Many people are unaware that Thai law clearly recognises our right to shape our own care at the end of life, through a document known as a living will (หนังสือแสดงเจตนา).
What the law says
Section 12 of Thailand’s National Health Act B.E. 2550 (2007) provides that a person has the right to make a written declaration refusing health services that would serve merely to prolong the dying process in the terminal stage of life, or to end severe suffering from illness. When healthcare professionals follow such a declaration, the law protects their actions.
Put simply: each of us may state in advance which treatments we do not want when the true final stage of life arrives — such as cardiopulmonary resuscitation, breathing tubes, or life-support machines — in circumstances where recovery is no longer possible.
What a living will is not
- It is not euthanasia. A living will does not ask doctors to hasten death. It allows the natural course of the illness to unfold, while the patient continues to receive full comfort-focused care.
- It is not a refusal of all care. Comfort care, pain management, and emotional support always continue in full.
- It is not permanent or unchangeable. It can be revised or cancelled at any time, as long as the person remains of sound mind.
How to prepare a living will
- Talk with your family and medical team first. Shared understanding prevents conflict and confusion when the time comes.
- Put it in writing. Include your name, the date, and a clear description of the treatments you do not wish to receive, then sign the document. Having witnesses sign is recommended, and naming a substitute decision-maker makes the document stronger still.
- Tell the people who matter. Give copies to your family and your chosen decision-maker, and ask for it to be recorded in your medical file at the hospital where you receive care.
- Review it from time to time — especially when your illness, or your thinking, changes.
The Prakongruk Palliative Care team has living will forms available and is glad to guide you through every step — whether you are a patient, a family member, or simply someone who wishes to prepare ahead. Please ask us at the outpatient clinic or on the ward.