Galician law requires three witnesses to execute a living will without a notary, and at least two of them may not be relatives of the person signing up to the second degree nor have any financial relationship with them. That is what article 5 of Law 3/2001, which regulates informed consent and medical records in Galicia, provides, and it is the point at which most documents of this kind lose their value without anyone noticing. A document signed before two witnesses, or before three of whom two are the signatory’s children, expresses a wish but does not have the form the law requires, and when the time comes to apply it the doctor is not bound by it. The same text, with three witnesses who meet the requirements or with a notary’s signature, is added to the medical record and binds healthcare staff. The difference between one side and the other lies in how it is signed, not in what is written.
What a living will is and what it is not
The legal name is advance directives. Law 41/2002, the basic law on patient autonomy, defines them in article 11 as the document in which an adult, with capacity and acting freely, states in advance their wishes about the care and treatment of their health, so that those wishes are followed when they reach a situation in which they can no longer express them. It may also set out, for after death, what is to be done with their body or organs. In Galicia the terms living will, advance directives and advance healthcare directive are used interchangeably and all mean the same thing.
It has nothing to do with inheritance. A living will does not distribute assets, does not appoint heirs and is not opened before a notary when someone dies. It deals only with healthcare decisions and what happens to the body. Anyone who wants to organise their estate needs a different document, and further on I explain how both relate to the lasting power of attorney, the third instrument with which it is usually confused.
Who can make one
Article 11 of Law 41/2002 reserves it for adults with capacity acting freely. That excludes emancipated minors, even though they have capacity for other acts, because the law requires the age of majority and admits no exceptions. Disability on its own does not prevent someone from making one. What the law requires is that the person understands what they are signing and decides without pressure at the moment of doing so, and if that person has support measures in place the sensible route is the notary, because the notary issues an assessment of capacity that nobody will easily dispute later.
It is always made in writing. A recording, a conversation with the family doctor or a letter to relatives will not do. Only the document formalised as the law provides has any effect.
The ways to formalise it in Galicia and which one suits you
Article 5 of Galician Law 3/2001, in the wording in force since May 2005, allows two forms of execution. Before a notary, with no witnesses needed. Or before three adult witnesses with full legal capacity, at least two of whom may not be related to the signatory up to the second degree nor have any financial relationship with them. Article 6 of Decree 159/2014, which regulates the Galician register, adds a third option, execution before the staff of the register itself or its authorised units, who check the form and register the document in the same act.
| Route | Who is involved | Cost | What it offers and what it risks |
|---|---|---|---|
| Notary | The notary, no witnesses | Notarial fee | Public faith and an assessment of capacity, the safest route if there is a diagnosis or a divided family |
| Three witnesses | Three adults with full capacity, two of them unconnected to the signatory | None | Immediate and free, but validity depends on the witnesses meeting the requirements of article 5 |
| Regional register | Register staff | None | Formal check and registration in the same act, with no notarial assessment of capacity |
All three routes produce an equally binding document if the requirements are met. The choice depends on the situation of the person making it. A healthy person with no family conflict and simple instructions can deal with it at no cost before the register. A person with a known diagnosis, with children who do not speak to each other, or with wishes the family does not share, has reason to go to the notary, because the day the document is applied someone may claim the person did not understand what they were signing, and the notarial assessment of capacity closes that argument before it starts. The witness route is the one that causes the most trouble, not because the law treats it worse but because it is the one most often done badly. The usual mistake is signing before three trusted people who turn out to be the spouse, a child and a sibling, so that only one of the three counts.
For any of the routes you need the signatory’s identity document and, if a representative is appointed, that person’s identity details. If the representative accepts the role in the same document, it is advisable that they sign it too.
What you can write and what does not bind the doctor
The content is set by article 11 of Law 41/2002. Care and treatment of your health, in as much detail as you wish, and what is to happen to your body or organs after death. In practice these documents usually record which treatments are refused when there is no reasonable prospect of recovery, whether sedation is wanted to avoid suffering even if it shortens life, where the person prefers to be cared for in the final stage, and whether organ donation or the use of the body for research is authorised.
The same article sets three limits. Instructions contrary to the law, instructions contrary to the “lex artis”, meaning good medical practice, and instructions that do not correspond to the factual situation the person had in mind when signing are not applied. That last limit is the one that surprises people most. If someone writes that they refuse mechanical ventilation thinking of a terminal degenerative illness, and years later suffers an accident with a good prognosis that requires ventilation for a few days, the doctor may take the view that the instruction does not correspond to that situation and act. That is why the generic templates circulating online cause so many problems, because they describe situations in the abstract and leave the doctor to decide whether the one in front of them is the one the patient meant.
Euthanasia has had its own law since 2021, Organic Law 3/2021, with its own procedure and its own medical requirements. That law refers to the living will in one specific case. Under its article 5.2, if the patient is no longer able to request it and had previously signed an advance directive, assistance in dying may be provided in accordance with what they left in writing, and the representative named in that document is the doctor’s point of contact. Anyone who wants their living will to serve that purpose has to say so expressly. The wish not to have life prolonged by extraordinary means and the wish to receive palliative care are a different matter, and any living will can record them.
The representative
Article 11 allows the appointment of a representative to act as the point of contact with the doctor or healthcare team to ensure the instructions are followed. The representative does not decide in the signatory’s place, but gives effect to what the signatory wrote and works out with the doctor whatever the document did not foresee. The choice matters more than it seems. A representative who lives far away, who does not share the signatory’s wishes or who falls apart in the hospital is no use for the role.
The law does not prevent naming a substitute in case the representative dies, resigns or cannot be found, and that is what we always recommend. A document with a single representative and no substitute is left orphaned the day that representative is missing, and the instructions remain valid, but nobody is there to enforce them.
Family, doctors and hospitals in another region
This is the real size of the problem, and it is what no leaflet explains. Once the signatory can no longer express themselves, the family cannot alter or set aside what was written. Article 11 only allows revocation in writing by the signatory, and while the document is in force it prevails over the views of children, spouse or anyone who turns up at the hospital. In practice the dispute is not framed as a revocation, it is framed as an argument about whether the document is valid, whether the signatory knew what they were signing or whether the situation foreseen is the one that is occurring. Those three questions are the ones a well-made document settles in advance and an improvised one leaves open.
Nor can the doctor depart from the document simply because they disagree with it. They may only decline to apply the specific instruction that falls within one of the three limits of article 11, and that is the ground where serious disagreements arise, because the judgment on whether something is contrary to good medical practice is made by the doctor. When the family believes the doctor is ignoring the document, or the reverse, when the doctor wants to follow it and the family objects, the matter is resolved in the hospital and, failing agreement, before the courts, and at that point the quality of the document decides almost everything. At the firm we step in at that stage, both for the signatory who wants a document that will hold up and for the family or representative who need it enforced, within our civil law practice.
Outside Galicia the document is just as valid. Law 41/2002 is basic state legislation and advance directives made in any region take effect throughout Spain. The problem is not validity but access. A hospital in Madrid or Asturias does not consult the Galician register, it consults the national advance directives register at the Ministry of Health, to which regional registrations are communicated. A living will registered in Galicia appears in the national register. One signed before witnesses and kept in a drawer appears nowhere.
Registration, revocation and the document that was never registered
Law 3/2001 provides that the document is to be taken to the healthcare centre where the person is treated and added to their medical record, and it creates the Regional Register of Advance Directives, attached to the Galician Health Department, known in practice as the Galician Register of Advance Directives. Registration is not a requirement for validity, it is a requirement for practical effectiveness. The document is valid from the moment it is correctly signed, but it only works if the doctor who has to apply it knows it exists and can read it. That is why a living will signed before witnesses and never registered or delivered to the centre is, as far as the health system is concerned, a non-existent document until someone brings it to the hospital, and at that point its form and its witnesses will have to be argued over with the patient already unconscious.
Checking that registration has been completed and that the hospital can consult it is something the signatory should do while still well. It is the only real guarantee that the document will work.
Revocation and amendment are free, at any time and always in writing. A later document sets aside the earlier one, and the prudent course is to review the living will when the diagnosis changes, when the family situation changes or when the appointed representative is no longer the right person.
Living will, will and lasting power of attorney
These are three different documents that solve three different problems, and clients often come in to make one thinking it covers the other two.
The will orders your assets for after death. In Galicia there are also instruments for bringing that distribution forward during your lifetime, as I explain in the article on apartación and inheritance during life in Galicia, and the rules on forced shares I cover when discussing whether you can be disinherited. None of that is touched by the living will.
The lasting power of attorney, governed by articles 256 to 260 of the Civil Code, is the document by which a person appoints who will represent them in managing their assets and personal affairs if they lose the capacity to decide. It is made before a notary, covers bank accounts, property, contracts and personal decisions, and is the natural complement to the living will, because one deals with health and the other with everything else. A person who makes a living will but not a lasting power of attorney has their medical care settled and has left unresolved who pays the care home, who sells the flat or who manages the pension.
All three can be made on the same day before the same notary, and that is what we do when the client wants the whole set closed. What is not advisable is signing all three without anyone checking that they are consistent with each other, that the healthcare representative and the attorney know what the other will do and that none of the documents contradicts another.
What you can do today on your own
Decide who will be your representative and who the substitute, and discuss it with them before signing. Think in terms of concrete situations rather than stock phrases, because the doctor will apply the document to the situation you foresaw and not to another. Do not sign a downloaded template without reading whether it describes your situation. If you already have a document signed before witnesses, check who they were and whether they meet article 5. And if you have it registered, keep the receipt and tell your representative where it is.
Anyone who does this on their own is risking two very specific things. A document that is formally void because of the witnesses, discovered when it can no longer be redone, and generic content that the doctor reads as not corresponding to the situation and stops applying. At the firm we draft the living will to fit the client’s situation, choose the route of execution that suits them, coordinate it with the lasting power of attorney and the will, and make sure it is registered and findable. You can call +34 677 841 007 or write through the contact page. When you call, have to hand your identity document, the name and identity document of the person you want as representative, information on any diagnosis you have, and any documents you have already made, whether a will, a power of attorney or an earlier living will.
Frequently asked questions
Can my family change my living will once I can no longer decide?
No. Article 11 of Law 41/2002 only allows revocation in writing by the signatory. While it is in force, the document prevails over the family’s views. What the family can do is argue about whether the document is valid or whether the situation foreseen is the one occurring, which is why it should be properly formalised and drafted with concrete situations.
Is my Galician living will valid if I am admitted to a hospital in another region?
Yes. Law 41/2002 is basic state legislation and advance directives take effect throughout Spain. The problem is whether the hospital can find it, and only registration in the Galician register, which is communicated to the national advance directives register at the Ministry of Health, guarantees that.
What happens if I signed it before witnesses but never registered it?
If the witnesses met the requirements of article 5 of Law 3/2001, the document is valid, but the health system does not know it exists. It will have to be taken to the centre to be added to the medical record, and at that point its form will be examined with you no longer able to explain it. The prudent course is to register it now, while you can.
Do I need a lawyer to make a living will?
Not always. A healthy person with simple instructions and no family conflict can make one at no cost before the regional register and does not need a lawyer. You do need one if you have a diagnosis, a family that does not share your wishes, support measures for a disability or an estate you want to organise alongside your health, because in those cases the document will have to withstand a dispute and be coordinated with a lasting power of attorney or a will.