Law 31/2018 of 18th of July set out the legal context of the rights of persons in the context of terminal disease or in end-of-life, establishing, in general terms, the right to not suffer in a sustained, disruptive and disproportional way.
This Law is only applicable in the case of persons the above in context of terminal disease or in end-of-life, when suffering a serious, incurable and irreversible illness with a life prognosis of 6 to 12 months.
All rights contained in this Law require a previous consent of the person in the context of an advanced disease or in end-of-life or, in case that they are not mentally capable, this consent should be provided by the responsible doctor and health team that accompanies them, after agreement from the family. This consent should be written, in case of invasive interventions and, cumulatively, with the presence of two witnesses in case of interventions that can put their life at risk.
The Law contains several rights regarding obtaining information by these patients, such as the nature of their illness, the prognosis, the possible clinical scenarios and available treatments. It guarantees to these patients, the active participation in their therapeutic plans, including the right to renounce these plans, having the right to be provided with the treatment that they agreed in their plan.
However, the refusal if the treatment is only admitted in the terms contained in the Law, so that the patients may only refuse artificial support of the vital functions and the provision of non-proportional or inadequate treatments to their clinical status when these are not exclusively intended to reduce the suffering and maintain same comfort, and no other treatments.
The Law highlights the right to these patients to be treated in the way that was previously agreed in their treatment plans, refusing the dysthanasia through therapeutic obstinacy and diagnosis by the medical team, as set out in the deontological codes of the Nurses and Doctors.
It also sets out the right to palliative care through the National Health System, including spiritual and religious support, and the right to adequate training, provided by the State, for informal caregivers that provide care at home.
Patients with a prognosis of life estimated in weeks or days, that present the symptoms of uncontrolled suffering by the palliative cares, can receive a palliative sedative with medication adequate to their treatment and, also, have a right to regular clinical monitoring.
The Law affirms that these patients have, in addiction to the right to prepare a vital will and nominate a health care attorney, the possibility of being the sole holders of their clinical information in relation to their illness and treatments. They also have the possibility to dispose of their bodies and organs after their death, designating a family member or a caregiver to assist them and, also, the right to receive support and payments due to them or to their families.