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  1. #1
    I'm in Jail

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    Would you turn off the life support of a loved one?

    My Gf's Aunty is on life support and the doctor has explained to them,if she isn't on the machine she will die quickly,its costing them 20,000 baht a day,which they can't afford.

    I've heard this story a few times and see how much shit they get themselves into,I believe the doctor will tell them very shortly that they have to switch off, if no money is forthcoming,which will hurt them more.

    The logic of people where death is concerned amazes me.

  2. #2
    I'm in Jail

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    It is a problem for Thais being Buddhist. The decision is basically killing someone for them. Mrs went through a similar issue with her father and Morphine administration. It took me a long time to explain to her that she is not killing him but that he is in a great deal of pain and is unable to ask her to do what needs to be done. I had a joint chat with her and the Doc and we agreed a form of words she could take to the family which carried the decision to up the morphine to a terminal dose but was agreed as increasing the dose to help with the pain but everyone knew the outcome. Its hard to press the switch ordinarily but if you couple that with the implication that you are killing someone rather than helping someone then its an extra hurdle.

    The binary nature of turning something off with the instant result of death is more problematic as the action and result are almost immediate. I think the approach has to be talking to the family about the person wanting to leave and move on but that they cannot do that whilst they are on the machine so you are basically helping them move on.

  3. #3
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    Yes exactly what i said to my GF, and her first response I was being heartless,though after a bit of time, she realised that the pain the person could be going through and the pain it would give the family,it could be the better option.

    Gives peace to all.

    If i was a burden to my family i would want the same.

  4. #4
    I'm in Jail

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    They see it as killing but the narrative must be changed to helping..can't see another way.

  5. #5
    Thailand Expat
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    Just a few days ago we had a ruling by our german constitutional court. This would be regarded as murder and punished accordingly. However they declared it legal if you install a button the patient can push to switch life support off. That's a major switch in regulations.

    The example they used was that an injection that kills the patient is illegal. But putting a cocktail of drugs that kills him where he can reach it is legal.
    "don't attribute to malice what can be adequately explained by incompetence"

  6. #6
    Thailand Expat
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    ^ Doesn't quite work for someone in a coma on life support though does it...

  7. #7
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    I think its about time living wills became universal law that instructs medical staff as to your wishes - at least you have the ability to control your end in much the same way you control the rest of your life.

  8. #8
    Thailand Expat CaptainNemo's Avatar
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    Drs and nurses are used to seeing medical tragedies, and Joe Blogged, generally is not. The perspectives are so different Many are compassionate, but a lot more realistic, based on probabilities and experience.
    Joe Bloggs and relatives tend to need someone or something to blame to deflect from the pain. Generally though, dragging things out is frequently worse than addressing hard decisions early.

  9. #9
    The Fool on the Hill bowie's Avatar
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    Interesting subject - been through it. Pulling the plug doesn't result in an "instantaneous" or quick death. Rather the body slowly starves of oxygen. The body typically twitches and convulses. In this one case a morphine drip was administered to "minimize" the twitching and movements of the body and to spare the loved ones in attendance the emotional pain caused by observing what is perceived as pain. For what it's worth.

    Had another close friend dying of terminal colon cancer in a hospice ward of a hospital whose was I guess threatened to be kicked out f the hospice ward if he didn't agree to a morphine drip. The family was in serious emotional distress, my buddy was semiconscious at best and barely coherent. A most troubling time for all involved.

    Living wills. We have both Thai and American living wills. Our American living wills have a clause added that specifically states any deviation from our DNR instructions require our signature. As per our attorney - several living will DNR's have been challenged in court. Successfully or not doesn't matter as the patient is keep alive during the time it takes for the court to make a decision.

    Another scenario I was through with a close family friend who suffered a massive stroke (vegetative state) was keep alive for three years via a feeding tube at the request of the son. The wife and daughters of the patient wanted to pull the plug. The son "what if they discover a cure?" The end result was the care of his body drained all of their money. A cure was not discovered and eventually he did die despite the feeding tube. But, horrible vigil for the wife watching her husbands body being keep alive in hospital bed in their living room. The son did spend al his spare time at his fathers bedside -visited every day at lunch and spent all evening at the bedside.

    The emotional drain cannot be explained in words. Each person is different and handles the situation differently.

  10. #10
    Thailand Expat Pragmatic's Avatar
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    Quote Originally Posted by Chico View Post
    ,its costing them 20,000 baht a day
    Excuse me for asking but why is it costing 20,000 a day when they still have the 30-50 Baht scheme still in operation? Just curious.

  11. #11
    Hangin' Around cyrille's Avatar
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    He means that it's costing the hospital 20,000 baht a day, I think.

  12. #12
    I'm in Jail

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    Quote Originally Posted by Pragmatic View Post
    Excuse me for asking but why is it costing 20,000 a day when they still have the 30-50 Baht scheme still in operation? Just curious.
    I would think she isn't covered under UHC,as she is a Laos national.

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