Organ donation and living will (advance directives)

The living will is the popular name for the advance directives document (documento de instrucciones previas). It is regulated by article 11 of Ley 41/2002, de 14 de noviembre, the basic law regulating patient autonomy.

It is the document through which a person states in advance their wishes regarding healthcare and treatment, and the destination of their body or organs once deceased, so that these are fulfilled when they can no longer express themselves.

It also allows you to appoint a representative: the person who will interpret your wishes and speak to the medical team on your behalf. It must always be in writing and can be freely revoked at any time.

Any adult of sound mind acting freely can make one. You do not need to be ill or of advanced age: it is a precaution that any adult can put in place.

In the document you can indicate which treatments and life support measures you accept or refuse, in which situations you want them applied, your values and life goals, whether or not you wish to donate your organs and tissues, and who your representative will be.

There is a legal limit: instructions contrary to the legal system or to lex artis (good medical practice) will not be applied, nor will those that do not correspond to the factual situation actually foreseen in the document.

Depending on your autonomous region, the document can be made before the staff of the regional registry, before a notario (Spanish notary) or before 3 witnesses who meet the required conditions. Managora prepares the document according to your region's model and accompanies you in the registration.

Once signed, it is registered in the advance directives registry of your autonomous region. That registry transfers the document to the National Registry of Advance Directives (RNIP) of the Ministry of Health, so that it is valid throughout the territory.

Thus, any doctor responsible for your care can consult it when needed, regardless of the region you are in. It is also advisable to give a copy to your representative and inform your family.

Spain is governed by presumed consent (Ley 30/1979 and Real Decreto 1723/2012): everyone is considered a donor unless they have expressly recorded their opposition during their lifetime.

In practice, before a donation, the advance directives registry is consulted and the family is informed. When there is an express wish left in writing and registered, that wish prevails and must be fulfilled: the family is consulted and informed, but they do not decide against what you have stated. That is why it is advisable to leave your wishes in writing and communicate them to your loved ones, so there are no doubts.

The donor card issued by the National Transplant Organisation (ONT) has testimonial value: it is a way of expressing the desire to donate, but it is not a legally binding document nor does it record personal data. The most solid way to record this is the registered living will.

Registering the document in your region's advance directives registry is free, just like obtaining the ONT donor card.

The time depends on the appointment given by your region's registry. Once signed, integration into the National Registry is fast and from then on the document is available to healthcare professionals.

Managora prepares the document, adapts the content to your wishes and manages the registration for you. You can see the updated service fee on the procedure's page.

The framework remains in force and stable as of 17 July 2026. The basis is Ley 41/2002 (article 11) and Real Decreto 124/2007, which regulates the National Registry of Advance Directives.

Real Decreto 415/2022, de 31 de mayo, updated that registry to include the provision of medical aid in dying (Ley Orgánica 3/2021) as one of the matters that can be included in the declaration.

Organ donation maintains the presumed consent of Ley 30/1979 and Real Decreto 1723/2012. There are no new regulatory changes in 2026 regarding these documents.