04.05.02.01. Provisions exist which promote supported decision-making, which enable people with and without dementia or network of persons to discuss issues and make decisions | Mexico

04.05.02.01. Provisions exist which promote supported decision-making, which enable people with and without dementia or network of persons to discuss issues and make decisions | Mexico

13 Jul 2022

In eleven states in Mexico (Aguascalientes, Chihuahua, Coahuila, Colima, Mexico City, Mexico state, Guerrero, Hidalgo, Michoacan, Nayarit, and San Luis Potosí), there are advance directive laws that allow people to freely and consciously decide how they want to be medically treated if they face a terminal illness or an accident. For this reason, people who wish to make the request, must present themselves before notaries to express in advance how to be treated if they find themselves in that position. Regulation regarding advance directives include power of attorney regulated by the Federal Civil Code[1] established as a legal and judiciary condition for those individuals who do not have the capacity to make decisions on their own because of a mental disorder, illness, or due to impairment as a consequence of substance abuses and who are consequently limited as to their integrity and ability to make decisions and take care of themselves, and therefore need to appoint a legal representative (guardian and curator) who must attend to their legal life. Thus, patients with chronic, progressive, and degenerative and/or dementia such as Cerebral Vascular Disease, Huntington’s disease, and Alzheimer’s disease, fall into this category.

The guardian is the person who will be in charge of the guardianship of a person or their material goods, and the curator will be the one who will supervise the fulfillment of the obligations of the guardian. Healthcare power of attorney trials, take place in a family court in most of the country, for which the advice of gerontologists, geriatricians and neuro-geriatricians are recommended. In fourteen states in Mexico, Do Not Resuscitate Orders (DNR) are established through a law and its regulation[2] so that all individuals with intact capabilities can decide if they want to be submitted or not to means, treatments or medical procedures that aim to prolong their life when the person is at the end of life, aiming to protect their dignity, and favouring palliative care and end of life care. The emphasis is on accompanying the patient during this stage of his life, not prolonging or shortening his life, but respecting the natural moment of death. It is a document that will be used at the moment a doctor has diagnosed an advanced stage disease.

[1] CÓDIGO CIVIL FEDERAL. Nuevo Código publicado en el Diario Oficial de la Federación en cuatro partes los días 26 de mayo, 14 de julio, 3 y 31 de agosto de 1928. TEXTO VIGENTE: Última reforma publicada DOF 03-06-2019; http://www.diputados.gob.mx/LeyesBiblio/pdf/2_030619.pdf

[2] Ley de Voluntad Anticipada para el Distrito Federal, 2008 (https://drive.google.com/file/d/0B0qDlFGzsYQfaHFCQWQ0cXZKRzA/view ) and its Reglamento (https://drive.google.com/file/d/0B0qDlFGzsYQfSEJJV2QyTmMtNjQ/view )