Monitoring of the dying process
In Thailand, physicians have not given formal orders for palliative
care, or resuscitation procured such as ‘do not resuscitate’
(DNR) orders. Instead, awareness of the dying process
could be obtained through the physician’s progress notes; that
is, often, the only place where information about the management
of the dying patient may be found. The participants used
their own experiences to monitor the impending deaths of
patients. Oftentimes, participants perceived that critically ill
patients were dying only when they became unresponsive to
treatment or showed poor vital signs, and became physiologically
constrained by having repeated cardiac arrests. As one
participant said: