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Thai doctors lose case against 'right to die' rule


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Doctors lose case against 'right to die' rule

THE NATION

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BANGKOK: -- THE SUPREME Administrative Court yesterday dismissed a petition from some doctors opposing a ministerial regulation that, in effect, gives patients "the right to die".

The regulation, which came into effect during the term of the Yingluck Shinawatra-led government, recognises patients' living wills, in which they can spell out their preferences for medical care at a time when they are unable to make decisions for themselves. In the living will, they can state what kind of treatments they would or would not want to receive when they reach a terminal stage. Doctors are legally required to comply with these wills.

The Supreme Court said yesterday that this regulation was in line with Article 38 of the 2007 Constitution, which enshrines people's rights and liberties, as well as the World Medical Association's announcement on patients' rights.

"This regulation has already taken into account the opinions of professional bodies and various organisations," the court added.

Dr Thapanawong Tang-uraiwan, Dr Cherdchoo Ariyasriwattana, and Dr Oraphan Methadilokkul have been trying to get this regulation nullified, as they believe it goes against the Medical Practice Act and is unethical.

They also pointed out that the regulation requires doctors to stop treating patients, when doctors have been taught to never stop saving a life.

The three doctors also said that many lives would be unnecessarily lost if this regulation is enforced.

"Nobody really knows when exactly a condition can become terminal," the petition said.

Defendants in the case are former PM Yingluck and then-public health minister Wittaya Buranasiri, as the regulation was passed by their administration. None of the complainants showed up at court yesterday, though officials from the Public Health Ministry turned up as representatives of the defendants.

Source: http://www.nationmultimedia.com/national/Doctors-lose-case-against-right-to-die-rule-30262647.html

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-- The Nation 2015-06-19

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"The regulation, which came into effect during the term of the Yingluck Shinawatra-led government, recognises patients' living wills, in which they can spell out their preferences for medical care at a time when they are unable to make decisions for themselves. In the living will, they can state what kind of treatments they would or would not want to receive when they reach a terminal stage. Doctors are legally required to comply with these wills."

Good.

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Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

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Why on earth would the ex-minister who brought about the regulation be a defendant? It's out of her hands completely now. If it's a ministerial regulation, then the current minister listens to the petition and then defends it or not.

Bizarre.

One good thing from the YL administration.....and yes, Robby, private hospitals would be very interested in having patients lingering for as long as possible...a VERY good reason to maintain the regulation.

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Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

Robby, to be honest i think that really does come into the decision here. Hospitals are greedy to the extreme here. Anyway good that Thailand follows the more enlightened countries where one has the right to die. Well done YL for something good for the people.

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Could it be the good doctors are bemoaning the loss of revenues from patients who chooses to

end life instead living in misery for them and their loved one? after all, they're running a business

aren't they? the doctor's oath is also about preserving people's dignity and free will, and not to be

subjected to a medico whims and orders just because he/she wears a white coat....

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Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

Robby, to be honest i think that really does come into the decision here. Hospitals are greedy to the extreme here. Anyway good that Thailand follows the more enlightened countries where one has the right to die. Well done YL for something good for the people.

Well done YL for something good for the people.

From robblok, Wow....................clap2.gifclap2.gif

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That is unfortunate, and reactionary rather than empathetic. It would be a different story if they or a loved one was it this position.

Essentially they are repealing provisions to allow for medical staff to consider the

Liverpool Care Pathway for the Dying Patient . Palliative units around the world consider this to be the best medium between actively prolonging a dying persons life and actively euthanasing individuals. There is a dignified pathway. Shame.

It is also a shame for the workers in a palliative environment.

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Could it be the good doctors are bemoaning the loss of revenues from patients who chooses to

end life instead living in misery for them and their loved one? after all, they're running a business

aren't they? the doctor's oath is also about preserving people's dignity and free will, and not to be

subjected to a medico whims and orders just because he/she wears a white coat....

It would be interesting to see which hospitals the doctors that complained about this regulation represent, for it is only private hospitals that have a financial interest in treating patients for as long as possible.

Don't start the 'all Thais are' BS, most doctors in this country are great and it is not them that would get the greatest benefit from a patient being kept alive in ICU but the private hospital which is a money making business.

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Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

Robby, to be honest i think that really does come into the decision here. Hospitals are greedy to the extreme here. Anyway good that Thailand follows the more enlightened countries where one has the right to die. Well done YL for something good for the people.

Well done YL for something good for the people.

From robblok, Wow....................clap2.gifclap2.gif

Why not I put her down for her faults, no problem to praise her for things she did do good. I even comment on things I don't like of Prayut. I have yet to find a government that I agree with 100% back home or here.

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Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

Robby, to be honest i think that really does come into the decision here. Hospitals are greedy to the extreme here. Anyway good that Thailand follows the more enlightened countries where one has the right to die. Well done YL for something good for the people.

Well done YL for something good for the people.

From robblok, Wow....................clap2.gifclap2.gif

The difference between enlightened liberals and close-minded conservatives.....liberals can face reality and not stick to one one-eyed, narrow-minded theme. They can give credit where credit is due.

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Could it be the good doctors are bemoaning the loss of revenues from patients who chooses to

end life instead living in misery for them and their loved one? after all, they're running a business

aren't they? the doctor's oath is also about preserving people's dignity and free will, and not to be

subjected to a medico whims and orders just because he/she wears a white coat....

It would be interesting to see which hospitals the doctors that complained about this regulation represent, for it is only private hospitals that have a financial interest in treating patients for as long as possible.

Don't start the 'all Thais are' BS, most doctors in this country are great and it is not them that would get the greatest benefit from a patient being kept alive in ICU but the private hospital which is a money making business.

There is a direct link between hospital profits and doctors salaries of course. But I can't say this is really the only reason. Some have religious reasons (could not find a vet to put down my suffering dog here either religion was often quoted during my search). So its possible some are against it on principle.

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Could it be the good doctors are bemoaning the loss of revenues from patients who chooses to

end life instead living in misery for them and their loved one? after all, they're running a business

aren't they? the doctor's oath is also about preserving people's dignity and free will, and not to be

subjected to a medico whims and orders just because he/she wears a white coat....

It would be interesting to see which hospitals the doctors that complained about this regulation represent, for it is only private hospitals that have a financial interest in treating patients for as long as possible.

Don't start the 'all Thais are' BS, most doctors in this country are great and it is not them that would get the greatest benefit from a patient being kept alive in ICU but the private hospital which is a money making business.

That is an interesting pov. Are you suggesting that their might be a medical faction with a political outlook?

I would not have thought so, actually doubt ward doctors would and agree with your comment re doctors generally in Thailand. Administrators might well have that inference you suggest and it would be disturbing if so. I doubt it would be financial as you suggest but other reason might pop up.

I reckon it is a conservative shot for gain from some quarter but really cannot see anyone finding the decision as being anything but regressive.

Edited by optad
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Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

Robby, to be honest i think that really does come into the decision here. Hospitals are greedy to the extreme here. Anyway good that Thailand follows the more enlightened countries where one has the right to die. Well done YL for something good for the people.

Of course in some of the supposed "enlightened" countries, absent a living will, they'll happily maintain you in a vegetative state for 15 years and the government will intervene to prevent a spouse from saying it's time to let the patient die.

Presidential hopeful Jeb Bush did all he could to prevent Terri's husband from allowing her to die.

In 1990, Terri Schiavo suffered major brain damage when her heart failed which cut oxygen to her brain. She entered the unfortunate condition of a persistent vegetative state. Her eyes are open and she goes through periods of sleep and wakefulness. But that part of her brain that controls most motor functions has been destroyed. She can breathe on her own, but cannot eat, thus she is kept alive with a feeding tube.

The legal fight over Terri Schiavo began almost immediately in 1990. Court-appointed doctors declared that Terri would never recover from the brain damage, and for the last 13 years, she's needed feeding and hydration tubes to stay alive. That's against her stated wishes, says Terri's husband Michael. He's been battling her parents in court, seeking to allow her to die. For all of the medical knowledge, legal wrangling and family anguish expended in the past 10 years over the fate of Terri Schiavo, the most pivotal question remains unanswered: Would the 39-year-old Florida woman want to go on living in her current vegetative state? That mystery could have been solved with a simple piece of paper - a living will

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Could it be the good doctors are bemoaning the loss of revenues from patients who chooses to

end life instead living in misery for them and their loved one? after all, they're running a business

aren't they? the doctor's oath is also about preserving people's dignity and free will, and not to be

subjected to a medico whims and orders just because he/she wears a white coat....

It would be interesting to see which hospitals the doctors that complained about this regulation represent, for it is only private hospitals that have a financial interest in treating patients for as long as possible.

Don't start the 'all Thais are' BS, most doctors in this country are great and it is not them that would get the greatest benefit from a patient being kept alive in ICU but the private hospital which is a money making business.

That is an interesting pov. Are you suggesting that their might be a medical faction with a political outlook?

I would not have thought so, actually doubt ward doctors would and agree with your comment re doctors generally in Thailand. Administrators might well have that inference you suggest and it would be disturbing if so. I doubt it would be financial as you suggest but other reason might pop up.

I reckon it is a conservative shot for gain from some quarter but really cannot see anyone finding the decision as being anything but regressive.

"Administrators might well have that inference you suggest [??] and it would be disturbing if so. I doubt it would be financial as you suggest but other reason might pop up."

"I reckon it is a conservative shot for gain from some quarter but really cannot see anyone finding the decision as being anything but regressive."

I'm sure you have a point to make, but I can't fathom what it is.

The right to die is regressive?

Edited by Suradit69
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Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

Robby, to be honest i think that really does come into the decision here. Hospitals are greedy to the extreme here. Anyway good that Thailand follows the more enlightened countries where one has the right to die. Well done YL for something good for the people.

Of course in some of the supposed "enlightened" countries, absent a living will, they'll happily maintain you in a vegetative state for 15 years and the government will intervene to prevent a spouse from saying it's time to let the patient die.

Presidential hopeful Jeb Bush did all he could to prevent Terri's husband from allowing her to die.

In 1990, Terri Schiavo suffered major brain damage when her heart failed which cut oxygen to her brain. She entered the unfortunate condition of a persistent vegetative state. Her eyes are open and she goes through periods of sleep and wakefulness. But that part of her brain that controls most motor functions has been destroyed. She can breathe on her own, but cannot eat, thus she is kept alive with a feeding tube.

The legal fight over Terri Schiavo began almost immediately in 1990. Court-appointed doctors declared that Terri would never recover from the brain damage, and for the last 13 years, she's needed feeding and hydration tubes to stay alive. That's against her stated wishes, says Terri's husband Michael. He's been battling her parents in court, seeking to allow her to die. For all of the medical knowledge, legal wrangling and family anguish expended in the past 10 years over the fate of Terri Schiavo, the most pivotal question remains unanswered: Would the 39-year-old Florida woman want to go on living in her current vegetative state? That mystery could have been solved with a simple piece of paper - a living will

Sorry, I don't consider the US enlightened on how it goes around with this issue. There are a lot of religious fanatic Christians in the USA. I would almost never call the US enlightened in its policies.

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I am not sure if I understand the last sentence, but if you mean to infer that doctors are agains the right to die for financial reasons... do you really believe there is not a doctor in the world who opposes the right to die on moral or ethical ground?

Incidentally, I am for the right to die.

Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

Edited by does
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I think a lot of the objections in Thailand would be due to misapplication (can't think of a more appropriate word at the moment) of Buddhism. Not treating a patient could be equated with doing harm resulting bad karma for the medical staff concerned.

Rather, they should not focus on treating an incurable problem, but respect the patient's wishes and provide proper palliative care. Make the patients last days as comfortable as possible. Surely, from a Buddhist perspective those acts would be considered meritorious.

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As far as I am concerned these doctors need to learn that the are not omnipotent. I was not able to choose to be here, my selfish parents took that decision. But sure as hell I will decide when and how I leave, and no doctor is going to stop me nor any law. All doctors, no matter how qualified they are nothing more than garage mechanics and have no right to run counter to my decisions. It is my body and my life and l have total control over it.

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Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

You hit the nail on the head. They want to treat you till you have no money left. Once your money runs out I wonder how far their Hypocratic Oath would extend. Next patient please.

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I am the surrogate in many living Wills and it is basically withholding life sustaining machines and medicine.

One person was well and truly dying with prostate cancer and in extreme pain. The hospital was giving him injections that did nothing for the cancer - nothing- but each shot was 32000 baht. When I told the hospital to stop they said they had already bought the medicine. I could not believe what I was hearing.

All medicine and machines were removed except comfort drugs and nurses. ie morphine for pain and sleepers. Nurses to wash him etc.

I am glad this Law has been upheld and that more and more doctors and hospitals have to adhere to it.

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I am not sure if I understand the last sentence, but if you mean to infer that doctors are agains the right to die for financial reasons... do you really believe there is not a doctor in the world who opposes the right to die on moral or ethical ground?

Incidentally, I am for the right to die.

Now there is something good that the Yingluck administration did.

I suppose if a doctor in a private hospital stops treating a patient in accordance with a living will and the patient dies then payment to the hospital stops. But that wouldn't come into the decision to petition against the regulation.

You must take both sentences together, the last is not a statement on its own.

The statement was not about a doctor but about the hospital, in this instance a private hospital.

What I want is doctors and hospitals to respect the wishes of someone who has made a living will (the subject of this topic) and not keep them alive by machine or medication when there is no hope of recovery against their express written wishes.

In this day and age it is easy to keep someone breathing and their heart beating even when all brain activity has stopped and there is no way they could ever wake to any sort of life. That is what I am against, if I were in that condition I would not want to be kept "Alive" with someone paying for the treatment.

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the topic of confort drugs is also being bandiad around, let a person have a choice. to personally have input based on her/his ability to withstand pain. i personally feel the awareness.withstanding of pain decreases as age increases, let the patient choise a level too many people act as they are the creator and the exterminator

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"The regulation, which came into effect during the term of the Yingluck Shinawatra-led government, recognises patients' living wills, in which they can spell out their preferences for medical care at a time when they are unable to make decisions for themselves. In the living will, they can state what kind of treatments they would or would not want to receive when they reach a terminal stage. Doctors are legally required to comply with these wills."

Good.

I wonder if these are the same doctors who would argue that terminally ill patients should not be given morphine as this would cause them to become addicts? I'm thinking probably. Ibuprofen for terminal cancer and HIV. Compassion in Thailand knows no bounds - especially in a medical community that refuses to make effective palliative care and drugs available to all.

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Well done to yinglucks administration. A good lesson to the bitter and twisted that it does not matter who implements a policy it is what the policy is that counts.

We should all have the right to die under certain circumstances and if we don't the 20 story building next door is always a good alternative. I would prefer to die with dignity though.

Again, well done to the yingluck government...

Edited by djjamie
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