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

1. 1

   Coordinate Palliative Care, Home Health Care, and Insurance Coverage

   Palliative medicine and home nursing support in Saudi Arabia are delivered through government medical cities and specialist hospitals as well as accredited private hospitals [1]:

   • Public palliative care units and the Home Health Care Program (Al-Ri'ayah Al-Sihhiyah Al-Manziliyah): Through the Saudi Ministry of Health (service center 937 and the Sehhaty platform) and major tertiary centers (such as King Faisal Specialist Hospital and Research Centre, King Fahad Medical City in Riyadh, King Abdullah Medical City in Makkah, and Ministry of National Guard Health Affairs hospitals), patients with advanced oncology or life-limiting conditions can be referred to multidisciplinary palliative care departments [1]. The Saudi Ministry of Health also operates the national Home Health Care Program, which dispatches medical teams, palliative nursing, pain management, oxygen therapy, and medical beds to the patient's residence based on the attending consultant's referral [1].
   • Cooperative Health Insurance (CHI) coverage for private-sector workers and expatriates: If the ill person is insured under a private employer health policy regulated by the Council of Health Insurance (CHI), verify the policy's inpatient, oncology, and home medical care limits and obtain prior authorization from the insurer through the treating hospital's insurance coordination desk [1][3].
   • Consolidating medical reports: Request an official bilingual (Arabic and English) Comprehensive Medical Report (Taqrir Tibbi Mufassal) signed by the treating consultant and stamped by the hospital's Medical Reports Department, as this document is required for disability benefit applications, caregiver leave certificates, and travel clearances [1][4].
2. 2

   Record Treatment Preferences, Informed Consent, and Medical Representation

   Healthcare decision-making and end-of-life care in Saudi Arabia are governed by the Patient Bill of Rights and Responsibilities of the Saudi Ministry of Health and the National Policy on Do-Not-Resuscitate (DNR) orders overseen by the Saudi Health Council [1][2]:

   • Informed consent and treatment preferences while capacity is intact: While possessing full mental capacity (Ahliyyah), the ill person holds the legal right under the Patient Bill of Rights of the Saudi Ministry of Health to be informed of their diagnosis and treatment options, to consent to or decline proposed surgical or medical interventions, and to request palliative pain and symptom relief [1].
   • Do-Not-Resuscitate (DNR) clinical governance: Under Saudi medical law and Islamic bioethical rulings (Fatwa No. 12086), a Do-Not-Resuscitate order is not executed as a private living will; instead, it is a formal clinical determination signed by three qualified specialist/consultant physicians confirming that the patient's condition is terminal and that cardiopulmonary resuscitation would be medically futile, with the family kept fully informed of palliative comfort measures [1].
   • Designating a medical proxy or representative (Wakeel): While retaining full legal capacity, the ill person should record their designated primary family spokesperson in the hospital's electronic medical file and execute a formal Power of Attorney (Wakala) through the Najiz platform of the Saudi Ministry of Justice (call center 1950) explicitly authorizing a trusted representative to access medical records, handle hospital admissions, and liaise with healthcare authorities [1][2].
3. 3

   Execute a Notarial Power of Attorney (Wakala) via Najiz and Arrange Bank Mandates

   In Saudi Arabia, if an individual loses mental capacity without a valid mandate in place, banks and registries will require a formal Guardianship Deed (Sak Wilaya / Qawama) from the Personal Status Court [2]. Acting while capacity is intact prevents administrative freezes:

   • Issuing an electronic Power of Attorney (Wakala) on Najiz: Using the Najiz portal (najiz.sa) of the Saudi Ministry of Justice, the ill person can issue an instant electronic Power of Attorney (Wakala) for healthcare, government procedures, real estate management, or litigation, authenticated via their Absher account [2][5].
   • Mobile notary (Muwathiq) for hospitalized or bedridden patients: Where a Power of Attorney requires in-person verification (such as broad financial disposal or real estate sale powers, or if the grantor cannot use digital verification), book a licensed private notary through the Muwathiq service of the Saudi Ministry of Justice (muwathiq.sa) or request a mobile court clerk to visit the patient at the hospital bedside or home while the patient is still alert and legally competent [2].
   • Saudi bank account mandates (SAMA rules): Saudi commercial banks operating under Saudi Central Bank (SAMA) rules often require either a specific banking clause in the Najiz Power of Attorney or the completion of the bank's own internal account authorization form signed in person or verified by a relationship manager while the account holder is competent [2]. Note that under Saudi law, every Power of Attorney (Wakala) terminates automatically upon the grantor's loss of legal capacity (unless supervised by the court) or death [2].
4. 4

   Activate GOSI Disability Pensions, MHRSD Support, and Caregiver Companion Leave

   Depending on employment history and citizenship status, several statutory financial and workplace protections can be activated during a serious illness [3][4]:

   • General Organization for Social Insurance (GOSI) disability benefits: Insured Saudi contributors who become permanently unable to work before retirement age due to a serious illness can apply to the General Organization for Social Insurance (customer service 199044; email [email protected]) for a Non-Occupational Disability Pension, which is increased by a statutory supplement of up to 50% if the medical board certifies that the beneficiary requires the continuous daily assistance of another person [4]. If the illness is occupational (covered for both Saudi and non-Saudi workers), file a claim under GOSI's Occupational Hazards branch for full medical care and disability compensation [4].
   • MHRSD Disability Assessment and Social Support: Saudi citizens diagnosed with a severe functional impairment can submit their electronic medical report via the unified portal of the Ministry of Human Resources and Social Development (call center 19911) for disability classification, monthly financial disability aid (I'anat Al-Ashkhas Dhawi Al-I'aqah), assistive medical device grants, and priority home-care services [3].
   • Caregiver / Patient Companion Leave (Ijazat Murafiq) and Employee Sick Leave: Under the Saudi Labor Law overseen by the Ministry of Human Resources and Social Development, an ill employee is entitled to up to 120 days of statutory sick leave per year (the first 30 days at full pay, the next 60 days at three-quarters pay, and the final 30 days unpaid) upon presenting an electronic medical report (Sehhaty sick leave certificate) [1][3]. For family caregivers accompanying a hospitalized patient (Murafiq Marid), Saudi Civil Service regulations grant paid companion leave when a physician certifies that a first-degree relative requires an inpatient attendant, while private-sector employees can coordinate companion leave or flexible remote work arrangements with their employer using the hospital's official companion certificate [1][3].
5. 5

   Organize Wills (Wasiyyah), Civil Status Records, and Cross-Border Estate Documents

   Reviewing civil status, property deeds, and testamentary instruments in advance ensures that family members are protected and reduces post-bereavement court delays [2][5]:

   • Registering a Will (Tawthiq Wasiyyah) or Endowment (Waqf) on Najiz: Through the Najiz platform of the Saudi Ministry of Justice, a competent adult can draft and officially authenticate an electronic Will Deed (Sak Wasiyyah) with two witnesses [2]. Under Saudi Personal Status Law for Muslim testators, a voluntary bequest (Wasiyyah) is valid up to one-third (1/3) of the net estate after debts and funeral expenses and is directed to charitable purposes or non-heirs (as the remaining two-thirds are distributed strictly according to statutory Sharia inheritance shares / Fara'id) [2]. Non-Muslim expatriate residents holding assets in Saudi Arabia should execute a clear bilingual will specifying that the law of their nationality governs their estate, and have it notarized and attested via their embassy and the Saudi Ministry of Foreign Affairs [2].
   • Verifying civil status records (Ahwal Madaniyah) and digitizing real estate deeds (Tahdith Al-Sukook): Check the Absher civil affairs profile (Ahwal Madaniyah) to confirm that all spouses and children are accurately registered on the Family Registry (Sijill Al-Usrah), as the Najiz succession system relies on these digital links [2][5]. If the ill person holds older paper real estate title deeds (Sukook), submit them free of charge through the Real Estate Deed Updating service (Tahdith Al-Sukook) on Najiz so they appear in the electronic registry [2].
   • Cross-border assets and Hague Apostille coordination: If your family member holds bank accounts, real estate, or citizenship outside Saudi Arabia, or if key family representatives live abroad, ensure that any foreign power of attorney or estate document is authenticated with a Hague Apostille (or Saudi consular attestation) and attested by the Saudi Ministry of Foreign Affairs and the Saudi Ministry of Justice so it is recognized in both jurisdictions [2][5].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Electronic Medical Services and Patient Care Portals (Sehhaty) — Saudi Ministry of Health (MOH)
2. [2]
   Najiz Electronic Justice Services - Powers of Attorney (Wakala), Wills, and Deeds — Saudi Ministry of Justice (MOJ)
3. [3]
   Labor Relations, Statutory Leave, and Social Support Services — Ministry of Human Resources and Social Development (MHRSD)
4. [4]
   Disability and Occupational Hazards Branch Benefits — General Organization for Social Insurance (GOSI)
5. [5]
   Civil Affairs (Ahwal Madaniyah) and Family Registry Services — Unified National Platform (GOV.SA)