Health authorities are promoting greater understanding about palliative care and how legal documents can help people make decisions about advanced treatment during the critical stages of a patient’s life.
Under Section 12 of the National Health Act 2007, people have the right to execute a living will in writing, which sets out their preferred medical options during the final stage of their life.
The National Health Commission Office (NHCO) and the Region 1 Health Provider Office recently held a public forum about the topic for 300 public health personnel and volunteers in Chiang Mai.
A living will serves as a directive for medical personnel and family members to carry out a patient’s wishes and help plan their treatment, particularly when they have reached the point where it is difficult to communicate, said Dr Suthit Khunpradit, deputy director of the medical department at Lamphun Hospital.
Thailand is fast becoming an ageing society with the number of patients afflicted with chronic diseases multiplying, said Dr Suthep Phetmak, the NHCO secretary-general.
These problems will require more resources and treatment as the number of elderly and bedridden patients will keep growing, he said. The costs for their health treatment could jump to 200 billion baht by 2037.
Life-prolonging medical intervention for dying patients tends to be futile from a medical perspective, while often having a negative impact on their families as well as the public health service system, Dr Suthep said.
“Palliative care is one system to improve wellness during the end-of-life phase,” he said. “But knowledge about palliative care and people’s right to experience a natural death is just getting started in Thailand, so most people are still unaware of this system.”
Dr Chortip Prommarat, a senior doctor at Lamphun Hospital, said the goal is for patients to have a better quality of life or die peacefully.
However, dying patients who undergo life-sustaining treatment sometimes suffer during the process, which can make family members feel guilty for deciding to sustain their loved one’s life.
“Patients will be able to plan their treatment in advance and state their last wish in their final moment,” said Dr Chortip. “They will later be able to access palliative care provided by health personnel to alleviate their pain and suffering.”