Modelo de Compliance Biolegal y ética en la toma de decisiones de fin de la vida

The study aimed to analyze the clinical, bioethical, and legal components related to Biolegal Compliance in end-of-life decision-making for patients receiving palliative care, with particular attention to mechanisms designed to respect patient autonomy and preferences and to guide healthcare professionals’ practice. A systematic literature review was conducted following the PRISMA guidelines, with searches performed in PubMed, Scopus, LILACS, and SciELO for studies published between 2016 and 2026. The results revealed difficulties related to identifying and respecting patients’ wishes, limiting treatments, and implementing palliative sedation. Challenges were also identified regarding healthcare professionals’ preparedness, communication with patients and their families, documentation of decisions, and the existence of clearly defined institutional procedures. The main mechanisms described included clinical protocols, advance directives, documentation practices, and the involvement of professionals or committees specializing in bioethics. Based on these findings, Biolegal Compliance may constitute an integrative approach to coordinating these mechanisms and promoting clear, organized, and traceable decision-making processes. Although the studies analyzed do not explicitly use this concept, its components are present in the literature and provide a basis for integrating clinical, bioethical, and legal dimensions, respecting patients’ preferences, and guiding professional practice when complex end-of-life decisions arise.