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The Public Health Law (Law 165/2023), disseminated in the Official Gazette Ordinary No. 9 this Friday, has for the first time in Cuba included a specific regulation regarding “determinations for the end of life.”
In the document, the right to a "dignified death" within the healthcare system was acknowledged.
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 upon the Ministry of Public Health (MINSAP) declaring that the conditions have been created and that it is 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 about the end of life?
The Law recognizes "the right... to a dignified death" through the exercise of decisions regarding the end of life.
Define these determinations as a “set of options” that are executed within the framework of: a) appropriateness of therapeutic effort; b) resuscitation; c) continuous care; d) palliative care; and e) “valid procedures that end life”.
It indicates that these actions are directed towards individuals with chronic, degenerative, and irreversible diseases, intractable suffering, or in the agonizing or terminal phase.
The text explicitly establishes a lock in Article 161. The law itself states that MINSAP is the entity that determines when the conditions are created in the country to carry out "valid procedures that end in death" 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 a detailed mechanism on its own to apply those “procedures”; it leaves its implementation subject to later regulation.
The Law reinforces the framework of informed consent
The same legal document reinforces the principle of informed consent as a requirement for medical procedures, with a record in an official form that is part of the medical history and with rules for cases where it cannot be signed in writing.
Furthermore, the law recognizes the right of individuals to refuse medical procedures, and mandates that this decision be documented according to the informed consent process.
In the chapter on end-of-life, the regulation also provides that a person may refuse to receive medical procedures, and stipulates that, if this decision persists, it shall be recorded in the official informed consent form and acted upon in accordance with articles 127 and 128.
Another important point is that the law stipulates that the execution 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 regulations.
In summary, Law 165/2023 opens a legal avenue for Cuba to potentially 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 regulatory development and an explicit decision from MINSAP.
The regulation stipulates that it comes into effect 90 days after its publication in the Official Gazette.
In 2024, the regime asserted that euthanasia remained punishable by law.
Specifically, the authorities have established that a person who could induce, facilitate, or assist in ending the life of another human being would automatically be committing a potential criminal act in Cuba.
The "determinations" for the end of life continue to be aimed at "people with degenerative or irreversible chronic illnesses who are experiencing untreatable 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 concern cancer patients, but also individuals with other diseases, such as neurological degenerative conditions.
A new regulation must establish who the professionals are 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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