against vacation entitlement or by compensatory agreement) when a direct family member is diagnosed with a serious or terminal illness, upon presenting to the employer the official medical certificate signed by an authorized healthcare professional from the Ministry of Health of Peru (MINSA), the Social Health Insurance of Peru (EsSalud), or a private clinic [1] [2].
5. 5

   Preventive Will Preparation, Insurance Review, and Documentation in Peru

   • Executing a will by public deed before a Public Notary: To simplify future estate transfer and avoid lengthy court proceedings, it is strongly advisable for the person who is ill to execute a will by public deed before a Public Notary in the presence of two qualified non-family witnesses, respecting the forced-heirship shares (legítima) set by the Peruvian Civil Code [4] [6]. The notary immediately records the existence of the will in the Registry of Wills of the National Superintendency of Public Registries (SUNARP), keeping its contents confidential during the testator's lifetime [4] [6].
   • Reviewing civil records, insurance policies, pension funds, and international coordination: It is helpful to gather and verify certified copies of birth and marriage records or registered domestic partnerships with the National Registry of Identification and Civil Status (RENIEC) and the National Superintendency of Public Registries (SUNARP), as well as updating beneficiary designations on life insurance policies, employee life insurance (Seguro Vida Ley), and pension accounts with the Pension Standardization Office (ONP) or AFP [3] [4] [5] [6]. If assets are located outside Peru or family members reside abroad, notarial powers of attorney or public documents intended for cross-border use must carry the Hague Apostille issued by the Ministry of Foreign Affairs of Peru [4] [5].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Comprehensive Care and Palliative Support for Patients with Terminal Illness at EsSalud — Seguro Social de Salud del Perú (EsSalud)
2. [2]
   Official Portal and Healthcare Regulations of the Ministry of Health — Ministerio de Salud del Perú (MINSA)
3. [3]
   Pension Procedures and Registration of Insured Members with the ONP — Oficina de Normalización Previsional (ONP) / Gob.pe
4. [4]
   Legal Registries, Wills, and Ownership Transfer at SUNARP — Superintendencia Nacional de los Registros Públicos (SUNARP)
5. [5]
   Official Civil Status Records and Identification in Peru — Registro Nacional de Identificación y Estado Civil (RENIEC)
6. [6]
   Registry Guide on Property and Testate or Intestate Succession — Superintendencia Nacional de los Registros Públicos (SUNARP)