Palliative care is not about death. It is about life and how to live it with dignity until the last moment. In this article, we will explain what palliative care is, who is entitled to it and what legal tools can help you maintain your freedom of choice even in the most difficult moments.
Palliative care is a type of health care that focuses on patients with a terminal illness. It does not seek to cure the disease, but to relieve pain, maintain dignity and the best possible quality of life. It is often confused with hospice care, but hospice care is only one type of palliative care – specifically, that which is provided in the final stages of life.
From a legal point of view, palliative care is part of the health care covered by public health insurance when indicated by a doctor. Its provision is governed by the Health Services Act. Every patient has the right to refuse this care, as well as to request it, whether in an outpatient setting, in hospital or at home.
It is important to see palliative care not as a resignation to life, but as an acceptance of it when the disease can no longer be beaten. It is a proactive approach to suffering and pain with the aim of alleviating it, not ignoring it.
Children’s palliative care is a particularly sensitive topic. Parents have the right to make decisions about their child’s treatment, but they must also respect their child’s rights – including the right to dignity, information and protection from unnecessary suffering.
The law distinguishes the rights of the child according to age:
Palliative care for children often takes place at home, supported by mobile teams. Parents are entitled to a care allowance, psychological support and legal advice.
We can prepare your advance directive, health power of attorney or assist you in dealing with a hospital or hospice. Contact us, we will help you with respect, experience and a human touch.
Palliative care can be provided in different forms. Most commonly, either on an outpatient basis, i.e. at home with the support of a mobile hospice or home care team, or in an inpatient setting – for example, a hospice or specialist ward in a hospital. Each option has its pros and cons, not only medically but also legally.
Home palliative care is preferred by most people because the patient remains close to his or her family and in familiar surroundings. The law allows this and insurance companies normally cover this care if it is recommended by the attending physician. It is necessary to provide safe conditions at home and to arrange visits by professionals.
Inpatient care, i.e. hospice care, is appropriate when the patient’s condition requires intensive supervision and specialised care that the family cannot provide. Again, care may be covered by health insurance, but some costs (e.g. accommodation, food) may be borne by the family.
The choice of type of care is not only a medical decision but also a legal act. Every patient has the right to be informed about the options and to make a choice. Doctors and the family are obliged to respect this will. We recommend that it is also recorded in writing.
The Health Services Act clearly defines the rights of patients, including those facing a terminal diagnosis. The right to live with dignity is not a phrase, but a legal entitlement.
According to Section 28 of the Act, every patient has the right to:
This includes the right to refuse life-prolonging interventions (e.g. artificial lung ventilation) if the patient does not perceive their benefit as valuable. The doctor has a duty to respect this will, even if he or she disagrees.
However, the law also provides for exceptions: if the patient is unconscious and no legal opinion has been recorded in advance, the patient’s legal guardian or a close relative makes the decision for the patient, but always taking into account the patient’s probable wishes.
A previously expressed wish is a legal instrument by which the patient formally communicates what he or she wishes or does not wish in a situation where he or she would no longer be able to communicate or make decisions. Typically this is in the advanced stages of dementia, coma or terminal illness.
According to Section 36 of the Health Services Act, the doctor is bound by this wish – unless:
A prior expressed wish may include, for example, opposition to chemotherapy, connection to machines or transfer to hospital. In practice, this document has the force of a will and is an expression of a person’s autonomy at the end of life.
If you need us, we can help you get this document right so that it is legally sound and truly respected by doctors and family.
Tip: Have you experienced inappropriate or arrogant behaviour from a doctor? Did the doctor make light of your serious medical condition or suggest an incorrect procedure? We can advise you on what to do if you want to complain about a doctor.
The family is often put in the difficult position of having to make decisions for their loved one. However, the law strictly defines when and how this is possible. In the first instance, the right to decide is always given to the person who is competent and able to communicate.
If the patient loses the ability to make decisions, the so-called close relative or legal representative steps in. However, they can only make decisions in accordance with the patient’s so-called ‘probable wishes’ – that is, what the person would want if he or she could speak.
The family cannot unreasonably order doctors to prolong treatment or prevent the patient from accessing palliative care. If a conflict arises (e.g. between the family and the healthcare facility), it is possible to appeal to the hospital’s ethics committee or the court.
From our own experience, we recommend having all legal documents prepared in good time – e.g. a power of attorney for medical decision-making, a prior expressed wish, or a will.
Yes, it does, and it is often essential. A power of attorney for health matters allows you to designate a person to make decisions for you in the event of your incapacity. But don’t confuse it with a general power of attorney for offices or property – it is a separate legal document.
This power of attorney can be made by anyone with capacity, and does not require notarisation (but is recommended). The attorney-in-fact then negotiates with doctors, signs informed consents or disapprovals, and can request changes in treatment or facilities.
The advantage is that you can specify exactly what the person may or may not do – for example, only allowing consultations but not signing consent for surgery. In practice, this saves time, stress and avoids conflicts between relatives.
It is ideal to write a power of attorney early and update it regularly. We can help you with the exact wording so that the document is not challenged and is in accordance with the law.
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Hospice care is a specialised type of palliative care provided to patients in the final phase of life. There is a network of inpatient and mobile hospices in the Czech Republic, partly financed by public health insurance.
Legally, it is a health service with precisely defined conditions. Patients must be admitted on the basis of a medical report and their diagnosis must correspond to the indications (e.g. terminal illness, terminal condition). A care contract is signed with the patient or family.
It is important to know that:
The family should be actively involved in care planning, and if they feel the facility is not following the contract or ethics, they have the right to file a complaint with the facility management, the health insurance company, or the Czech Medical Association.
Palliative care is ideally a space for peace and reconciliation. Unfortunately, disputes also arise here, often between family and doctors, or between loved ones and each other. The problem tends to be disrespect for the patient’s wishes, pressure to prolong life, or, conversely, suspicions of inadequate care.
If a dispute arises, you can proceed as follows:
At the end of life, we want to be heard, understood and respected. The law should be a help, not a hindrance. Palliative care has a legal framework that allows you to choose how you want to live, even in the final stages of your illness. You have the right to dignified care and if you suspect a breach of the law, take action. In many cases, just starting to ask the right questions with the support of a lawyer will help.
Tip: Have you undergone a treatment or procedure and only found out in hindsight that it carried risks your doctor didn’t tell you about? This may be a breach of his or her legal duty. Read more in our article.
Palliative care is a health service for patients with a terminal illness, the aim of which is a dignified life and pain relief. Legally, you have the right to refuse treatment, to choose a form of care (home, hospice), and to make an advance directive or medical power of attorney to ensure that your decisions are respected even if you lose the ability to express them. Family can make decisions for you in certain situations, but only according to your probable wishes. Conflicts can be resolved through complaints or legal action. Early legal preparation helps prevent disputes and enhances a person’s dignity at the end of life.
Any patient with a terminal illness whose goal is no longer a cure, but to ensure quality of life.
Basic health services are covered by the insurance company, but some additional services (e.g. hospice accommodation) may be charged for.
This is a legal document that tells the patient in advance what care they would or would not want if they were unable to make decisions.
Yes, if the patient is not competent – but only in accordance with his probable will. Not arbitrarily.
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