Death taboo fades as Thais turn to living wills

Death is traditionally a taboo topic in Thailand, rooted in the belief that discussions about the end of life invite misfortune – or even an untimely demise. However, this age-old superstition is now giving way to a more pragmatic concern as a growing number of Thais recognise the value of living wills.

More and more individuals are now actively planning the final stage of their life, leaving explicit instructions on medical intervention in case time robs them of the ability to speak for themselves.

“I have already made a living will. I see no point in putting my family through a painful situation where they are unsure of what is best and end up prolonging my life for no good reason,” said a woman in her 50s who asked to remain anonymous.

Her decision was triggered by the emotional burden of dealing with end-of-life care for her elderly mother and older brother. “I don’t want my relatives to go through that same ordeal,” she said.

After drafting her living will via the national portal – https://e-livingwill.nationalhealth.or.th/– she distributed printed copies to members of her family.

A rising trend

Thailand formally recognised living wills in 2007 under Section 12 of the National Health Act (2007). The law grants any legally competent person the right to prepare an advance directive or living will refusing medical treatment that merely prolongs the final state of terminal illness or inflicts unnecessary physical suffering.

Since the law’s passage, public health organisations have actively campaigned to expand awareness about the freedom to make end-of-life choices.

One of the primary educational resources is the “Bao Jai” (“Relieved Heart”) booklet. Designed as a step-by-step guide, the booklet lists simple questions on personal values, wishes and the life people want to live, as well as how they would like to be looked after if they become gravely ill or are diagnosed with a terminal condition.

By completing these prompts, people can record whether they prefer to be kept alive via life-support devices or if they are willing to forego such intervention so they can die naturally. Once the form is completed and signed, it serves as a legally valid living will.

To streamline access, the National Health Commission Office (NHCO) has developed a digital platform that is linked directly to eligible medical facilities nationwide.

The portal allows Thai citizens to draft new directives or upload existing documents detailing their personal information and end-of-life preferences. Once submitted, the record can be accessed by the user and printed and shared. It can also be modified or revoked at any time.

“To date, nearly 100,000 people have made their living wills through the online portal,” the NHCO states. “This marks a huge jump from the 8,000 or so registrants recorded in late 2025.”

Cultural shift in mindset

The demographic of people engaged in end-of-life planning is no longer limited to the elderly, with growing numbers of younger individuals making living wills.

“People’s mindsets are changing,” remarked Dr Apichat Rodsom, deputy secretary-general of the NHCO. “More Thais are dismissing the superstition that making such preparations is a bad omen. They understand that a living will can benefit their families, protect their own autonomy and reduce unnecessary burdens on the healthcare system.”

He emphasised that writing a living will does not mean refusing all medical care, but rather ensures that palliative treatment aligns precisely with the patient’s expressed wishes.

“It’s not about abandoning patients, but about delivering care the way they have specified,” he said.

By Thai PBS World’s General Desk