Thailand adopts ‘Living Will,’ protecting right to dignified death for elderly
Source the Institute for Population and Social Research, Mahidol University (Press Release, January 2025), Matichon
Photo Credit to Image by Alex Borghi from Pixabay
Thailand’s annual birth rate has drooped below 500,000 for the first time in 75 years. The decline continues despite the government’s ‘Give Birth Great World’ campaign, according to Mahidol University. “The low birth rate and aging society remain critical issues for the population,” said Assoc. Prof. Dr. Chalermphon Chaemchan, Director of the Institute for Population and Social Research, Mahidol University.
Data from the Registration Administration Office, Ministry of Interior showed that Thailand’s 2024 population totaled 65,951,210. The birth rate was recorded at 462,240, marking the fourth consecutive year where deaths have outnumbered births. Thailand’s Total Fertility Rate (TFR) in 2024 stood at 1.0, placing it among countries with the lowest fertility rates globally, alongside South Korea and Singapore.
Alarmingly, this rate is even lower than Japan’s, at 1.2. These figures signal Thailand’s progression towards a “super-aged society,” with individuals aged 60 and above comprising over 20% of the total population.
A survey by the Institute for Population and Social Research found that 71% of Thais view the declining birth rate as a national crisis. However, only 44% support government policies encouraging higher birth rates, with women showing less support (42%) compared to men (52%).
Two-thirds of respondents (66%) favor raising the official retirement age from 60 to 65 years, while 64% support redefining the definition of ‘elderly’ to apply to individuals aged 65 and older.
A survey revealed that Thai society is prepared to adapt to an aging population, although boosting birth rates remains a significant challenge.
The government faces mounting pressure to address the demographic shift as Thailand approaches a critical population milestone. Over one million people born annually between 1963 and 1983 are set to enter retirement age, a phenomenon researchers have described as a “senior tsunami.”
This situation highlights the urgent need for a comprehensive welfare system capable of addressing the needs of all age groups.
One crucial social health policy is the ‘e-Living Will,’ which grants individuals, especially the elderly, the right to express their preferences regarding end-of-life care. This includes the option to refuse life-prolonging medical treatments in cases of severe health decline, as outlined in Section 12 of the National Health Act of 200.
Raising awareness about the ‘e-Living Will’ empowers the elderly to plan their end-of-life care according to their needs. This initiative reduces potential family conflicts, upholds individual dignity in their final days, and supports treatment planning. These efforts align with the government’s priority healthcare policies.
An online survey conducted by the Institute for Population and Social Research, Mahidol University, titled “Situation of Low Births and Aging Society,” found that 84.7% of respondents support the right to create living wills. These documents allow individuals to decline life-prolonging treatments in terminal cases.
This right is consistent with Section 12 of the National Health Act, which states: “A person has the right to make a written statement declining medical services intended solely to prolong death in terminal illness or to alleviate suffering from disease.”
The survey indicated that Generation X and older groups showed the highest level of agreement (90.3%), reflecting an increased awareness of the importance of end-of-life planning.
Dr. Suthep Petchmark, Secretary-General of National Health Commission, Thailand, emphasized, “A good life includes planning for end-of-life care while we are still capable of making decisions. When that time comes, relatives and medical professionals will respect the wishes expressed through the e-Living Will system.”
Dr. Viroj Tangcharoensathien, Vice Chair of the Intergovernmental Negotiating Body Bureau at the World Health Organization (WHO), emphasized that, “Thailand is one of the first developing countries to enact a Living Will law. While awareness is widespread across all age groups, successful implementation requires cooperation from families, society, and medical personnel.”