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Living Wills - make one before you need it!
One medical situation that appears not to be well understood, is the making of
Living Wills. I am repeatedly asked about whether a Living Will is legal in this
country, and how do you enforce the provisions. Read on, all will be made clear.
A short while ago there was a small paragraph in one of the Bangkok English
language daily papers, reporting on the fact that Living Wills were now accepted
as being legal in Thailand. I cheered as I read it. It was ‘about time’, in my
opinion.
However, there is confusion in the minds of many people, as to what a “Living
Will” actually is and what it covers. Borrowing from the Mayo Clinic in the US,
it states on their website: “This written, legal document spells out the types
of medical treatments and life-sustaining measures you do and don’t want, such
as mechanical breathing (respiration and ventilation), tube feeding or
resuscitation.” The important words to note are “life sustaining” and
“resuscitation”. Neither of these concepts imply medically assisted suicide, or
euthanasia.
Once again from the Mayo Clinic: “Injury, illness and death aren’t easy subjects
to talk about, but by planning ahead you can ensure that you receive the type of
medical care you want, to take the burden off your family of trying to guess at
what you’d want done.”
Remember that we are talking about terminal situations here. Not situations from
which it would be reasonably expected that you will recover and still have a
good quality of life. A fractured hip when you are 90 is a serious situation,
but provided you are healthy otherwise, then it would be expected that you would
recover. You might need a stick for a while, but you would still be able to have
a beer with your mates or play Scrabble or whatever your pursuits were before
the incident. In other words, the expectancy of a reasonable quality of life is
there.
However, if you are in the terminal phase of metastatic cancer, which has
progressed despite treatment, the future quality of life is not there.
Artificially prolonging life under that situation is then covered by the Living
Will.
As an example, I ask you to note the following:
The Living Will is made while in sound mind. It is not something you scribble
out while lying in God’s waiting room. An example of a Living Will. “Being of
sound mind and understanding all the implications, I ask that this document be
brought to the attention of any medical facility in whose care I happen to be,
and to any person who may become responsible for my affairs.
“This is my ‘Living Will’ stating my wishes in that my life should not be
artificially prolonged, if this sacrifices my Quality of Life.
“If, for any reason, I am diagnosed as being in a terminal condition, I wish
that my treatment be designed to keep me comfortable and to relieve pain, and
allow me to die as naturally as possible, with as much dignity as can be
maintained under the circumstances.
“As well as the situation in which I have been diagnosed as being in a terminal
condition, these instructions will apply to situations of permanently
unconscious states and irreversible brain damage.
“In the case of a life-threatening condition, in which I am unconscious or
otherwise unable to express my wishes, I hereby advise that I do not want to be
kept alive on a life support system, and I do not want resuscitation, nor do I
authorize, or give my consent to procedures being carried out which would
compromise any Quality of Life that I might expect in the future.
“I ask that you are sensitive to and respectful of my wishes; and use the most
appropriate measures that are consistent with my choices and encompass
alleviation of pain and other physical symptoms; without attempting to prolong
life.”
Now those are only examples. The Bangkok Hospital Pattaya has a pro forma Living
Will, which is also repeated in the Pattaya City Expats website, I believe.
The message is that a Living Will is not euthanasia, and that you must lodge it,
before you need it!
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