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

1. 1

   Coordinating Palliative Care and Functional Assessment

   • Free palliative care under the Medical Guarantees Programme: Under national standards overseen by the Ministry of Health of Ukraine, patients with severe or life-limiting conditions are entitled to free inpatient palliative care or mobile home-based palliative care delivered by a multidisciplinary team [1] [2] [6].
   • Electronic referral and choosing a contracted facility: To access palliative care, the family doctor or treating specialist issues an electronic referral in the Electronic Healthcare System, allowing the family to select any facility contracted by the National Health Service of Ukraine (NSZU) for the relevant palliative care package [1] [2].
   • Pain relief and home medical support: The palliative care package funded by the National Health Service of Ukraine (NSZU) covers regular clinical monitoring, prescription and provision of effective pain relief (including opioid analgesics via e-prescription), oxygen support, assistive medical devices, and practical caregiver training for family members [1] [2].
   • Assessment of everyday functioning (EKOPFO / disability status): Where the illness causes lasting functional impairment, the treating physician issues an electronic referral for an assessment of everyday functioning by an expert clinical team (which replaced the former MSEK medical-social commissions) to establish formal disability status and an individual rehabilitation programme [1] [6].
2. 2

   Recording Medical Treatment Decisions and Designating a Healthcare Representative

   • Written informed consent and refusal of interventions: Under the Fundamentals of Legislation of Ukraine on Healthcare, a patient with full legal capacity has the right to make autonomous medical decisions, sign informed consent for treatment, or submit a written refusal of specific medical interventions [1] [2] [6].
   • Authorizing access to medical records: While the ill person is fully able to express their wishes, it is advisable to record in the medical file and primary care declaration the full name and contact details of the family member or representative authorized to receive confidential information on diagnosis, treatment, and test results [1] [2].
   • Agreeing on a personalized palliative care plan: Together with the treating physician and palliative specialists operating under Ministry of Health of Ukraine protocols, the patient and family establish an individualized care and pain-management plan specifying preferences for home-based versus inpatient care [1] [6].
   • Using the NSZU patient rights hotline: If a contracted medical facility refuses palliative care or requests out-of-pocket payment for state-guaranteed services or pain medication, the family can contact the National Health Service of Ukraine (NSZU) hotline at 16-77 [1] [2].
3. 3

   Executing Notarial Powers of Attorney and Bank Mandates

   • Notarizing a power of attorney while legal capacity is intact: While the ill person understands the nature of their actions and can freely express their will, they can execute a general or specific notarial power of attorney before a state or private notary authorizing a trusted person to represent them before public authorities, medical institutions, banks, and utility providers [3] [4].
   • Arranging a home or hospital visit by a notary: If illness prevents travel to a notary office, Ukrainian law allows a state or private notary to attend the person's residence or hospital ward to notarize the power of attorney on site; in urgent inpatient circumstances, a power of attorney may also be certified by the chief physician or deputy medical director of the healthcare facility [3] [4].
   • Registration in the Unified Register of Powers of Attorney: Every notarized power of attorney is mandatorily entered into the Unified Register of Powers of Attorney overseen by the Ministry of Justice of Ukraine, enabling banks and government agencies to verify the representative's authority immediately [4].
   • Setting up bank account mandates: Alongside a notarial power of attorney, it is helpful to verify the account rules at the ill person's Ukrainian banks and register a direct bank mandate or notarized authorization expressly covering pension and current account management [3] [4].
4. 4

   Activating Disability Pensions, Social Benefits, and Caregiver Compensation

   • Applying for a disability pension or care supplement: Once disability status is established by the expert assessment team, an application for a disability pension (or conversion from an old-age pension and addition of a statutory care supplement) is submitted to the Pension Fund of Ukraine (PFU) at any service centre or online via the PFU electronic portal [5].
   • State social assistance where insurance record is insufficient: If the ill person does not meet the social insurance contribution requirements for a contributory pension, social protection offices grant state social assistance for persons with disabilities together with a care allowance for Group I (Subgroup A or B) disability [3] [5].
   • Monthly compensation for family caregivers: A family member who lives with the seriously ill person and provides continuous non-professional care can apply through the local council executive body or TsNAP for monthly state caregiver compensation, and the period of caregiving is credited toward the caregiver's pension insurance record maintained by the Pension Fund of Ukraine (PFU) [5].
   • Free legal assistance on social entitlements: Where questions arise regarding disability benefit calculations or caregiver entitlements, the Free Legal Aid System of Ukraine provides free legal consultations and assistance with administrative filings [3].
5. 5

   Organizing the Will, Civil Status Records, and Property Documents

   • Executing and registering a notarial will: While retaining full civil capacity, the ill person may execute a will (zapovit) before a state or private notary (including during a home or hospital visit), which is mandatorily recorded in the Inheritance Register administered by the Ministry of Justice of Ukraine [3] [4].
   • Accounting for statutory forced heirship shares: When drafting a will, Ukrainian law reserves a mandatory share (oboviazkova chastka) for minor children, adult children incapable of work, an incapacitated surviving spouse, and incapacitated parents, who are entitled to half of what they would receive under intestacy regardless of the terms of the will, as explained by the Free Legal Aid System of Ukraine [3].
   • Verifying civil status certificates and property registration: It is advisable to check original birth and marriage certificates for any spelling discrepancies in names and ensure that ownership titles to apartments, houses, and land plots are digitally recorded in the State Register of Real Property Rights [3] [4].
   • Cross-border preparation for foreign assets or family members: If family members or assets are located outside Ukraine, notarized copies of key documents and civil status records can be certified with an Apostille through the Ministry of Justice of Ukraine so they are ready for cross-border recognition [3] [4].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Inpatient and mobile palliative medical care under the Medical Guarantees Programme - NSZU — Національна служба здоров'я України
2. [2]
   Palliative care in the Medical Guarantees Programme: what patients need to know - NSZU / MOH — Національна служба здоров'я України / Міністерство охорони здоров'я України
3. [3]
   Inheritance under a will: what you need to know - Free Legal Aid System — Координаційний центр з надання правничої допомоги
4. [4]
   Ministry of Justice of Ukraine - Notarial certification of powers of attorney and wills — Міністерство юстиції України
5. [5]
   Pension Fund of Ukraine - Electronic services and disability pension administration — Пенсійний фонд України
6. [6]
   Ministry of Health of Ukraine - Official Portal — Міністерство охорони здоров'я України