Thailand's National Health Act allows Thai nationals and residents to set out in advance which life-prolonging treatments they do not want at the final stage of terminal illness. Known formally as a Declaration of Intent and commonly as a Living Will, the document is protected under Section 12 of the National Health Act B.E. 2550 (2007). Medical staff who follow a valid declaration are legally protected from liability. For foreigners living legally in Thailand, this offers a way to record end-of-life wishes before a medical crisis leaves family members, partners or doctors having to make difficult decisions without clear instructions. What a Living Will does - and does not do A Living Will is not euthanasia, which remains illegal in Thailand. It does not authorise anyone to actively hasten death; instead, it permits a person to refuse procedures which artificially extend dying when there is no prospect of recovery. Palliative and comfort care must continue. This can include pain medication and oxygen, while the treatments declined may include CPR, intubation, tracheotomy, dialysis, feeding tubes, antibiotics or intravenous fluids that offer no clinical benefit. The declaration takes effect only in two circumstances set out in ministerial regulations: an incurable illness or injury diagnosed by the attending doctor, under medical standards, as inevitably leading to death within a short period; or permanent loss of cerebral cortex function, leaving a person unable to perceive or communicate beyond automatic responses. It does not apply to emergencies where there is a realistic chance of survival. Someone injured in a car crash, for example, would still receive full resuscitation. Who can make one and what it needs Anyone aged 18 or over and of sound mind may make a Living Will, whether or not they are ill. Those with chronic conditions are advised to discuss likely progression and treatment options with their treating physician first. The document must include the person’s full name, age, national identification number and contact details; the date; and the full name, national identification number and relationship of at least one witness. It must clearly state which treatments or healthcare services are refused. If another person writes or types it, their name and national identification number must be included. The person, witness and any writer must sign or provide fingerprints. A person may also appoint someone to clarify their intentions, provided that person signs and supplies identification details. End-of-life preferences - including where they wish to die, emotional or psychological support, and religious or cultural practices - can also be added. Medical facilities must reasonably cooperate with those preferences. Keep it available and discuss it The document can be changed at any time, with the latest version taking precedence. People should tell relatives, spouses, siblings and treating doctors where it is kept, and ensure it is presented promptly when they are admitted to hospital. Dr Thakoon Kanjanopart, an internal medicine physician specialising in palliative care, stated that two or three ICU beds can typically be occupied by patients certain to die while patients with a chance of survival cannot access them. He said the document is only one part of Advance Care Planning: continuing conversations with loved ones and medical teams. Those discussions can spare families conflict, uncertainty and guilt when a patient can no longer speak. Picture courtesy of Thaiger Join the discussion? 21 August 2026
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