The form for End-of-Life Provisions and choice of person of trust

End-of-Life Provisions are a request for euthanasia that is made in anticipation of a situation later in life where one find himself or herself irreversibly unconscious according to the current state of science and suffering from a serious and incurable accidental or pathological condition.

It is preferable that one draws up his or her End-of-Life Provisions while one is still legally capable and in good health.

A sudden accident or disease might put you in a situation of dependence, such as for instance prolonged unconsciousness, by which you can no longer manifest your will. If you do not manifest your will in writing beforehand, you run the risk of having others decide instead of you.

Your arrangements must be recorded in writing, dated and signed by yourself.

It is a document included in the blue section of the brochure “My will at the end of life”
You can also download it directly at the bottom of this page!
• On the first page you will write your family name and first name, your date and place of birth as well as your National registration number (matricula national)
You may also indicate details about the situation where you would choose to undergo euthanasia.

• On the second page of this official document, you will write optional information such as the person of trust or your choice of burial method.

You will have therefore the opportunity to register a person of trust by writing his or her personal data. It is that person who will see to it that your arrangements are respected in case you might be irreversibly unconscious like in a coma or in a state of physical deficiency where you cannot manifest your will.

It is important to chose well the person of trust, to inform him or her about your choice in advance and talk to him or her about your will and wishes.

It is of prime importance that you inform your treating doctor about your will and ask him or her whether they consent to help you if the case arises. Otherwise, you yourself or your person of trust will have to find a doctor who is favourably disposed and who will respect your choice later on.

Once the End-of-Life Provisions are completed:

  • Have several copies of the signed document made.
  • Give a copy to your life partner, a member of your family, person of trust.
  • Deliver a copy to your family doctor or treating doctor and talk to him or her about any concerns you might have in relation to the end of life.
  • In case of hospitalization, provide a copy at admission to the hospital with a request for it to be put in your medical file.
  • And most importantly, send the original to La Commission Nationale de Contrôle et d’Evaluation sur l’Euthanasie et le Suicide Assisté.

Registration of the end of life provisions

End-of-Life Provisions must be sent to the following address in order for them to be valid:

Commission Nationale de Contrôle et d’Evaluation sur l’Euthanasie et le Suicide assisté
p/a Ministère de la Santé L-2935 Luxembourg

Registration by La Commission Nationale de Contrôle is mandatory.
After about a month, the Commission will send you a letter to certify the registration of your arrangements.

Every 5 years the CNCE will ask you by mail if you are still in agreement with your request.

If you do not reply, your arrangements will remain valid another 5 years (automatic renewal).

Important to know: Arrangements may be reiterated, withdrawn or modified at any moment!

Also when for example there is a change in your address or phone number or those of your person of trust.
Thank you for informing the secretary of the Commission about that as soon as possible by phone at: 2478-5626

 

End of Life Provisions