End of life care in Thailand
The population of Thailand is approximately 63.5 million people.
Life expectancy has risen to 67.9 years in men and 75.0 years
among women (Phungrassami 2005).The leading causes of death
are cancer, accidents, heart disease and acquired immune deficiency
syndrome (AIDS) (Phungrassami 2005). The demand for
care at the end of life is increasing because of the growing number
of terminally ill persons seeking optimal care. Recently, the Thailand
National Hospital Accreditation Authority has introduced
the provision of palliative and end-of-life care as a quality indicator
(Nilmanat & Phungrassami 2006). ‘The right to refuse treatment’
was also announced in the National Health Act (2007).
Thailand does not have hospice units for dying patients in
every hospital. A few university hospitals have opened palliativehospice
care units with 5–10 beds for inpatients and outpatients.
Government-run hospice care for dying patients does not exist.
However, several temples in Thailand provide convenient places
for dying patients, particularly those patients with AIDS. Few
hospitals provide home palliative care services, and bereavement
services are not formally provided for families (Nilmanat &
Phungrassami 2006; Phungrassami 2005).
In Thai culture there is little emphasis on individual rights or
individual autonomy as these are not central or core values
(Manosilapakorn 2003). Thai family presence strongly impacts
on end-of-life care and has a vital role in making decisions and
care for the terminally ill loved ones in the hospitals or in their
homes.