Medical Decisions in Mexico: What Expats Need to Know

A dear client — a dual U.S.–Mexican citizen — recently contacted us with an important question. She needed a medical power of attorney in Mexico as a precaution for an upcoming surgery in Quintana Roo. This is not the first time an expatriate has asked us about this topic, and together we decided it was important to share with our community.

How Mexico Differs from the U.S. and Canada

Unlike the U.S. and Canada — where a person may grant a durable medical power of attorney that remains valid even after they lose mental capacity — Mexican civil law works differently.

• No power of attorney remains valid once the grantor becomes legally incapacitated.
• A "medical POA" or "advance healthcare directive" as commonly understood abroad does not exist as such.
• No one can legally authorize the withdrawal of life support on behalf of another person.

State-Level Regulation in Mexico

Mexico does not have a federal law regulating advance directives; instead, regulation happens at the state level. Several states — such as Ciudad de México, Estado de México, Morelos, Aguascalientes, San Luis Potosí, Michoacán, Guanajuato, Coahuila and Nayarit — already have their own Ley de Voluntad Anticipada or "muerte digna" acts. Quintana Roo is now moving toward joining this group.

Each local law varies slightly, but they all share the same core principles:

• Respect for patient autonomy
• Palliative care
• Avoidance of extraordinary or disproportionate measures
• Ortotanasia as an ethical guideline

For expats living in Mexico, this means that the available options depend on the state where they receive medical care.

What Options Exist Today in Quintana Roo?

The New Legislative Initiative in Quintana Roo: Voluntad Anticipada & Ortotanasia

Shortly after our client executed her declaration before a notary, that notary shared with us a proposed legislative reform in the State of Quintana Roo. The initiative has not yet been approved, but it is currently under review in the State Congress.

What Is Voluntad Anticipada?

According to the draft law, Voluntad Anticipada is an autonomous, legitimate, and legally protected decision aimed at guaranteeing a person's right to a dignified death. It applies to patients in a terminal stage, with a life expectancy of less than six months based on medical criteria. In simple terms, it is a formal way for a person to state in advance what type of medical care they want — or do not want — if they reach a terminal condition.

Ortotanasia vs. Euthanasia

The legislative proposal is based on the principle of ortotanasia: allowing the natural process of dying to occur, avoiding the unnecessary prolongation of that process through extraordinary means, and ensuring dignity, comfort and pain relief through palliative care. It is not euthanasia. Euthanasia remains prohibited in Mexico. Ortotanasia does not induce or accelerate death — it simply avoids artificially extending the dying process when there is no reasonable possibility of recovery.

Two Legal Instruments Proposed

Final Thoughts

While Mexico does not recognize a medical power of attorney in the same way as the U.S. and Canada, there are meaningful mechanisms to express your wishes and protect your dignity — and the available options depend on the state where you receive medical care. The proposed legislation in Quintana Roo represents an important step forward for that state and for the many people — nationals and expats — who receive medical care here. At CityLaw.mx, we will continue to monitor its progress and help our clients understand how these changes may affect their planning.