You are using an outdated browser and your browsing experience will not be optimal. Please update to the latest version of Microsoft Edge, Google Chrome or Mozilla Firefox. Install Microsoft Edge

July 29, 2011

Living Wills and the Right to Refuse Life-Sustaining Medical Treatment

Subscribe to Updates
Bangkok Post, Corporate Counsellor Column

Every day, you control your health and finances. You decide whether to go to the doctor when you become ill or are injured. You also decide whether to purchase, sell, or gift your assets. In case of severe sickness or injury or death, the law must take over to best carry out your wishes.

In our July 15 column we discussed the importance of drawing up your will. Today we will discuss living wills and the right to refuse medical treatment.

For the first time in Thailand, the right to refuse medical treatment is expressly provided under Thai law. The Ministerial Regulation prescribing the rules and procedures for living wills took effect on May 20. The Ministerial Notification was issued under Section 12 of the National Health Act of 2007, which endows a person with the right to make a living will.

Before we define a living will, it is important to note certain characteristics and limitations of the instrument.

First, a living will should not be confused with a last will and testament, which provides for the distribution of an estate or assets. A living will has nothing to do with property.

Second, a living will does not allow euthanasia or mercy killing. Medical practitioners are not authorized to cause the death of their patients by performing an affirmative act, such as a lethal injection. Moreover, doctors retain the duty to relieve pain and perform other aspects of palliative care. The National Health Act of 2007 and the Ministerial Regulation relieve a healthcare provider of criminal and other liability only where the provider acts in accordance with the law, the regulation and the particular living will.

Third, a living will under Section 12 of the National Health Act does not include a medical or healthcare power of attorney, by which an individual may appoint an agent or proxy to make decisions regarding his or her health care and medical treatment in specified circumstances. Instead, the living will is a legal document through which a person may inform medical care providers, friends, and family members of his or her medical wishes, in the event that he or she is unable to communicate these wishes due to a serious illness or injury.

Meaning of a living will

A living will is also referred to as an advance directive, healthcare directive, or physician’s directive. It allows a person to make two choices in advance and in writing to (1) refuse health treatments provided merely to prolong his or her “terminal stage of life” or (2) refuse health treatments so as to cause the person to cease physical or psychological suffering caused by injury or incurable disease.

The “terminal or final stage of life” is specifically defined in the Ministerial Regulation, but can be understood by laypersons to include conditions caused by injury or incurable disease that lead to imminent death or that result in the permanent loss of brain function, which renders the person unable to communicate or comatose.

Living will requirements

A living will may be made by any person age 18 or older (referred to as a “declarant”) and should contain the following components:

  • The declarant’s full name, age, Thai identification number, and address or contact number.
  • The date the living will was made.
  • The full name and Thai identification number of the witness(es) and the relationship of such person(s) with the declarant.
  • The type of health care that the declarant does not wish to receive.
  • The full name and Thai identification number of the writer or typist (if the letter is written by another person).
  • The signature (or thumbprint, if necessary) of the declarant, witness(es), and writer or typist.

The National Health Commission Office of Thailand provides guidelines on the types of treatments that may be refused in a living will, including resuscitation, mechanical ventilation, nutritional and hydration assistance, and dialysis. If a patient is pregnant, her wishes will be followed after the birth of her child.

The intent of the declarant

Before performing under a living will, doctors must verify the patient’s intent. Per the Ministerial Regulation, such intent may be confirmed by the patient or, in the event that this is not possible, by witnesses or the patient’s relatives. As such, it is important for patients to tell their relatives and loved ones about their living will and their wishes for medical treatment.

In sum, patients are now entitled to have their living will enforced and to refuse health services that would prolong their terminal stage of life or to refuse health services in order to end their suffering. Thai law now gives patients the freedom to choose and the freedom to refuse medical treatment during the most critical time of their life.

Download Full Article
Related Professionals

Practices

Dispute Resolution and Litigation

Location

RELATED INSIGHTS​ 

November 13, 2025
The Land Department in Thailand’s Ministry of the Interior (MOI) plays a central role in ensuring the stability and legality of real estate transactions in the country. Its core responsibilities include issuing land title deeds, registering transactions (e.g., sales, mortgages, leases), conducting surveys for subdivision or consolidation of land, and providing information and guidance on land and property development laws. These administrative functions secure investor confidence and support transparency in the Thai property market, so any delay can have a significant impact. This is especially true for investors who depend on timely registration to secure or transfer property rights. Delays can create liquidity risks, postpone project timelines, and even reduce Thailand’s attractiveness as a real estate investment destination. This article explores the nature of these challenges, the legal framework governing the timelines for administrative actions, and remedies available under Thai law. Sources of Delay Procedural delays at land offices can arise for a variety of structural and operational reasons. These include approval processes that require several levels of internal review, heavy staff workloads, and occasional communication gaps within the bureaucratic chain. Many processes still rely upon manual documentation, which can prolong administrative steps and increase the likelihood of bottlenecks. Some delays stem from ongoing investigations into the legality of land titles. For example, a land title deed may have an annotation indicating that the title deed is under investigation to verify its legality. Even though this annotation does not legally prohibit the sale or transfer of the land, in practice, most prospective purchasers are reluctant to proceed with a transaction until the annotation is removed. As a result, the land can become effectively illiquid during the investigation period, leading to significant investment delays. While such investigations are essential to maintaining the integrity of Thailand’s land registration system, prolonged inquiries
Read More
October 30, 2025
Thailand has introduced a comprehensive overhaul of its tax litigation procedures that will significantly impact how tax disputes are handled. The Regulations for Tax Cases B.E. 2568 (2025) take effect on November 24, 2025, and repeal the prior B.E. 2544 (2001) regulations in full. These regulations support the implementation of the Act on the Establishment of the Tax Court and Tax Case Procedure (No. 3) B.E. 2568 (2025), which expands the Tax Court’s jurisdiction to certain criminal tax matters. Published in the Government Gazette on October 14, 2025, the regulations have been reorganized into three parts covering civil cases, criminal cases, and forms, and are designed to accelerate proceedings, tighten evidentiary discipline, and modernize court operations. Structural Reform and Scope The prior regime governed only civil tax disputes. Under the new framework, the regulations introduce a dedicated chapter for criminal cases alongside updated civil procedures, as the Tax Court now has express authority to adjudicate specified criminal tax offenses. Select mechanisms applied in civil case proceedings, such as electronic communication, recording testimony, and appointing experts, also apply to criminal proceedings mutatis mutandis where they do not conflict with criminal procedure. Civil Cases: Evidence Submission, Deadlines, and Scheduling Parties must submit, together with the witness list, originals of all documentary evidence, media, or electronic data (such as files, USB drives, or CDs), and all physical evidence in the party’s possession. Failure to submit any original within the deadline (see below) results in a loss of the right to adduce that item at trial, subject only to narrow exceptions where submission is impossible due to force majeure or where receipt of the evidence is indispensable to the interests of justice. The practical impact is that parties are now obligated to assemble and verify all original documents and data at the very
Read More
October 24, 2025
The Thai Arbitration Institute (TAI), a division of Thailand’s Office of the Judiciary, has taken a step toward harmonizing the tools available for dispute resolution. On August 8, 2025, the institute formally launched the TAI Mediation Center (TAI-MC). Although the amendments to TAI’s Arbitration Rules that will govern the TAI-MC have not yet been finalized, the framework now under consideration suggests that TAI is positioning itself to become a more attractive venue for commercial dispute resolution. In the regime contemplated under the current version of the amendments, TAI proceedings will adopt an “arbitration-annexed mediation” mechanism—commonly termed the “Med-Arb” model—while preserving the procedural safeguards indispensable to arbitral neutrality. Mediation will be entrusted to a separate, dedicated mediator appointed under the TAI-MC who is precluded from serving on the arbitral tribunal in the same matter. By clearly separating the functions of mediator and arbitrator, the institute eliminates any risk that confidential information disclosed during mediation could influence the adjudicatory outcome if the parties do not settle. Only when all parties subsequently make a request may that same mediator assume arbitral duties in the case. The parties will retain substantial autonomy in selecting the mediator. They may either designate a mediator by mutual consent or invite the TAI-MC to appoint one from its authorized panel. TAI has announced its intention to curate that panel with particular emphasis on commercial expertise and cross-cultural negotiation skills, supplemented by ongoing professional training. Where the parties cannot agree on remuneration, the mediator’s fee will default to a tariff comparable to the TAI-MC’s cost schedule, which under the current version of the amendments will be approximately THB 45,000 for disputes in which the aggregate claims do not exceed THB 10 million, with incremental increases tied to higher claim values. This predictable cost matrix is aimed at enhancing
Read More
October 24, 2025
In Vietnam, litigation is generally treated as a last resort in dispute resolution. Businesses often strive to avoid court proceedings, given the potential for disrupted relationships, higher costs, and lengthy timelines. Yet, litigation is sometimes unavoidable, whether to secure a remedy or respond to a claim. Familiarity with Vietnam’s court system and procedures is therefore crucial for any party involved in such matters. Civil Litigation in Vietnam offers a concise overview of the country’s civil court system and litigation process. The guide a highlights essential points for navigating legal disputes in Vietnam, whether as a plaintiff or a defendant. Tilleke & Gibbins also publishes a similar guide for Thailand. The full Civil Litigation in Vietnam guide is available as a PDF through the button below.
Read More