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

1. 1

   Coordinate Palliative Care, Home Nursing, and Health Coverage

   • Specialist palliative care network: Under the Ministry of Health and the National Cancer Control Programme, Palliative Care Consult Services (PCCS) operate across major tertiary and provincial teaching hospitals, including Apeksha Hospital (National Cancer Institute) in Maharagama, National Hospital of Sri Lanka in Colombo, Teaching Hospital Karapitiya, Teaching Hospital Kandy, and Teaching Hospital Ratnapura [1] [2]. Your family member's treating specialist can refer them to the hospital palliative care clinic for pain management, oral morphine prescriptions, and multidisciplinary symptom control [1].
   • Community and home-based care: The Ministry of Health integrates hospital palliative units with community follow-up delivered by Public Health Nursing Officers (PHNOs) attached to regional Medical Officer of Health (MOH) divisions, alongside charitable hospice facilities such as Shantha Sevana Hospice and Karunakaraga [1] [2]. Establishing a shared care plan early ensures continuity between inpatient wards and home nursing visits [1].
   • Public and private health coverage: Inpatient and outpatient care at state hospitals under the Ministry of Health is provided free of charge at the point of delivery, while critical-illness grants may be requested from the President's Fund for specific high-cost interventions [1] [2]. If the ill person holds private health insurance or public-sector Agrahara medical coverage, notify the insurer early to obtain pre-authorization for inpatient palliative admissions, home-oxygen equipment, and ongoing specialist consultations [1].
2. 2

   Record Medical Treatment Preferences and Designate a Healthcare Contact

   • Clinical documentation of advance care preferences: Sri Lanka does not currently have a standalone statutory Living Will Act, so advance medical preferences (such as goals of care, comfort-focused treatment, or limits on invasive cardiopulmonary resuscitation in end-stage illness) are recorded through clinical Advance Care Planning discussions with the treating consultant and hospital palliative team under Ministry of Health clinical guidelines [1] [2].
   • Written statement of wishes and next-of-kin designation: While your family member has full mental capacity, we suggest recording their treatment wishes in writing, signed in the presence of witnesses and shared with the treating physician so it is placed in the hospital medical file [1] [2]. You should also ensure the hospital admission registry clearly identifies the primary next of kin or designated family representative whom clinicians should consult if the patient later becomes unable to communicate [1].
   • Capacity confirmation by the treating clinician: Asking the attending consultant or psychiatrist to document in the clinical notes that the patient currently possesses sound mind and full decision-making capacity strengthens both medical consent records and concurrent legal instruments executed during the same period [1] [2].
3. 3

   Execute Powers of Attorney and Bank Mandates While Capacity Is Intact

   • Notarial Power of Attorney under the Powers of Attorney Ordinance: In Sri Lanka, a Power of Attorney must be executed while the principal has full mental capacity, signed before a licensed Notary Public and two attesting witnesses [5]. Under the Powers of Attorney Ordinance (as amended), powers of attorney intended for formal legal, property, or banking transactions should be duly stamped and registered with the Registrar General's Department within the statutory registration window so third parties and financial institutions can verify their validity [5].
   • Dedicated bank mandates and joint account review: Commercial banks in Sri Lanka enforce strict internal compliance on general powers of attorney. While your family member is able to visit the branch or meet a bank officer, we suggest completing each bank's specific third-party operating mandate form and reviewing whether everyday household expense accounts should have an authorized signatory so medical and living bills can be paid without interruption [3] [5].
   • Safeguards if capacity is already declining: Standard Sri Lankan powers of attorney generally cease to operate if the principal loses mental capacity. Establishing bank mandates, standing orders for recurring medical bills, and registered powers of attorney early avoids the need for lengthy District Court curatorship or guardianship proceedings under the Civil Procedure Code [5].
4. 4

   Activate Critical-Illness, Disability, and Provident Fund Benefits

   • Employees' Provident Fund (EPF) medical and incapacity claims: If your family member contributed to the Employees' Provident Fund administered by the Central Bank of Sri Lanka and the Department of Labour, a member who is permanently and totally incapacitated for work due to serious illness may apply to withdraw their accumulated EPF balance early upon certification by a qualified government medical board (using Form K and medical incapacity certificates) [3].
   • Employees' Trust Fund (ETF) critical-illness and medical welfare schemes: The Employees' Trust Fund Board provides specific welfare grants for active or eligible members diagnosed with qualifying critical illnesses (including advanced cancer, end-stage renal failure, or severe cardiac conditions), alongside permanent disability withdrawal entitlements [4]. Submit clinical diagnosis reports and hospital records directly to the Employees' Trust Fund Board regional or head office [4].
   • Public assistance and workplace leave: Low-income households facing severe illness or disability can apply through the Grama Niladhari and Divisional Secretariat (National Secretariat for Persons with Disabilities / Department of Social Services) for monthly chronic-illness (such as kidney or cancer) financial assistance allowances [2] [5]. Family caregivers employed in the public or private sector should coordinate accrued medical, casual, or unpaid family care leave with their employer's human resources department [3].
5. 5

   Organize the Will, Statutory Nominations, and Civil Status Documents

   • Executing a Last Will under the Prevention of Frauds Ordinance: Under Section 4 of the Prevention of Frauds Ordinance, a valid Last Will and Testament in Sri Lanka must either be executed in writing before a licensed Notary Public and two witnesses present at the same time, or signed by the testator in the simultaneous presence of five witnesses if no notary is present [5]. Executing a notarial will while capacity is medically documented is the most reliable way to appoint an executor and avoid intestate court disputes [5].
   • Updating EPF, ETF, and bank statutory nominations: Because EPF and ETF balances pass according to registered statutory nominations rather than automatically under a general will, verify with the employer, Department of Labour, Central Bank of Sri Lanka, and Employees' Trust Fund Board that the member's nomination forms are current and accurately reflect surviving family members [3] [4]. Likewise, check beneficiary nominations on commercial bank accounts and life insurance policies [3].
   • Consolidating civil registry and property records: Gather originals and certified copies of the ill person's National Identity Card (NIC), Birth Certificate, Marriage Certificate, and Land Registry property deeds, requesting replacements if needed via the Registrar General's Department (using Form B63a or the eBMD portal) [5] [6]. If assets or family members are located abroad, ensure foreign powers of attorney or estate documents are notarized and authenticated through the Ministry of Foreign Affairs Consular Affairs Division [5].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Palliative Care Consult Services and National Palliative Care Directory — National Cancer Control Programme, Ministry of Health, Sri Lanka
2. [2]
   National Policy and Strategic Framework on Non-Communicable Diseases and Chronic Care — Ministry of Health, Sri Lanka
3. [3]
   Employees' Provident Fund (EPF) - Member Benefits, Medical Incapacity, and Nominations — Central Bank of Sri Lanka
4. [4]
   Employees' Trust Fund (ETF) - Member Welfare Benefits and Critical Illness Claims FAQs — Employees' Trust Fund Board (ETFB), Sri Lanka
5. [5]
   Civil Registration, Legal Registries, and Official Application Downloads — Registrar General's Department, Sri Lanka
6. [6]
   Civil Registration Services and Divisional Secretariat Procedures — Registrar General's Department, Sri Lanka