Leaving this world with dignity was the message Dr. Iain Corness delivered to the members and guests of the Pattaya City Expats Club at their meeting on June 19 at the Amari’s Tavern by the Sea Restaurant. Dr. Iain really needed no introduction by Master of Ceremonies Richard Silverberg, as he is well known as a medical doctor employed as an international consultant by Bangkok Hospital Pattaya (BHP) and for the articles he writes for the Pattaya Mail and other publications along with his two bestselling books about living in Thailand.
Dr. Iain spoke about the certainty of death and the desirability of having a Living Will if you want to leave this world with dignity. For instance, he pointed out that cancers are the cause of about 30% of deaths. Many of these cancers can be terminal if they have spread and can be very painful in the end. He said that if you are diagnosed with cancer, the first thing you will want to know is if it terminal or treatable. If tests show that it is benign, it is something you will die with; whereas if it is malignant it is something you will die of.
Pattaya identity Dr Iain Corness, consultant to the Bangkok Pattaya Hospital, shows PCEC members the 2 page ‘Living Will’.
He then explained several things you should ask or do if the diagnosis is that you have a malignant cancer. Find out the survivability rate for the type of cancer, get a 2nd or even a 3rd opinion, and then get a PET scan to determine how far the cancer has spread. Dr. Iain said in his opinion, if the PET scan shows it has spread it is time to “go to Disneyland” (have a good time while you still can). If it has not spread, then pursue an aggressive treatment regime followed by another PET scan to see if the treatment was effective.
If it has spread and has a very low survivability rate, you need to consider how it will affect your quality of life and whether you want to die with dignity. If you don’t want your suffering prolonged through measures that will only delay, but not hold off the inevitable, you should consider making a Living Will. Dr. Iain said that it probably should be called a Dying Will as it directs doctors on how you want to die if your condition is terminal.
It is a doctor’s nature, especially in Asia to want to prolong life; but at what cost to your quality of life and dignity. Do you really want someone jumping up and down on your chest or a tube down your throat to help you breathe when all it is doing is prolonging the inevitable and the pain that often goes with it? Deciding how you want to die is not something to do on a whim; it needs careful consideration. Also, waiting till you are at death’s door is not the way to approach it. A key factor is that in order for a Living Will to be valid, it must have been done when you are competent and of sound mind.
PCEC’s resident Dr, Dr Quack (aka Sig Sigworth) (with genuine fake stethoscope) seeks clarification from Dr Iain on some of the finer points of human physiology, such as “Why is alcohol listed with smoking and obesity as one of the three nos?” Dr Iain’s reply began by establishing a definition for an alcoholic as one who drinks more than their doctor.
He then displayed a copy of a 2 page form that follows the requirements of Section 12 of the Medical Health Act of 2007 and the Ministerial Regulations that implement the law and explained the options it gives you in deciding what life supporting measures you do not want in the event you have a terminal illness. It also allows you to designate someone to make decisions about withdrawing such support in the event you are unable to communicate.
Dr. Iain emphasized that you should talk with that person so they fully understand what your wishes are. He also said that you should consider having a Living Will even if you don’t have a terminal illness such as cancer. One never knows when they might have a serious accident that can result in terminal injuries.
He concluded by saying if you want to ensure the quality of life and dignity, then you can prepare the form and take it to BHP or a hospital of your choice. He knows that BHP will accept it, but cannot speak for the other hospitals.
Master of Ceremonies Richard Silverberg then updated everyone on upcoming events and called on “Hawaii” Bob Sutterfield to conduct the ever informative and sometimes humorous Open Forum, where questioned are asked and answered, movies and restaurants are recommended and sometime a joke or two are told. It was also announced that the Pattaya City Expats Club would make the new Living Will form available on their website: www.pattayacityexpatsclub.com.