Living Wills in Thailand

[uptheos]

Can anyone give a definite answer saying they are, with a link showing that they are both legal and must be recognized?

[CharlieH]

If you do a search on this forum for "living will" you will find a number of topics on it.

Here is a start, that may be of interest.

"BANGKOK: THE OFFICE of National Health Commission (ONHC) is planning to raise public awareness about terminal patients right to die, after the Supreme Administrative Court recently endorsed the legitimacy of living wills"

http://news.thaivisa.com/thailand/commission-to-raise-awareness-of-living-wills/99743/

[uptheos]

Thank you Charlie, but despite recommendation to recognize them, I sill can't find any articles that say doctors must unequivocally follow the instructions in the Living Will. Which leads me to believe it would be pot luck depending where you finished up. Of course you could end up in a place with Doctors that agree with living wills I doubt if there's anywhere that states 'the patients wishes must be followed to the letter or legal action will follow'. It would be followed to the letter in a legal WILL (i.e. if I left you my watch, legally you must get it, it's the law) but I have my doubts about Living Wills and I guess it's just a question of research, research and if something happens 'pot luck', Living Will or not..

[CharlieH]

As with many things here in Thailand there is rarely consistency, and I agree it may well be "pot luck". I would suggest maybe ask at the hospitals in your area, but then again, the answer you get may be different dependent on who you speak to. Not an easy or straight forward answer.( as usual). Perhaps someone could post with actual experience.

Will move this over to the Health forum, for possibly better knowledge/experience.

[uptheos]

It would be useful if someone with actual experience could post, but I doubt if anyone has actually used the procedure.

Anyone regardless or age could finish up in ITU if they were in the wrong time at the wrong place, being kept alive on

a respirator, multiple drugs, etc, with no real hope of recovery. I for one wouldn't like to be in that situation, yes it could run

into many millions of baht, but more so who wants to die in such an undignified long drawn out way People think it's never

going to happen to them, but I know of a situation where someone died, (actually never had a chance of recovering) and

the bill I believe was around $120,000 for not very long in hospital.

[Sheryl]

People have used it, successfully. But there have also been cases where the contents were disregarded because a relative requested this.

AFAIK there is no provision that states doctors have to follow the terms of an Advanced Directive or face legal consequences and certainly has not been a prosecution for failure to do so. rather the law is slanted towards assuring doctors that they will not face prosecution if they comply with the terms of an Advance Directive.

Most of the major "international" hospitals now have their own, hospital-specific forms.

It is important to have a relative or person with POA to advocate for you. (That is true even in Western countries, where as in Thailand terms of Advance Directives are often ignored if the family so requests. Dead people don't sure or bring legal action, their survivors do).

in addition, doctors will vary in their familiarity with these documents and comfort level and some will have never dealt with it or even heard of it, especially up country.

[keeniau96]

I have the BKK Phuket hospital form (their letterhead), will it be honored at another hospital?

[simple1]

OP: When I was living in Thailand I arranged & registered a Living Will with Bangkok Pattaya Hospital who issued a card to keep in my wallet. In addition I arranged for a certified copy for my Thai GP and wife. There is some detail about Living Wills in Thailand via internet search, an example below:

http://www.thailawonline.com/en/family/living-wills-in-thailand.html

[Speedo1968]

Hi

This is my first time to reply on thaivisa.

Regarding Living Wills. My situation is that I have a host of allergies including all antibiotics and other "useful ??? tools" to keep one alive.

Some 4 years ago I was admitted to hospital in Khon Kaen ( 45Km from where I live ) when I was having what turned out to be my first 2 TIA's.

I was completely out of it on arrival so recall little if anything of what happened

I am told I had gone in to spasms and the situation was complicated by acute and allergic bronchitis. No chemical treatments were possible ( due to drug allergies ) and I am told I fought like a madman to stop a breathing tube being forced down my throat ( comes from surfing accident years ago ). The eventual and life saving treatment was having urine therapy administered by the person who went with me to the hospital.

Following the experience I discussed my thoughts with my children ( one of whom had flown out from the UK with emergency status to go to the hospital ).

My intention was not to allow the bystanders or myself to suffer again. Both children agreed to this and I made out a Living Will. I also discussed with the person most likely to be with me ( close long term friend but not a partner ) and they, having been with me the first time understood and agreed.

Further, I discussed with the specialist doctor at my hospital in Khon Kaen and he verbally agreed a Do Not Resuscitate ( DNR ) letter / form would, if I was in the same condition again and in his presence be honoured. I have stated that urine therapy may be used but NO form of artificial breathing or heart restart may be. On regular check-ups to my specialist I check that my files still contain the DNR form and all updates to new allergies etc are registered.

I took time to check various countries DNR information and forms they may have. Checked with UK Age Concern etc and UK Embassy in Bangkok.

Eventually I found suitable wording in a form available online. I have shown this to everyone concerned and placed on file with all of them.

Because of my allergies ( many fatal such as antibiotics ) I carry all relevant information with me at all times, have given signed copies to all concerned, have placed on file at all hospitals I am registered with, and a copy is prominent in my house.

Sorry if this is too long to read and understand but Living Wills can be a very emotive subject. Fortunately for me, experience, discussion and understanding went a long way.

[manfredtillmann]

Hi

This is my first time to reply on thaivisa.

Regarding Living Wills. My situation is that I have a host of allergies including all antibiotics and other "useful ??? tools" to keep one alive.

Some 4 years ago I was admitted to hospital in Khon Kaen ( 45Km from where I live ) when I was having what turned out to be my first 2 TIA's.

I was completely out of it on arrival so recall little if anything of what happened

I am told I had gone in to spasms and the situation was complicated by acute and allergic bronchitis. No chemical treatments were possible ( due to drug allergies ) and I am told I fought like a madman to stop a breathing tube being forced down my throat ( comes from surfing accident years ago ). The eventual and life saving treatment was having urine therapy administered by the person who went with me to the hospital.

Following the experience I discussed my thoughts with my children ( one of whom had flown out from the UK with emergency status to go to the hospital ).

My intention was not to allow the bystanders or myself to suffer again. Both children agreed to this and I made out a Living Will. I also discussed with the person most likely to be with me ( close long term friend but not a partner ) and they, having been with me the first time understood and agreed.

Further, I discussed with the specialist doctor at my hospital in Khon Kaen and he verbally agreed a Do Not Resuscitate ( DNR ) letter / form would, if I was in the same condition again and in his presence be honoured. I have stated that urine therapy may be used but NO form of artificial breathing or heart restart may be. On regular check-ups to my specialist I check that my files still contain the DNR form and all updates to new allergies etc are registered.

I took time to check various countries DNR information and forms they may have. Checked with UK Age Concern etc and UK Embassy in Bangkok.

Eventually I found suitable wording in a form available online. I have shown this to everyone concerned and placed on file with all of them.

Because of my allergies ( many fatal such as antibiotics ) I carry all relevant information with me at all times, have given signed copies to all concerned, have placed on file at all hospitals I am registered with, and a copy is prominent in my house.

Sorry if this is too long to read and understand but Living Wills can be a very emotive subject. Fortunately for me, experience, discussion and understanding went a long way.

seems like 'lucky' you are still around to post...

hang in there, mate

[jayceenik]

I'm a senior living in Thailand with a much younger TGF.

I have no relatives of any importance left in the old country.

I have thus made my TGF sole inheritor of my earthly possessions (bank accounts, really).

More important to me I have made a Living Will (in Thai and English) following the Thai Health Ministry recommendations (used their template online) and

stipulated all the medical care I do not want if I go unconscious for some reason of catastrophic accident or stroke or whatever and naming my TGF as sole decider when to pull the plug if I'm thus in a very bad situation. I do not want to end up like Schumacher, for instance.

As incentive for my TGF to act swiftly (no long and co$tly heroic hospital care for me, please) I've emphasized to her that the longer she waits to have the MDs pull the plug the richer they'll be and the less $$$ on my bank account for her when I finally go to the the Big Beerbar Complex in the Sky.

[curtklay]

Careful now...she may pull the plug tomorrow.

[NancyL]

It would be useful if someone with actual experience could post, but I doubt if anyone has actually used the procedure.

Anyone regardless or age could finish up in ITU if they were in the wrong time at the wrong place, being kept alive on

a respirator, multiple drugs, etc, with no real hope of recovery. I for one wouldn't like to be in that situation, yes it could run

into many millions of baht, but more so who wants to die in such an undignified long drawn out way People think it's never

going to happen to them, but I know of a situation where someone died, (actually never had a chance of recovering) and

the bill I believe was around $120,000 for not very long in hospital.

Uptheos, the Advance Health Directive (i.e. Living Will) that Lanna Care Net and Cancer Connect have honed over the years has been used successfully in dozens of cases, probably over a hundred, here in Chiang Mai.

Unfortunately,most of the people who implement this document are elderly and/or have been diagnosed with a condition that is likely to be terminal. The people who turn out in droves (of over 50 or more per session ) for the LCN seminars in planning for the end-of-life (in English and Japanese) seem t be over age 50. Frankly, young people seem to consider this subject to be obscene, Interesting, since they don't consider much else to be obscene. But, death and dying is something they don't want to talk I guess it's just not in the same category as, well I was about to use an obscene word to describe the sex act and another two to describe oral sex, but you get what I mean. The same twenty-somethings who can so casual about one aspect of life can't think freely about another. They should. After all -- it's all part of life and we'll all experience it.

Anyway, the key aspect of having an Advance Health Directive is that you've had "The Conversation" with the key people in your life. Actually, you should be talking with them over and over again so that they know your wishes about how you want to die. You may not believe it, but there are numerous opportunities in daily life to open channels of communication with your loved ones about your beliefs. Thru watching movies together and seeing acquaintances with health difficulties, Hubby has made it very clear to me -- "don't try to keep me alive if I get to that point" and I hope I've made my wishes known to him, which aren't as "just shot me" as his are. I figure if I'm not in pain and still enjoy some basic pleasures then I want to stay around. We have different levels of when we want the plug pulled and I hope he understands that.