Table 4 The legal status of advance care directives in Colombia

The rights of persons at the end of their lives are described in the Resolución 13,437 of 1991, in Law 1737 of 2014 and the Resolución 1216 of the 20th of April 2015. Together, these describe the processes and information needed to express an advance directive (“living will”). In article 5 of the Law 1737 of 2014 the rights of patients in the last phases of their lives are described, including the right to sign advance directives, including: the right to palliative care; the right to information; to a second opinion; to actively participate in the care processes. Rights of children, adolescents and family members are also described. Article 5.4 is dedicated to the right to sign advance directives and described these as follows:

“Any capable, healthy or diseased person, in full use of their legal and mental faculties, with full knowledge of the implications that this right carries may sign an advance directive. Whoever subscribes such a document indicate his/her decisions regarding undergoing unnecessary medical treatments that impede a dignified life of the patient and in the event of death the decision regarding organ donation, should this person in the future be suffering from a terminal, chronic, degenerative and irreversible disease with a strong impact on quality of life.”

When providing information as part of the medical attention process, physicians are obliged to explain these rights to the patients, including the potential contents of the living will (advance care directive), explanation that the patient can revoke this will at any moment and that neither family members nor members of the medical staff can modify this will when the patient can no longer decide for himself.

Medical-legal experts on the topic have summarized the following barriers to an adequate implementation of advance directives in Colombia: the scarce knowledge in the general population of the right to sign advance directives, the scarce training of healthcare professionals on the subject and the absence of national information systems or national registers of advance directives that are easy to consult by professionals to guide decision-making [23].