A year ago, I wrote
on Living Wills, but with the legalization of euthanasia in the state of
Victoria in Australia in November this year, I felt I must re-run the
item from one year ago.
A couple of years
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. First off, it is not euthanasia. I
repeat, it is not euthanasia. 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.
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 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, note
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
“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
“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