Certification of a patient's will in healthcare institutions: Medico-legal challenges and practical application

Aim: To analyze medico-legal challenges and the practical application of patients' will certification in healthcare institutions during inpatient care.

Materials and Methods: A retrospective medico-legal analysis of court decisions from the Unified State Register of Court Decisions of Ukraine (2015-2026) was conducted. Of more than 450 identified cases, 60 met the inclusion criteria related to disputes over wills certified in healthcare institutions. Statistical analysis included Pearson's χ² test, Fisher's exact test, and odds ratios (OR) with 95% confidence intervals (CI). Additionally, a survey of 28 medical professionals assessed practical aspects and challenges of will certification in clinical settings.

Results: Wills certified by medical professionals and healthcare institution officials accounted for 60.0% of cases, while 40.0% were notarized. The proportion of wills declared invalid or void was significantly higher in the medical group (41.7%) compared to the notarial group (12.5%). A statistically significant association was identified between the certifying subject and court outcomes (χ² = 5.83; p=0.016; Fisher's exact test p=0.031). Certification by medical personnel was associated with a fivefold increase in the likelihood of invalidation (OR=5.0; 95% CI: 1.24-20.15). Survey findings revealed insufficient legal knowledge and difficulties in assessing testamentary capacity and voluntariness.

Conclusions: Wills certified in healthcare settings demonstrate lower legal reliability compared to notarized wills. This may be attributed to clinical, organizational, and legal factors, including challenges in capacity assessment and limited legal training of medical staff. The findings highlight the need for improved interdisciplinary protocols.