Within the last two days I have heard from reliable sources that Bangkok Hospital Udon will no longer be honoring the Living Will. They say that other branches of their hospital group will honor it, but the Udon branch says that it is against their religion to take someone off life support and allow them to die. Sounds like a lot of hog wash to me. They honored it a few weeks ago when a close friend of mine dropped off a Living Will to have stored in his file at the hospital, but now they don't according to an email that he just received from the hospital. My cynical self tells me that it was a decision motivated by profit rather than a decision based on religious preference. What better way to increase the hospital's bottom line than to drain the family's bank account in order to take care of someone who has a desire not to remain on life support. Your wife or next of kin won't even be allowed to remove you from the hospital in order to take you home to die, so for all intents and purposes one is a captive patient. For those of us who are concerned for the future of our wife and/or children and have set aside a nest egg for them for after we are gone, there is a good chance now that we could wind up at the mercy of Bangkok Hospital Udon and they could drain every last baht out of that account. I personally think it's a travesty and the issue should be addressed by the proper authorities. The Bangkok Hospital Udon allows the Udon Expat Club to use their seminar room on the 4th floor to conduct their meetings, and of course this gives the hospital a platform to promote it's services within the expat community. Seems to me that the Expat Club should lodge a formal complaint with the hospital against this new policy of theirs. Is there anyone else out there who cares enough to get involved, and/or does anyone else have any suggestions on what can be done to have this policy reversed?

I actually have a Living Will on the Bangkok Hospital letterhead which I got from their website, but I am not able to post a pdf file on this thread. Additionally, on Oct 6, 2010 the Prime Minister and the Minister of Public Health issued a Ministerial Regulation in accordance with Section 4 and 12 Paragraph 2 of the National Health Act of 2550 allowing the use of the Living Will in Thailand.

Have you spoken to Curt or John yet?

If I understood your post correctly it is accepted in Bangkok?

bumper wrote:Have you spoken to Curt or John yet?

If I understood your post correctly it is accepted in Bangkok?

Not sure if it's accepted in Bangkok or not. I got a copy of their Living Will format off their website a few months back and saved it in a pdf file, but now I can't seem to locate that form again on their site. No, I haven't spoken with John or Kurt, but I will at first chance.

You have a strange way of thinking sfg. Let's say you're correct and BH doesn't accept living wills. Fine.....if that's what you want, you have a variety of hospitals to choose from......but I wouldn't count on any Thai doctor to pull the plug...no matter what sort of paper you've signed.
This is Buddha country.......I know people who won't swat a mosquito that's injecting dengue fever in their bloodstream. A dog will sit on the side of the road in misery and no one will stop and put the dog out of his misery.
No one in Bangkok Hospital or any other Thai hospital is going to force you to keep a family member in the hospital (at least, I can't imagine they can). Most Thai hospitals seem only too happy to let a dying cancer patient go home.....some families choose to take their loved one home, some don't.
To be honest, I don't think I'd value a living will much in Thailand. You can draw one up and sign it, the hospital can put it in their records......but I wouldn't be betting my cash on the assigned doctor at the time removing the life support from a loved one. Maybe he would......but maybe it would go against his religious beliefs and he wouldn't. Then what do you do??
My bitch, sfg, is that you are slinging accusations at Bangkok Hospital when you apparently haven't talked with them about the issue. Why not go talk with Kurt or John and get the straight scoop. And if the straight scoop is that they won't accept the living will, drop over to AEK and see what they say.....or Wattana or the General Hospital.
Once you have the straight scoop, then you can vent your anger.

parrot wrote:You have a strange way of thinking sfg. Let's say you're correct and BH doesn't accept living wills. Fine.....if that's what you want, you have a variety of hospitals to choose from......but I wouldn't count on any Thai doctor to pull the plug...no matter what sort of paper you've signed.
This is Buddha country.......I know people who won't swat a mosquito that's injecting dengue fever in their bloodstream. A dog will sit on the side of the road in misery and no one will stop and put the dog out of his misery.
No one in Bangkok Hospital or any other Thai hospital is going to force you to keep a family member in the hospital (at least, I can't imagine they can). Most Thai hospitals seem only too happy to let a dying cancer patient go home.....some families choose to take their loved one home, some don't.
To be honest, I don't think I'd value a living will much in Thailand. You can draw one up and sign it, the hospital can put it in their records......but I wouldn't be betting my cash on the assigned doctor at the time removing the life support from a loved one. Maybe he would......but maybe it would go against his religious beliefs and he wouldn't. Then what do you do??
My bitch, sfg, is that you are slinging accusations at Bangkok Hospital when you apparently haven't talked with them about the issue. Why not go talk with Kurt or John and get the straight scoop. And if the straight scoop is that they won't accept the living will, drop over to AEK and see what they say.....or Wattana or the General Hospital.
Once you have the straight scoop, then you can vent your anger.

I'd say that an email from the hospital to one of their patients announcing that they would not honor a Living Will is proof enough of their policy on the matter. The patient called me this morning with the news since I was the one to help him to complete his Living Will form from Bangkok Hospital.

I understand that I have other options available to me, but I have instructed my wife to take me to where I think I will get the best care if hospitalization is necessary, and that is Bangkok Hospital; so, the fact that they will not honor a Living Will could put me and my family between a rock and a hard place.

And just remember that not every terminal patient has the ability to leave the hospital and return home to die. If one is already on life support, and to dismantle the support to send a patient home would result in the immediate cessation of life, then I guarantee you that patient will stay in the hospital and the bill will continue to run it's course. When I make a plan I always plan for the worse case scenario...especially here in Thailand where things seldom go as planned, and if anything can go wrong...it will (Murphy's Law).

I would think the best plan for that would be to have the best medical insurance you can get. I have to agree religious beliefs are strong motivators. I know of one guy who really needed to be in the hospital not terminal but senile. He found a way out slapped a nurse. Then I had the privilage of watching him drag himself around screaming for help. till he died. I got medical help and that kept him alive. only to be threatened for me to pay his medical expense. He died alone screaming in pain. But, he did save money on additional medical expenses.

I have no idea what Thia law is on this. But, I can tell you from personal experience it is not a pleasant decision. I could have helped him again. But, I couldn't risk my families future on it a second time.

A living will may hold weight here in that instance and it may not legally. If it doesn't and you were the Dr. would you risk it. I know now that I won't.

I'd be interested to know the resolution regarding the Living Will at BU. My wife knows to give me a couple of weeks and then unplug me, put me in a paper box, light the big fire, and scatter the ashes to the wind. I'd come back to haunt any BU staffer who would not honor those wishes.

The Bangkok Hospital group does accept living wills - if problems I suggest you ask them to talk to their Managers in BKK.

Do you know if that is based on Thai Law or a hospital policy?

It is law, but you have to push for its use! Goes against some Buddhist tenets

Anyone have any current info on BH honoring living wills?

Yes they do - read the previous post

joepai wrote:Yes they do - read the previous post

I stopped by the hospital today....with a copy of the Bangkok Hospital Living Will (Pattaya) that I downloaded from the internet. I spoke with Kurt.......he said the Udon hospital does NOT accept them and will not keep a copy of such a will in your records.

That said, he suggested filling one out and keeping it with your important papers.....your next of kin may be able to use it to influence the hospital/doctor in their treatment......but they are under no obligation to do so. Other Bangkok Hospitals (outside of Udon) may or may not accept the form.

It's Thailand try to get a sick dog put down here. Vets more then likely won't do it. Next life you know.

ME I want to be sent home. loaded up with drugs, have a nurse come and keep me that way and let nature take it's course.

Here are two very good articles:
http://www.zocalopublicsquare.org/2011/ ... eas/nexus/
http://www.zocalopublicsquare.org/2012/ ... eas/nexus/

As far as Thailand goes, A friend was in the hospital, he signed a DNR(Do Not Resucitate) order at Bumrungrad Hospital. Four people had to witness his signing, his doctor, a nurse, someone from their legal department, and his wife.
They never needed to use it, he died a month later. However he died in terrible pain, he wanted to die, he knew he was terminal, everyone knew he was terminal.
I spoke with his doctor, as did my friends wife, and his sister. We told the doctor to let him go, to up his morphine dose every hour. He was as good as dead anyway. The Oncologist wouldn't do that.
Bottom line here in Thailand, they ain't pulling no plugs, they won't slowly intentionally overdose you.
I have no idea whether they would even honor a DNR order.
On a further note, my friend had BUPA Platinum Plan, five million baht cap, it had just crossed over the four million baht mark, when my friend finally was allowed to die. Guess Bumrungrad didn't want to push the envelope all the way with BUPA. That is only my theory, based on my own paranoia. No proof.

***MODS this topic of Living Wills, etc., might be better served, if these posts on Living Wills, be split off into it's own thread. IMO

Mod Note: Done.....good idea!

We visited our British friend in SriNakarin Hospital again today. He's battling a multitude of cancer problems and he's losing the battle. Up until a few days ago, he was willing to put up a fight......but at last, as the doctors proclaimed there was nothing further they could do to improve his prospects for recovery, he signaled (however weakly) that he was ready to call it quits.
Today, the man's longtime doctor turned off his phone and met with his wife for a full hour, detailing his withering condition and her options. While maybe not along the same lines as a signed living will, the options include the options that I would want my wife to take if the same thing were to happen to me.

Thanks, sfg, for bringing this topic to light. For anyone concerned about how their hospital might treat them or their loved ones in a terminal case, it would be a good idea to consult with your hospital of choice beforehand.

This is of no surprise to find that cessation of life is not condoned at all. Even vets have problems, so intelligent people doctors will also have the same problem. It goes against the grain as it were, , following which shouyld you pass away they then spend the next few minutes bouncing your body around and trying to restart it, and often they succeed only to go through the whole process in another couple of days.

While I have personally witnessed this action twice, i did feel for the relatives watching what they were doing, they cling to faint hope all the time, so for any medically qualified in Thailand to issue a DNR notice AND stick to it would be hard to find as well as allowing a person to diue pain free by upping the pain medication to a level that you would probably die.

This is Thailand and say what you will, one has to admire their tenacity to keep one alive at all costs.

SFG: "especially here in Thailand where things seldom go as planned, and if anything can go wrong...it will (Murphy's Law)."

I think you need a holiday SFG. Despite often pressing our buttons,Thailand is really a fantastic place and that's why you're there? In a Buddhist country farang are going to face these kinds of issues but in this case they seem avoidable. I respect your considerations of your family.

Worse comjes to worse there is always ways to get narcotics to ease the pain. Not somehtign I particiapte in. But, i'm not dying agozing pain if I were I would certailny consider it.

Watching Grand Mother die in pain is not what I would want for myslef. Terminal throat cancer the Dr. would give a shot for the pain every three days. She had terminal throast cancer. Dr said he wouldn;t give her moer for the pain as it might hurt her.

Persoanally I thought the lady had endured enough. The thought that pain meds might hurt her, is beyind my comprehention. It wasn't money I offered to a pay for the pain meds, still wouldn;t do it.

Another experience was wiht my Brother in the Satates, he had fought as long as he could, He went inot hospice at home, nurse came by every few days. They trained my nephew to give him pain injections and the stopped the othre meds. He died pain free at home wioth people who loved him.

Given those two situations I know the one I would choose Wehn the timer comes I will do all that I can to gte what my brother had.

Sometimes it's not a matter of a DNR.

My brother died with dignity. Grand Mother died in terrible pain.

As a matter of fact my wifes Aunt in Bangkok just went through this, she went home and hung herself, two days ago.

The framily is having a difficult time dealing with the suicide. I understand it, when there is no hope. Then you got to do waht you got to do.

Don't expect help from te Medical Community, your not going to get it

My mother passed away in the privacy of her own home back in 2005 from complications of heart disease. She was under the care of a hospice nurse who had her on a morphine drip to ease the pain and keep her sedated. Near the end her lungs were filling with water and you could hear the gurgling sound, or what they call "the death roll". The hospice nurse knew what that sound meant, so she called all the kids at our respective homes to come to her bedside in the middle of the night, then she cranked up the morphine to allow mom to go in peace. Folks in Thailand might just label that nurse as an "angel of death", but for me and the rest of the family she was a Godsend from Heaven. Surely mercy and compassion is a tenet of the Buddhist faith; but then again, for one to demonstrate mercy and compassion means that they put the interest of another before their own. We all know that's not going to happen in Thailand. Any doctor contemplating taking someone off life support is going to be more concerned about the Karma surrounding his own life than the suffering and well-being of his patient and the patient's family. Pretty typical in a culture where selfishness takes priority over selflessness!