Connect with us


Aging in Thailand : nation must learn to talk about death




We may not know when death will strike, but we can certainly choose to have a good death. However, if you don’t know how to do it, you are not alone.

The right to have a good death is the right to pass away naturally and peacefully without having to go through painful and expensive life-prolonging medical interventions.

The right to die with dignity

Refusing life-sustaining medical technology during one’s terminal illness is now the right of every Thai under the law. Yet most people still don’t know about this. Nor do they know about palliative care services which help terminal patients die “naturally” and comfortably instead of being kept alive artificially.

According to recent research on “Public Awareness and Attitudes toward Palliative Care in Thailand” by the Thailand Development Research Institute (TDRI), more than 75% of Thai people do not know that palliative care is available for terminal patients.

Moreover, 79% have not heard of a “living will”, a written directive prepared in advance to refuse life-prolonging medical technology.

Death is still a huge taboo to talk about in Thai society

Why do the majority of Thais refuse to prepare themselves for a good death? The reason is simple. It’s still a huge taboo to talk about death in Thai society.

Bringing it up is considered a bad omen, a curse even.

Even when one is not afraid of death for oneself, suggesting preparations for the imminent death of a family member who has a chronic or severe illness is blasphemy, making that person blatantly rude in the eyes of others.

Such taboo makes the patient and family unprepared when the critical time arrives. Without a living will, the use of life-prolonging machines against the patient’s wishes may actually inflict more physical pain.

The stubborn use of expensive medical interventions is considered a gesture of love and gratefulness by family members. More often than not, it ends up plunging the family into bankruptcy.

The right to a good death

As Thailand rapidly becomes an ageing society, it’s more urgent than ever to embrace palliative care and allow natural death for terminal patients to take its course. This is not only a kinder option for the patient, it’s also less costly for both the family and the national healthcare system.

The law is supportive. According to Section 12 of the National Health Act 2007,

“a person has the right to make a directive in writing to refuse medical interventions which can only prolong one’s terminal stage of life, or to refuse medical services in order to cease one’s severe suffering from the illness”.

Section 12 of the National Health Act

This is known as the right to a natural death, or good death.

A rude awakening awaits those who refuse to plan for their end-of-life care in advance. The medical expenses during this period are catastrophic due to the sky-high costs of modern medical technologies to prolong life.

A global phenomenon.

When Nobel Prize winner Leon Lederman died last year, he was not remembered only for his contribution to experimental physics, but also for selling his Nobel Prize to pay his medical bills.

Society’s refusal to accept a good death also affects people afflicted with severe pain from chronic illness, as in the case of Vis Arshanakh who decided to seek euthanasia in Switzerland.

His Facebook post about his decision went viral and helped Thai society to discuss death with a physician’s assistance. Euthanasia is still illegal in Thailand.

Many people mistake natural death without medical intervention for euthanasia.

It is not. It is returning to society’s traditional way of dying; a peaceful, natural death, preferably surrounded by loved ones. Having this gooddeath option is legal in Thailand.

Despite being legal, the living will of the patient may not prevail when it faces strong resistance from family members and physicians – especially when the patient is no longer in the condition to insist on his or her right.

Therefore, as important as a living will is the mutual understanding between the patient and family, objective information about medical options and consequences, and respect for the patient’s wishes.

Since fear of lawsuits prevents many doctors from opting for palliative care for terminal patients, giving legal protection to the doctors who respect patients’ wishes goes a long way to strengthening the right to die with dignity and end-of-life care services in Thailand.

Preparing a living will and mentally preparing family to accept it is increasingly important in a greying society like ours. It helps terminal patients to have a comfortable transition before their last breaths. It prevents families from financial bankruptcy.

It also helps soften the pangs of grief knowing one has done one’s best to fulfil patients’ wishes. One of the biggest wishes is to die at home.

Providing end-of-life care at home is also less costly for the national health system.

Studies from the universal healthcare system show medical treatment for cancer inpatients during their last month of lives costs about 45,000 baht. For outpatients receiving palliative care at home, it is about 27,000 baht.

Interestingly, even those who know about palliative care think of it as only the medical services for terminal patients at hospitals or hospices. This thinking is too narrow.

End-of-life and palliative care is not just about concerns about aggressive medical technology and money.

It’s about helping loved ones with terminal illnesses to live their last stages of life as comfortably and with as little physical pain as possible.

Apart from medication to reduce pain, family members play a key role in providing psychological support for terminal patients so they can pass away without worry, guilt, or regret. Only then it can be considered a good death.

Wannapha Kunakornvong is researcher at Thailand Development Research Institute. Policy analyses from the TDRI appear in the Bangkok Post on alternate Wednesdays.

Wannapha Kunakornvong

First Published on Bangkok Post
The post Greying nation must talk about death appeared first on TDRI: Thailand Development Research Institute.

Source link



Skin-lightening products market to reach US$31 billion by 2024

In emerging Asian and African economies, the natural aspiration to enhance one’s circumstances has led to rapid growth in the market for skin-lightening products, which is projected to reach US$31 billion by 2024.




Recent years have seen evolving awareness of systemic inequities including racism, sexism and pro-Western chauvinism.


Continue Reading


Has Covid-19 prompted the Belt and Road Initiative to go green?

Oxford Business Group



Has Covid-19 prompted the Belt and Road Initiative to go green?
– Covid-19 led to a slowdown in BRI projects
– Chinese overseas investment dropped off in 2020
– Government remains committed to the wide-ranging infrastructure programme
– Sustainability, health and digital to be the new cornerstones of the initiative 


Following a year of coronavirus-related disruptions, China appears to be placing a greater focus on sustainable, digital and health-related projects in its flagship Belt and Road Initiative (BRI).

As OBG outlined in April last year, the onset of Covid-19 prompted questions about the future direction of the BRI.

Launched in 2013, the BRI is an ambitious international initiative that aims to revive ancient Silk Road trade routes through large-scale infrastructure development.

By the start of 2020 some 2951 BRI-linked projects – valued at a total of $3.9trn – were planned or under way across the world.

However, as borders closed and lockdowns were imposed, progress stalled on a number of major BRI infrastructure developments.

In June China’s Ministry of Foreign Affairs announced that 30-40% of BRI projects had been affected by the virus, while a further 20% had been “seriously affected”. Restrictions on the flow of Chinese workers and construction supplies were cited as factors behind project suspensions or slowdowns in Pakistan, Cambodia and Indonesia, among other countries.

Read More

Continue Reading


Marijuana could generate up to Bt8 billion for Thailand’s pharmaceutical industry

Last year, Thailand removed cannabis and hemp leaves from its list of banned narcotics (seeds and buds remain banned).




Marijuana could generate up to Bt8 billion for Thailand’s pharmaceutical industry over the next five years, but farmers stand to make little from growing the herb, experts say.


Continue Reading


Most Viewed

Subscribe via Email

Enter your email address to subscribe and receive notifications of new posts by email.

Join 13,634 other subscribers