Movement of Thai Medical Law !

Living Will is the new concept of the Thai medical law adopted in Thailand recently. In 2007, the National Assembly, under the 2006 coup's sponsor, adopted the National Healt Act of 2007. The provision according to section 12 provides that:

[A]t any period, a patient shall enjoy the right to stop medical service, which merely to prolong death, at the end of life expansion, or to stop painful from sickness by expression of the living will or advance directive to the medical personnel.

To further proceed the living will must comply with the form and details prescribed in the Minister's Rule in according with this Enabling Act.

The medical personnel who perform in accordance with the living will, or advance directive shall be immuned and privileged from civil and criminal charge."

This law aims at assuring the physicians and the other medical personnel to avoid being sued after they practice and stop any medical treatment as the living will requires. The Minister of Health and the Medical Council of Thailand began the hearing process on July 31, 2009 to enact the Minister's Rule complying with the clause 2 of the section 12.

When reading the draft, I found that the draft provides the directive how the doctors decide when the medical treatment should end; it, however, cause undesirable impacts to the medical personnel themself. The drafting rule requires them to consider it the patient physical body and mentality can be further treated. In other words, the treatment should be stopped because the patients become the vegetative status or other signs of brain death, including the multiple failure of human bodily organs. The burden under this rule,then, is on the sholder of the physicians, instead of the patient's relatives.

I totally disagreed with this law and I think that the patient, either by himself or his relative, should have the burden to prove that the patient intended to die with dignity without "unnecessary medical treatment." Prolongating the death is undesirable and the patient should be able to exercise the right to self-determination. However, the relatives should file the ex patre motion to court, under the preponderance test, to show the actual intention to death peacefully of the patient. The physicians should have duties to cure the patient as long as it can but subject to the patient's will, not to kill anyone. In addition, the doctors should have had vere limited duties to consider if to stop treatment by himself only when the clear evidence show that the patient become death or the treatment is totally useless!