Living Wills in Thailand ?? get answers this Sunday June 15

[travelerjim]

Living wills in Thailand ...Valid or not ???

The Pattaya City Expats Club will have as its guest, Dr. Iain Corness, Consultant at the Bangkok Pattaya Hospital,
to discuss this topic at this Sunday's morning meeting..June 15th.

PATTAYA CITY EXPATS CLUB
FOUNDED IN MARCH 2001
PATTAYA'S FRIENDLIEST EXPAT CLUB MEETING EVERY SUNDAY FOR SEVEN YEARS
JOIN US AT HENRY J. BEAN'S RESTAURANT, AMARI ORCHID RESORT, BEACH ROAD, PATTAYA
A buffet breakfast is available from 9:30 am - the program starts at 10:30 am

"What is a Living Will?

A Living Will gives you, or the person you designate, the right and responsibility to tell your treating physicians to stop all treatment, and allow you to pass-on (die) as comfortably as possible. The condition which might cause you or your designate to stop all treatment is that you are terminal тАУ due to incurable cancer, a terribly injured body that no treatment will correct, or just the effects of old age, and life sustainment means tubes from every orifice in your body.

What is the problem? In Thailand we live in a Buddhist culture, and a BuddhistтАЩs desire is to live a long as possible, almost regardless of the individualтАЩs pain or suffering. Thai physicians learn this in their training and in their culture. For Thai hospitals it is both the culture and government regulations that promote this policy, and for Thai people in general - it is part of their culture.

Can a Living Will be made effective in Thailand? Yes it can, but there are difficult limits, and it must be set up carefully. Dr. Iain Corness, Consultant at the Bangkok Pattaya Hospital, wrote an article in the June 6 issue of the Pattaya Mail in his тАЬModern MedicineтАЭ article discussing this problem for expats.

That article left a lot of questions unanswered тАУ so we have asked him to explain in detail, and propose some answers this Sunday."

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As Dr Iain Corness is a medical doctor, not a lawyer, so his knowledge and expertise in this particular area are questionable at best.

The simple and effective solution to stopping all treament - stop all payment.

[Bob]

As Dr Iain Corness is a medical doctor, not a lawyer, so his knowledge and expertise in this particular area are questionable at best.

Dr. Corness may not be a lawyer but he sure as hell knows a lot about the subject (thai doctors' willingness to honor living wills). Strange that you would suggest you have the basis to question his judgment or knowledge about the subject.

Strange that you would suggest you have the basis to question his judgment or knowledge about the subject.

Not that "strange" - it is a question which I discussed with my lawyer at considerable length some time ago and which he assured me is strictly a legal one, not a medical one. I have since checked the position again when re-writing my will and the position has not changed, consequently the only people qualified to give advice and with "knowledge and expertise in this particular area" are lawyers, not doctors.

I agree that Dr Corness is certainly in an excellent if not unique position to give an opinion on "thai doctors' willingness to honor living wills (sic)", but that was not the main subject of his talk, as advertised by those hosting it, which concerned the question of "Can a Living Will be made effective in Thailand? Yes it can, but there are difficult limits, and it must be set up carefully" which is very much a legal subject not a medical one, and unless he has re-trained since the last time we met at my house Dr Corness is a medical doctor and part time reporter and author with no training whatsoever in Thai law.

The legal position, so I have been told by a lawyer, is that "Living Wills" are valid in Thailand as long as no-one actively ends life, in which case they are breaking the law; you could, for example, turn off a life support machine on the instructions of the person on it but you could not legally administer an overdose of morphine. Any doctor is at liberty to refuse to assist in such acts, in which case the person legally designated by the individual concerned is legally entitled to insist he is moved to another medical facility. I would respectfully suggest that anyone wanting advice on the legal position take advice from a lawyer qualified in Thai law, not an expat doctor.

[Geezer]

тАЬI would respectfully suggest that anyone wanting advice on the legal position take advice from a lawyer qualified in Thai law, not an expat doctor.тАЭ

Dr. Corness writes in the Pattaya Mail article:

тАЬWhat you have to do is to make what is called a тАЬLiving WillтАЭ (even though it is really a тАЬdying willтАЭ). Now this is a medico-legal document, so you need to run it by your own legal person, and to be legal in Thailand, it must also be written in Thai, remember.тАЭ

http://www.pattayamail.com/775/columns.shtml#hd3

Dr. Corness's talk was interesting and informative. His premise, which is the same as that in his article, is that this being a Buddhist country, it goes against their tenets to not make every effort to prolong life. In his talk, he specifically said he was not talking about euthanasia, but about asking that no extraordinary measures be taken if it only prolongs life (i.e., terminal illness such as cancer, etc.). His talk did not address the "legal" issues, but rather the mind set of the Thai medical profession and that, if you want your wishes carried out, it must be in a written document and registered with the hospital.

[Hmmm]

I am not cynical by nature, but Thailand has perhaps made me more so (at least that's my excuse, and I'm sticking to it).

In that vein, one could say that the best way to ensure that you are not subjected to medical treatment in Thailand that will prolong your life against your will is to make sure that you are unable to pay for it. Stating that the concept of a living will is foreign to Thai Buddhism should perhaps be balanced with the fact that many people (mainly Thais of course) die every day in Thailand of treatable illnesses because they cannot afford the treatment.

The bottom line as far as living wills in Thailand are concerned would seem to be that unless you're in a farang-oriented hospital - to which you have had the foresight to deliver your written living will (in Thai) - and are represented by someone who has the strength to question what the god-doctors are doing to you (eg a Thai bf might not be very useful in this regard), then you'll probably be with us until the money runs out or you die despite all medical efforts.

However, if anyone has had real (but presumably not personal) experience of a living will being honored in Thailand, it would be good to hear about how it worked.

I In that vein, one could say that the best way to ensure that you are not subjected to medical treatment in Thailand that will prolong your life against your will is to make sure that you are unable to pay for it.

You may be cynical, but you are also right. The mother of a friend of mine (farang) was in a local Pattaya hospital as an emergency The hospital said an operation was needed within the next hour to save her life, but, of course, the funds had to be deposited first. When my friend queried this the response was "We can have your mother ready in 5 minutes for you to take home", unconcious and dying even though she was.