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The Public Health Law (Law 165/2023), publicized in the Official Gazette No. 9 this Friday, introduced for the first time in Cuba a clear regulation on "determinations for the end of life."
In the document the right to a “dignified death” within the healthcare system was recognized.
In that section, the regulation includes among the options the "valid procedures that end life", a formulation that—without mentioning the word "euthanasia"—opens the legal door to assisted dying practices, although its application is contingent on the Ministry of Public Health (MINSAP) declaring that conditions have been created and that it will be regulated in a future "specific law."
The core of the change lies in Article 158, under the heading "Determinations for the end of life."
What does the law establish regarding the end of life?
The law recognizes "the right... to a dignified death" through the exercise of determinations for the end of life.
Define these determinations as a "set of options" implemented within the framework of: a) adequacy of therapeutic effort; b) resuscitation; c) continuous care; d) palliative care; and e) "valid procedures that end life".
It notes that these actions are aimed at individuals with chronic degenerative and irreversible diseases, intractable suffering, or in an agonizing or terminal phase.
The text establishes an explicit lock in Article 161. The law itself states that the MINSAP is responsible for determining when the conditions are created in the country for carrying out "valid procedures that end with life" and specifies that, in this regard, they will be regulated in a "specific law."
In practice, this means that the Law does not describe an already operational procedure nor does it establish on its own a detailed mechanism to apply those "procedures"; it leaves its implementation subject to subsequent regulation.
The law strengthens the framework of informed consent
En el mismo cuerpo legal se refuerza el principio de consentimiento informado como requisito para procederes médicos, con constancia en modelo oficial que forma parte de la historia clínica y con reglas para casos en que no pueda firmarse por escrito.
Furthermore, the law recognizes the right of individuals to refuse medical procedures, and requires that this decision be documented according to the informed consent mechanism.
In the chapter on end of life, the regulation also provides that a person may refuse to receive medical procedures, and orders that, if this decision persists, it must be recorded in the official informed consent form and procedures should be followed according to articles 127 and 128.
Another important point is that the law stipulates that the implementation of the actions approved to realize the right to a dignified death does not generate civil, criminal, or administrative liability for the professionals involved, as long as they act in accordance with the established provisions.
In summary, Law 165/2023 opens a legal pathway for Cuba to regulate assisted dying in the future under the umbrella of "procedures... that end life," but it does not by itself equate to an implemented euthanasia: it remains pending further regulatory development and an explicit decision from MINSAP.
The regulation states that it comes into effect 90 days after its publication in the Official Gazette.
In 2024, the regime assured that euthanasia remained punishable by law.
Specifically, the authorities determined that anyone who could induce, facilitate, or assist in ending the life of another human being would automatically incur a potential criminal offense in Cuba.
The "determinations" regarding end-of-life decisions continue to be aimed at "individuals with chronic degenerative or irreversible diseases accompanied by intractable suffering, who are in the agonizing or terminal phase of life, or who have suffered injuries that place them in this condition."
It would not only involve oncology patients, but also individuals with other diseases, such as neurodegenerative disorders.
A new regulation must establish who the professionals will be that will implement these actions and the doctor's decision must be respected, as they may agree to proceed or not.
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