Medical Directive

[zippydedodah]

Back in USA, i had a medical directive on file with my medical provider (Kaiser). It detailed what should be done "in the event of" and who should make decisions if i was incapacitated. Does such a thing exist in Thailand?

Recent experience with the wifes father really raise the question.

He was declared brain dead, due to a stoke, but the family refused to take him off ventilator as long as the heart was beating... said it would be the same as killing him. This might have gone on for a long long time, with tremendous emotional and financial cost to the family. Fortunately, in this case, it did not.

I might care to have a different medical path, if such an event were to happen to me (like pull the plug!)... how can i insure that my wishes are followed?

Or... is the simple fact that we are in thailand, my wife is thai, therefore, any decisions SHE makes are the final ones, as far as doctors are concerned?

Comments? Suggestions?

[SoloFlyer]

Good question.

[Nawtier]

Perhaps put it on file with your insurance company......perhaps not, they might be too quick to act........say a broken leg or such and call for euthanasia.

[Nawtier]

Tell your wife to do as explicitly instructed as your request, on the advice of doc if same happens to you.

Tell her if she does not, you will return and haunt her for the rest of her life, no matter where she moves and how many monks she gets in to get rid of you.......should work a treat

[jayinoz]

SHE will pull the PLUG as soon as she can LOL.... do not worry about that. Hopefully not too soon. Lol.

Seriously this is what a 'THAI Will' should detail.... as assets in Thai and elsewhere need to be distributed to loved ones. Not caught up in legal fees and government BS.

Also a copy of instructions in medical care should be included, as well as buried, cremated, etc. Give copy to trustee, loved ones and lawyer then it all done. Trustee should follow through on your wishes then all A OK.

Any amendments should be given as an update to all. I have amended mine 5 times in last 10 years. Still only 35yo.... most do not wish to think about it. I been at my old man for years to include a grand child they care for full time as equal to adult siblings. As he has a fair few 10s $US Mil to distribute. Yet thinks all will sort its self out- but it a fact that us siblings will probably battle to the death for a higher cut when the time comes. Lol. So huge costs to lawyers and government seem ripe for such cases.

Your trustee should be your most trusted person or group of people. Sometimes this is not your spouse as is often the case in the Thai\Farang deal. Chok Dee.

Cheers JAY

[BarnicaleBob]

In America this is called a Living Will; An advance health care directive, also known as living will, personal directive, advance directive, or advance decision, are instructions given by individuals specifying what actions should be taken for their health in the event that they are no longer able to make decisions due to illness or incapacity, and appoints a person to make such decisions on their behalf.

This is from the Thai Health Act of 2007:

"Section 12: An individual is entitled to make a Living Will expressing that person's intentions to refrain from receiving medical treatment for the purpose of extending the last phase of their life or for ending the suffering arising from the illness.

The Living Will should be based on the principles and regulations of the Ministerial Regulation.

Public health officials abiding by the Living Will, based on paragraph 1, "are not conducting themselves improperly and will not be held responsible."

Of course there is one thing you should be aware of when picking the person to be the holder of this document; If it is your wife, you have to take into account would she do anything to prolong your life in order to keep the retirement checks coming? Good reason to consider a third party to manage this for you.

[zippydedodah]

jayinoz: there is NO will, and NO executor until i am dead... not before.. even if i am brain dead, that is not ded dead.... so that does not come into play.

barnicalebob: yes, i completely agree and a few years ago, i was part of a similar situation. An old friend, living in thailand (he is american) married to thai, was on ventilator and unlikely to recover. Now... on file, in america, was the power of attorney and medical directive, that gave a mutual friend the decision making power. Now, enter the thai wife, into thai hospital, with thai doctors and she is paying the thai bills. My friend in USA was hard pressed to enforce his authority - in fact, at the end of the day, he could not. The thai hopital (that famous one in BKK) would only recognize the wife's wishes... some guy on the phone from USA, trying to bark orders was no good... fortunately... our friend recovered and has lived to tell the tale.

Granted, a designated 3rd party in thailand MIGHT be usefull... but where/how will they get authority?

In other words... again... is there such a thing as a medical directive here in thailand?

[uptheos]

"Or... is the simple fact that we are in thailand, my wife is thai, therefore, any decisions SHE makes are the final ones, as far as doctors are concerned?"

As long as your bills are being covered by insurance it is most likely that your wife will adhere to whatever the 'God' doctors tell her.

If she's drawing lots of money out of your (her) account day after day to pay, then this might change how she thinks.

Dying in Thailand isn't a problem, but finishing up in a vegetative state is!

It's not something a lot of people want to discuss, many seem to think that the LOS somehow finds its way into your hospital room at such times, which it does not. Once in, if there is a money making opportunity to be had then be assured the hospital will go for it.

If you make advance directives, make enough copies so that not just one or two people know.

These things are only as good as the people you trust to come forward at such times.

Thanks for raising the awareness.

[elektrified]

SHE will pull the PLUG as soon as she can LOL.... do not worry about that. Hopefully not too soon. Lol.

Seriously this is what a 'THAI Will' should detail.... as assets in Thai and elsewhere need to be distributed to loved ones. Not caught up in legal fees and government BS.

Also a copy of instructions in medical care should be included, as well as buried, cremated, etc. Give copy to trustee, loved ones and lawyer then it all done. Trustee should follow through on your wishes then all A OK.

Any amendments should be given as an update to all. I have amended mine 5 times in last 10 years. Still only 35yo.... most do not wish to think about it. I been at my old man for years to include a grand child they care for full time as equal to adult siblings. As he has a fair few 10s $US Mil to distribute. Yet thinks all will sort its self out- but it a fact that us siblings will probably battle to the death for a higher cut when the time comes. Lol. So huge costs to lawyers and government seem ripe for such cases.

Your trustee should be your most trusted person or group of people. Sometimes this is not your spouse as is often the case in the Thai\Farang deal. Chok Dee.

Cheers JAY

Trust Law is not recognized in Thailand. Therefore, no such thing as a Trustee here. I don't know if they have Probate Courts, appoint Executors and such...but no Trustees.

[Nawtier]

j. some guy on the phone from USA, trying to bark orders was no good... fortunately... our friend recovered and has lived to tell the tale.

Granted, a designated 3rd party in thailand MIGHT be usefull... but where/how will they get authority?

You dont sound too happy with the outcome.......were you in the will ??

I would say good on the thai wife in this situation.

[zippydedodah]

"Or... is the simple fact that we are in thailand, my wife is thai, therefore, any decisions SHE makes are the final ones, as far as doctors are concerned?"

As long as your bills are being covered by insurance it is most likely that your wife will adhere to whatever the 'God' doctors tell her.

If she's drawing lots of money out of your (her) account day after day to pay, then this might change how she thinks.

Dying in Thailand isn't a problem, but finishing up in a vegetative state is!

It's not something a lot of people want to discuss, many seem to think that the LOS somehow finds its way into your hospital room at such times, which it does not. Once in, if there is a money making opportunity to be had then be assured the hospital will go for it.

If you make advance directives, make enough copies so that not just one or two people know.

These things are only as good as the people you trust to come forward at such times.

Thanks for raising the awareness.

thanks for the thoughts... but again, i cannot see where anyone else's ability to ENFORCE anything in the face of the wife would come from.

I am not saying i do NOT trust the wife, in fact, i do... But at the end of the day, she is thai and all her promises to abide by my wishes could be overridden by her cultural mandates = until the heart dies, he is alive. So.. in spite of how it might impact her financially, in spite of how she might WANT to honor my wishes, her cultural imperative and fear of damning her soul (her monk brother told her that she better NOT authorize taking dad off ventilator or she would spend a thousand lifetimes in hell!), could supersede it all and i could end up vegging out .... and out... and out...

I know that my kids in america would not want that, i would not want that... but how could they (the kids, for example) do anything?

[Theo007]

It is possible to make a " Living Will " which gives instructions to the hospital. A copy of this may be found on The Pattaya Expats Club web page. Download it, fill it in and have it placed in your file at the hospital of your choice.

[zippydedodah]

It is possible to make a " Living Will " which gives instructions to the hospital. A copy of this may be found on The Pattaya Expats Club web page. Download it, fill it in and have it placed in your file at the hospital of your choice.

thank you for that reply. I dug into google and found the legal basis for the document: http://www.loc.gov/lawweb/servlet/lloc_news?disp2_l205401531_Death%20and%20dying

Looks to be exactly what i am looking for.

zippy

[Chrisf]

We do advanced directives at Chiang Mai University with the Clinical Pastoral Education Program. If you need one you can find details here:

http://www.chiangmaicpe.org/services

Edited May 15, 2011 by Chrisf

[uptheos]

It is possible to make a " Living Will " which gives instructions to the hospital. A copy of this may be found on The Pattaya Expats Club web page. Download it, fill it in and have it placed in your file at the hospital of your choice.

I'd have copies in a lot more places than 'the hospital of your choice'.

You can't guarantee which hospital you are going to finish up in.

You need people whom you trust and who have no fear of damnation or bad karma, to come forward at such times to try and get the living will wishes enforced.

It's worth considering filing a copy with your lawyer and regular GP if you use one.