Formalizing these documents before healthcare professionals has become the primary method for exercising the right to decide on future medical care. This modality accounted for 84.41% of all formalizations in 2025, with 44,365 documents. In comparison, 13.01% were formalized before a notary and 2.52% before three witnesses.
The advance directive document allows any adult with sufficient capacity to record their preferences for future medical care and designate a representative to ensure their wishes are followed. Women continue to be the main users, representing 63.77% of registrations (33,520 documents), compared to 36.23% for men (19,040).
Regarding territorial distribution, the province of Barcelona accounts for 74.74% of registrations. The Barcelona City health region leads in absolute terms with 13,767 registrations, while the Girona health region shows the highest rate per inhabitant (805.3 per 100,000 inhabitants).
The integration of the formalization and registration process within the healthcare system has been key to the increase. 84.98% of documents were registered directly from healthcare centers, surpassing the 51.66% of the previous year. By the end of 2025, 1,196 healthcare centers were participating in this registry.
The Department of Health has strengthened information and awareness campaigns, expanding resources on Canal Salut. The online self-learning course on advance directives for citizens registered 1,538 enrollments in 2025, with an 87.5% completion rate.
These results confirm the consolidation of a more accessible and integrated model within the healthcare system, which enhances individual autonomy and ensures that future health decisions are known and respected.
