THE NATION Issued date 2 August 2011

Medical doctors are pushing for some changes to a legal clause that gives terminal-stage patients the right to die with dignity.

“Doctors don’t want to feel they leave the patients to die,” Dr Amnaj Kussalanan, president of the Medical Council and chairman of the committee on the living-will implementation guidelines, said yesterday.

The committee’s meeting found that the ministerial regulation for the living-will clause in the National Health Act defined the patients’ final moments too broadly.

“This may cause problems during the implementation stage. The Medical Council would like to define the term itself via consultation with all parties including royal medical colleges,” Amnaj said.

The committee also disagreed with the ministerial regulation-prescribed green light for patients to write their living will anywhere.

“We think the living will must be done at the hospital where the patient is receiving treatment, the provincial public health office, the district office or the National Health Commission Office only,” he said.

The doctors also want to remove “terminate medical services” from the living-will sample.

“No doctors will dare do that. Termination means causing the death of the patient,” he said.

Dr Samphan Kongrit, secretary-general of the Medical Council, said the act only describes the living will as an expression of intention to forego treatment and to end suffering from terminal illnesses.

“It does not mention patients in the process of receiving treatment but suddenly the ministerial regulation includes these patients too,” Samphan said.

The current laws allow only the patient to write his own living will, he said.

“In reality, most patients have not prepared such documents, he said.

“So, legitimate heirs or legal guardians should also be allowed to prepare the living will for the patient,” he said.

Amnaj said his committee would soon submit its proposal to the Public Health minister.

“Pending the changes, physicians will stick to following the guidelines prepared by the Medical Council,” he said.

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