“Great is the art of beginning, but greater is the art of ending.”

I really like law. I went to school (among other things) for biology, anthropology and law. Exploring these various subjects allows me the opportunity to appreciate human nature from a privileged perspective.

“A thousand lawyers at the bottom of the ocean is a good start” said Joe Miller in the movie Philadelphia. I get it, people do not like attorneys, and people take law for granted, but the most important events in our lives are legal in nature; to be born, to get married, to have children, to buy a house, to get divorced, and to die. All of these events have a profound impact in our lives, and yet people generally do not realize the how juridical these events are. Even, the most mundane activities develop and function within the realm of law such as purchasing groceries at the store, using a cellphone, using electricity in our homes, driving a car, eating in a restaurant, and pooping.  Seriously, have you thought about poop and law? Do you think that you can poop anywhere? We have legally decided where to poop, where it goes, and what to with it.  Anyhow, among all of the legal things happening in our lives, being born and dying are the two most important.

When we are born, our parents are legally obligated to take care of us up to the age of 18, even the government and the people at large have certain obligations with us. There are laws protecting the right of access to education, healthcare, protecting minors against child labor, domestic violence and sexual activity. We have nothing to do but cry, sleep, eat and poop in the dawn of our lives. An interesting aspect of our legal existence is that it only begins once we are born but it persists even after our death. It persists as our estate.

Today, we will talk about our estate, the disposition of our assets according to our will. We will also talk about the legal action of dying, what to expect and what to do when dying in Costa Rica. These topics are quite extensive so we will break it down in two installments. First, we will talk about the considerations when passing away, and in our second installment we will talk about our assets.

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Passing Away

Death is a very sensitive topic for most people. Emerson shared with us the thought that life is a journey and not a destination. It is my thought that our departure is an opportunity to celebrate our existence, to commemorate the chapters of that journey.  People have a hard time coping with the idea of death, primarily because we tend to focus on the departure instead of the journey. When my father passed away, my mother asked me to share some words at the pulpit with the attendees. I did not want to talk about how sad I was because it was an overstatement, people certainly expected me to be sad for the passing of my father. Instead, I talked about something they did not expect. This one day, while my father was taking a shower, he heard the cries for help from my little sister and mother who pointed out to my dad that a fire had started in the electric meter out on the street. My father put on a towel around his waist and ran out to the sidewalk to put out the fire. The meter was about seven feet high, so my father decided to take his bath towel off to whip it at the meter to put the fire out while all of the neighbors astonishingly looked at my dad’s naked bottom. At the end of the story, everyone was laughing at church that day, including my mother and sisters.

It is difficult to wrap our heads around us passing away on the one hand, but we also face great difficulties dealing with the loss of our immediate relatives and close friends. I suggest that we embrace death as the natural and unavoidable event that it is as part of our existence. The riddle of what happens after death has entertained our minds for thousands of years and it is not my intention to begin speculating about the after death. However, what I can tell you that if we socially and casually talk about death, and seriously address this subject with our families, we will all be better prepared when the event happens.

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What to do

For expats, living in another country represents the peculiar challenge of distance. One is faced with the question of whether to have a funeral service in Costa Rica or back at the home country which brings a particular set of challenges. I have never seen a case of an expat wanting to have funeral service back in their home country or wanting to have their remains sent. Primarily, when the remains are transported back to the home country is when the decedent is a tourist without any ties to Costa Rica, thus it will make sense to have the remains transferred close to home.

If you are not a tourist and your place of residence is in Costa Rica, you will have to make some decisions regarding your remains, whether to have a funeral in Costa Rica, or whether to have a funeral back in your home country, should you be cremated or would you rather donate your body to a medical school. All of these are valid options which should be considered.

Doing a funeral service is complicated as far as trying to coordinate with your family to travel to Costa Rica or whether to send your remains back to your home country. I have never encountered a situation under which the decedent desired to have the remains transferred to the US. Expats always choose for their remains to stay in Costa Rica. Transporting a body in a special coffin by plane back to the US, Canada or Europe is quite expensive. As you may imagine, there is some paperwork required to make that happen, but on the other hand, there are the costs of transportation. Funeraria del Recuerdo has extensive experience with the transfer of human remains out of the country. They process the paperwork as well as arranging the transportation of the remains. In the case of US nationals, the US Consulate is also involved in the process of coordinating the paperwork and the transportation. If this is something that you may want, it is possible to arrange for these services ahead of time.

For people who do not wish to transfer their remains to their home country, they will need to determine what they want to do with their remains in Costa Rica.

I have noticed a lot of times that expats decide to donate their bodies to a medical school. Currently, there are four schools to which you can donate your body, these are the Universidad de Costa Rica, UCIMED, Universidad Latina and UNIBE. In order to donate your body, it is required to complete some paperwork with the university. Needless to say, it is required to do some coordination with the medical school once the event happens for the university to collect the remains and transport them to their campus. A recurring question that we are asked is: what happens with the remains once the medical school is done with the body? Well, as far as I have been told by the various schools is that they place the remains in a common grave. Some people do not feel comfortable with this idea and prefer to have their bodies cremated instead of donating it to the medical school. An interesting comment that I have heard from the staff and the universities dealing with this type of process is that most of the bodies donated are from expats, ticos are not that much into this practice.

If having your body on a stainless steel table to be cut open and poked by strangers is not your thing, then, you can either do a regular funeral and bury your body, for which you will need to purchase a lot in a cemetery. In Costa Rica, you will be able to find both public and private cemeteries. Private cemeteries can cost thousands of dollars, while the local public cemeteries which are administered by the municipalities are a lot more cost efficient.

The last option is to do a cremation. There are three services in the country who offer cremation. Generally, the other funeral homes coordinate with the cremation company to have the service completed.

The costs for all these services can range between $1000 and $5000 USD depending on what you want to do. As mentioned, the appropriate thing to do is to plan ahead in order to have things taken care off once you embark in that your journey.

All of these previous lines have been focused on when one passes away. But, we also need to do some planning as far as protecting your interests while you are still alive, but unconscious. Do not resuscitate orders are not very common in Costa Rica, but they are legally possible. I will need to make some points here, so please bear with me.

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Do Not Resuscitate

A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. Unless given other instructions, hospital staff will try to help any patient whose heart has stopped or who has stopped breathing.

In Costa Rica, these type of dispositions are not very common. For the most part, people just accept whatever the doctors tell them to do. The average tico sees a medical professional with an aura of authority, so whatever the doctor says it is ok. Nevertheless, people have the right to reject treatment.

To analyze DNRs we should see it from the prism of euthanasia. There are two types of euthanasia, passive and active.  Active euthanasia is the most controversial as it allows the patient to actively terminate his/her own life by various means. Passive euthanasia entails the withholding of common treatments, such as antibiotics, necessary for the continuance of life.  Active euthanasia entails the use of lethal substances or forces, such as administering a lethal injection. As of June 2016, passive euthanasia is legal in the Netherlands, Belgium, Colombia, and Luxembourg. Active euthanasia or assisted suicide is legal in Switzerland, Germany, Japan, Canada, and in the US states of Washington, Oregon, Vermont, Montana, and California. DNR orders can be interpreted as passive euthanasia since it entails the withholding of medical treatment.

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A significant variable and a point of controversy with passive euthanasia is whether the patient has the cognitive ability to make the decision to withhold treatment. The purpose of a DNR order is to be effective while the person is not conscious. If there is not a DNR order, who makes that decision?

Under Costa Rican law, the medical staff, and primarily, the physician in charge are the ones who make that call. As noted, DNRs are not very common in Costa Rica and there is the prevailing practice that the physician is obligated to do whatever it is possible to keep a patient alive.

In Costa Rica, there is currently a bill in Congress to allow passive euthanasia. It never ceases to impress me how representatives in Congress do not read the already existing law, as there is already provision in the law that allows people to practice passive euthanasia. It is contained in section 46 of the Civil Code which states that every person has the right to refuse: a medical exam, medical treatment or a surgical procedure with the exception of mandatory vaccinations required for the protection of public health.

People will be faced with two options, they can either enforce their right to refuse medical treatment while conscious; or they can delegate that authority to a proxy through a power of attorney if it happens that the patient is unconscious.  DNRs are a mild form of passive euthanasia as it only involves withholding minor treatments, but it does not engage on the cessation of extensive medical treatment or surgery. When drafting a medical POA people need to be very detail regarding the possible variables of a medical condition that may be life-threatening. For the most part, people think about DNR orders in order to avoid being brought back to life in a vegetative state, but not all instances of unconsciousness can result in vegetative estate. A life can be saved with just a blood transfusion or an EPI pen.

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So, what did we learn?

Well, you can make some planning in order to enforce some final dispositions during and after your passing away. Part of the planning includes allocating some funds to that purpose which can come out of your estate, which we will talk about next.

If you have any questions or comments about this process, please drop us an email. We will be glad to answer your questions and help you with your planning.

Rafael Valverde