The National Health Bill, which recognised the directive, sailed through the National Legislative Assembly (NLA) yesterday.

The bill will become an act as soon as it receives royal endorsement.

Section 10 of this bill reads: "A person has the right to make an advance directive stating his or her decision not to receive medical treatment in a way that serves only to delay his or her death during the terminal stage of his or her life. Compliance with the said advance directive shall be conducted in line with procedures and criteria required by ministerial regulations. Health professionals shall be required to honour the advance directive and by doing so, they shall not be held responsible for any resulting consequence". 

While supporters wholeheartedly embraced the bill, citing it respected a person's will to choose whether to live on or die, critics like NLA member Somkiat Onwimon expressed concerns that such a move would lead to euthanasia.

"The right to die is a big issue. How can we leave this to ministerial regulations?" Somkiat said.

After the NLA gave the green light to the bill, Somkiat immediately held a press conference expressing his opposition.

"How can we decide that this person is already at his or

her terminal stage?" Somkiat said.

He also believed that by not going all out to help the patient, the doctors could be viewed as committing a mercy killing.

Somkiat said if this controversial section took effect, several lawsuits would follow.

However, just an hour after Somkiat talked to the media, Public Health Minister Mongkol na Songkhla and other supporters of the bill held a press conference to hail the bill that had sailed through the NLA.

"I am delighted that this bill is going to become law. It's not like any other law. The people have been actively involved in the drafting of it," Mongkol said.

The key parts in the National Health Bill are about people's participation in the health

system.

On the Section 10, Mongkol said the advance directive was intended to give the patient the right to choose whether to receive medical treatment and the doctors would have no say in such a case.

"Without the advance directive, the patients' relatives and doctors usually make decisions together," Mongkol said.

He said his ministry was going to draft clear regulations that would prioritise who would have the first say among the patients' relatives in such important decisions.

According to Mongkol, some patients apparently felt it was not worth prolonging their lives by just a few hours at huge medical cost to their families.

"Medical bills can sometimes bankrupt a family," Mongkol said.

Dr Nirut Utha, a supporter of the National Health Bill and a key member of a doctor's group, said 99 doctors would be ordained in dedication to people who have pushed for this bill as soon as the National Health Act took effect.

NLA member Ampon Jindawattana, who sits in the NLA panel vetting the bill, said there were similar laws about the advance directive in many other countries including Singapore and Denmark.

"The good point is that the advance directive allows a person the right to die peacefully when the time arises," Ampon said.

He cited the late monk Buddhadasa Bhikkhu as an example.

The famous monk, who died in 1993, made an express intention to pass away peacefully at his temple and not use a respirator to cling on to life in the last stages of his existence. However, his followers went against his wish and asked that the respirator be used.

According to Ampon, the advance directive is going to specify clearly the condition of a person whose decision will be respected. Key conditions included irreversible coma and lung failure.

"Doctors will examine the [patient's] condition and decide whether it's time to honour the advance directive. For example, had teacher Juling Pangamoon made the advance directive before she had fallen into a coma, doctors would not agree to stop treating her because she's still young and stands the chance of recovery," Ampon explained.

Juling, 24, was severely beaten by an angry mob in the deep South last year as they tried to demand the release of suspects accused of instigating violence there.

"But if an 80-year-old patient has a similar symptom, doctors may honour the advance directive," Ampon said.

He said the Medical Council would be asked to lay down guidelines about how doctors could determine which was the terminal stage of a patient's life.

"There are going to be clear-cut details. Section 10 will not allow euthanasia," Ampon said.

Prapasri Osathanon,

Chularat Saengpassa

The Nation