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!

My friend's wife signed papers with the doctor last night at 9PM. He passed away at 1:30AM.
Based on my discussion with the Bangkok Hospital rep and my friend's experience at SriNakarin, it goes to show that not all hospitals operate the same way (not even all Bangkok Hospitals!!)

Sorry to hear about your loss. But, its a good thing to knw

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

I'm not so sure that is correct from a strictly religious belief, SFG. Yes, it is against Buddhist principles to kill any living thing. But, like all things relating to Buddhism and other religions, it is all open to interpretation and circumstances.
My wife, who served as a Buddhist nun for three years, said a doctor would need to speak with family, explain the situation, get their permission, similar to what Parrot described:

parrot wrote: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.
My friend's wife signed papers with the doctor last night at 9PM. He passed away at 1:30AM.
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.

I would think that if a doctor is not comfortable with a similar situation... Perhaps it comes from a personal moral value of the doctor, rather than a religious value?
Bottom line, as we "baby boomers" age, many of us and our families, will be faced with these issues.

I still think you need that holiday SFG. I too heard that death rattle with my mother over 20 years ago but only learned what it was through reading your post. Thanks for sharing that.

I'm listed as an organ donor and amongst other things it's noted on my driver licence. I'm more worried in my own country that they'll whack me off early to use my organs!

Whoops - death roll.

GT93 wrote:Whoops - death roll.

Yes, you're correct GT93. It's actually "death rattle" I got it confused with drum roll...as in:

a rapid succession of beats sounded on a drum, often used to introduce an announcement or event.

Thanks for correcting me.

According to National Health Act BE 2550 section 12 a living will is legally enforceable.
It can be written and witness as a normal will, as there is no legal format for drafting the living will.
More info from here:
Website: http://www.siamfirm.co.th

Bangkok: 496-502 Amarin Plaza Building 5th. Ploenchit Rd, Pathumwan, Bangkok, 10330
Hua Hin: 13/59 Soi Huahin 47/1, Petkasem Rd, Hua hin District, Prachuabkirikhan Province, 77110
Pattaya: 413/33 Moo 12 Nongprue, Banglamung, Chonburi 20150
Tel: Bangkok 02 2569150
Tel: Hua Hin 032 531508
Tel: Pattaya 038 251085 or Mobile 09 12393495

This is very common in Thailand, the difference between theory and practice.
Your spouse or family will have to fight against the hospital and you should win.

I wrote an article about living Wills in Thailand and even put the regulation that was adopted many years later here:

http://www.isaanlawyers.com/living-will-thailand/

And in the download section, we offer a FREE LIVING WILL should you wish to make own. You have to add your name, date, and change what you wish but it is pretty standard and was done according to Thai law.

Jingjai is wrong, there are criteria to respect according to the regulation.

Obviously, things have changed... However, my post was written two years ago.
I spoke with Kurt of Bangkok Udon Hospital a couple of weeks ago, and he provided me with the blank "Living Will" documents in both English and Thai. They are very simple to fill out.

The regulation is from 22 October 2010 and can be found here:
http://www.thailawonline.com/images/doc ... 20Thai.pdf

Some Living Wills can be very simple. I've seen others of 20 pages. I wouldn't advise in Thailand to have a document too complex. Bangkok Hospital have their form. The one we provide free on Internet is Thai and English, respect the regulation of 2010 and was done by attorneys with experience in this matter. Remember that before the health act of 2007, there was nothing.

We had a client refusing treatment somewhere 2 months ago. He was lucid and knew what he was doing. He made a Last Will and a living Will. He refused all treatments and the hospital didn't do anything. He died about 3 weeks later.

There are conditions to respect in the regulation. Like the witnesses should not benefit of the death of the person making a last Will. They must also write their relation, who is the writer of the document and others.

Because of that regulation, we also modify our LAST WILL to reflect some of these conditions in case the law changes in the civil code. We just wanted to uniformise what the government asked.

Hope this help.

Thanks issanlawyers. I just downloaded your forms.
One question, I was told I didn't need to have the "Living Will" notarized? Seems odd...

No. In Thailand, notaries have a strange status. They are lawyers and I think there is no law about them. Notaries study 4 days in Bangkok to get their license.

The health act and regulation do not mention it has to be notarised. Same as a Last Will with 2 witnesses. But there are more conditions about the witnesses, like giving their address, etc.

We translated the regulation in English and I think it's the only one available: http://www.thailawonline.com/images/doc ... awyers.pdf

I was working on living Will today and saw that topic. But I am not often on Udon Map.

Bangkok Hospital information can be found here:
http://www.pattayacityexpatsclub.com/ex ... 20form.pdf

I have used Issan Lawyers for my will and very professional.

jingjai wrote:One question, I was told I didn't need to have the "Living Will" notarized? Seems odd...

"Notary" can mean different things in different places. In most states in the U.S., notarization means that the notary has positively identified the person signing the document, usually by photo ID. The purpose of notarization is to ensure that the person signing the document is that actual person and not an imposter. But I believe that there are a few states where it is slightly different. It may be different in different countries, too.

In some places, the seal makes it official; but that can vary. In some U.S. states, for example, it is the signature of the Notary Public which makes it official. The seal is just for show, and has no legal significance.