In the Autonomous Region of Madrid, Healthcare Directives have been regulated at regional level since 2001 by the Ley 12/2001, de 21 de diciembre, de Ordenación Sanitaria de la Comunidad de Madrid (Law 12/2001 of December 21^st, concerning Health Regulation in the Autonomous Region of Madrid).

The official name of Advance Directives in the Autonomous Region of Madrid is "Instrucciones Previas"

• Any individual over 18 years of age who is acting freely and not legally incapacitated may draw up a healthcare directives document.

• One or more proxies may be appointed to act as interlocutors with doctors and healthcare personnel with regards to the content of advance directives.

• The proxy may be any individual of legal age who is legally qualified to act in this capacity, with the exception of the following individuals: the notary who authorises the Advanced Directives Document; the civil servant in charge of the Advanced Directives Registry (in the event that the document is executed before personnel in the employ of the Administration); the witnesses before whom the document is formalised; and the staff in the health institution where the Advance Directives will be applied.

• Once executed, the Advance Directives document may be modified, substituted or revoked by the executor at any time and a written record will be made. In the event that the Advance Directives have been registered, modification, substitution or revocation will be requested via the official model prior to re-registration.

• In addition to the National Registry of Healthcare Directives, Madrid has created its own registry, a dependency of the Autonomous Government’s Department for Health, wherein executors may register their documents. This registry is connected to the National Registry of Healthcare Directives.

• As of the 1^st of January 2010, 5,209 advance directives have been registered in the Autonomous Region of Madrid (the equivalent of 81.6 healthcare directives per 100,000 inhabitants).