Health Care Directives (Living Wills)

This topic is discussed in more detail, with legal citations, on-line resources and references, etc. in Life Planning in Jalisco Part II.

What’s available from the State of Jalisco?

For lots of years lakeside, living wills for palliative or end-of-life care have been drawn up (and paid for), but have had no legal standing.  The lakeside doctors typically recognize the desires of their patients who draw up such documents.  The snag comes when the patient goes into a private hospital in Guadalajara, in which case, the attending doctor changes.  The local doctor typically has no further input into the patient’s care. Without legally-binding health care directives, the hospital is not obliged to abide by the patient’s requests.

There is progress in the State of Jalisco, but it is not yet clear exactly ‘how much.’

July 30, 2011, the State of Jalisco passed legislation improving aspects of ‘legal’ guardianship.  With that legislation came a provision for establishing health care directives specifically for therapeutic treatments (Source: Lic R. Espinosa and R. Rodriguez).  Therapeutic treatments are typically ‘curative’ and do not provide patient’s rights for palliative or end-of-life care as provided in the Mexican federal legislation noted below.   It is still to be determined how broadly this health care directive will be interpreted (9/10/2011).

If Not From Jalisco, then, From Where?

From Other Mexican States? Yes!

The Mexican states of Coahuila and Mexico (DF) have health directives in their civil codes that are ‘legally recognized’ in the State of Jalisco.  This option can be explored to determine the type of health care directive you can obtain from one of these states.

With health care directives from another state, make sure you get a durable power of attorney for medical decisions, for example, from the State of Coahuila or another Mexican if you still cannot get one for medical decisions in the State of Jalisco (see July 2011 Jalisco State legislation).

From The Mexican Federal Government? Yes!

In 2008, Mexican federal end-of-life legislation passed allowing for a person to designate a person(s) to act on his/her behalf when they cannot speak for themselves in any way and allows for patient’s rights and health care directives for palliative and end-of-life care.   This legislation supersedes the Jalisco state laws. The catch here is that it is only for persons who have been diagnosed with a terminal situation with less than an expected 6 months to live.

There are many situations, especially in the aging process, where someone might not be able to speak for themselves in anyway and not be terminally ill (i.e., stroke,  dementia). In that case, the legislation does not apply (this is confirmed through several interviews and the legislation; see Part II of the publication).

From North Of The Border?  Yes!

You can get a living will (it comes with various names) made in the state from which you come.  Some states in the US, such as Nevada, have a living will (health care directives) embedded in the body of a durable power of attorney for health.  Most states have separate documents, and many of the documents do not require a notary.

If you want to use the document in Mexico, it has to be notarized (by a US notary) so that the notary’s signature can be ‘apostilled.’  

By completing a NOB living will/health care directive (aspostilled and translated) and the Mexican federal legislation, you stand a better chance of getting the care you want, Or Don’t Want, when you cannot speak for yourself.

For a sample NOB living will, or related document, for your specific state, check AARP (i.e., Five Wishes) or NOLO press.

If you get your health care directives from NOB, make sure they are accompanied by a durable power of attorney for medical decisions.