A conventional will explains what should happen to your assets after you die. A living will deals with a very different question: what happens if you become seriously ill and can no longer tell doctors what medical treatment you do or do not want?
For expats living in Thailand, a living will can provide a clear record of those wishes if you are no longer able to communicate them yourself.
Thailand legally recognises written living wills under Section 12 of the National Health Act B.E. 2550 (2007). They can be used to record certain wishes about healthcare towards the end of life, including treatment that would merely prolong the dying process.
A living will is different from a conventional will, a do not resuscitate order and a power of attorney. It also does not mean refusing all medical care.
Making the document is only part of the process. Your wishes need to be clear and the living will needs to be available to the doctors and people who may need it if the time comes.
This guide explains how living wills work in Thailand, whether foreigners can make one and the practical steps expats should consider.
What Is a Living Will in Thailand?
A living will is a written record of certain healthcare decisions and preferences made while you are still able to understand and express them.
It is intended to guide doctors and others if you later become seriously ill and are no longer able to communicate for yourself.
You may also see similar documents described as:
- Advance directives
- Advance healthcare directives
- Advance decisions
- End of life directives
The terminology varies between countries, but the key distinction is between a living will and a conventional last will and testament.
A last will deals primarily with what happens after death, including assets, beneficiaries and executors.
A living will deals with certain healthcare decisions while you are still alive.
The two documents therefore serve very different purposes.
Are Living Wills Legal in Thailand?
Yes. Living wills are expressly recognised under Section 12 of Thailand’s National Health Act B.E. 2550 (2007).
In broad terms, Section 12 allows a person to make a written living will refusing public health services that would merely prolong the terminal stage of life, or refusing services where the purpose is to bring severe suffering from illness to an end.
More detailed rules are set out in a Ministerial Regulation issued in 2010, which took effect on 20 May 2011. The linked document is an unofficial English translation hosted by Thailand’s National Health Commission Office.
Healthcare professionals who act in accordance with a living will that meets the legal requirements are also protected from liability under the Section 12 framework.
Can Foreigners Make a Living Will in Thailand?
Yes. Section 12 gives the right to make a living will to ‘a person’ and does not restrict that right to Thai citizens.
Neither the National Health Act nor the Ministerial Regulation appears to impose a nationality, visa or permanent residence requirement. Foreigners can therefore make a living will for use in Thailand.
One practical issue is identification. Foreign residents should ensure their identifying details are clear and consistent with the passport, Thai identification documents, if any, and hospital records they use in Thailand.
When Does a Thai Living Will Apply?
A Thai living will is not a general instruction refusing medical treatment in every future emergency.
The Section 12 framework applies in specific end of life circumstances.
The Ministerial Regulation defines the terminal phase as an incurable condition caused by disease or injury, diagnosed by the attending medical practitioner, where death is expected within a relatively short period according to reasonable medical standards.
It also covers circumstances involving complete and irreversible loss of cerebral cortical function, including irreversible loss of cognition and consciousness, even where some automatic bodily functions continue.
This is important because it addresses one of the situations many people worry about when considering a living will: being kept alive without any realistic prospect of regaining awareness.
A living will does not therefore mean: ‘Do not treat me.’
You may want full emergency treatment for a serious but reversible illness or injury while also wanting to avoid prolonged artificial life support if your condition later meets the legal criteria. The living will should make that distinction as clearly as possible.
Your current wishes also remain important. If you are conscious and able to communicate, the Ministerial Regulation requires the attending medical practitioner to explain your medical condition and confirm whether you still want the living will to be followed. A decision recorded years earlier does not prevent you from changing your mind when you are actually facing the medical situation.
What Can a Living Will Cover?
The instructions in a living will will depend on your wishes and the circumstances in which you want them to apply.
Thailand’s National Health Commission Office publishes an official sample living will, which includes decisions about life sustaining treatment such as:
- Cardiopulmonary resuscitation
- Mechanical ventilation
- Artificial life support
- Artificial nutrition or hydration
- Intensive care
- Treatment of complications
- Other interventions whose main effect would be to prolong the dying process
A living will does not mean that every form of treatment must be refused. You may want some treatments but not others, or you may want treatment to continue while there is a reasonable prospect of recovery but not indefinitely once that prospect has gone.
The Ministerial Regulation also expressly preserves the right to palliative care. Refusing treatment that merely prolongs dying does not mean refusing pain relief, symptom management, nursing care or other appropriate comfort care.
Nor is a living will the same as euthanasia. It allows a person to refuse certain healthcare in circumstances covered by Section 12, but it does not authorise a doctor or anyone else to deliberately cause death.
A living will can also record wishes about matters such as your preferred place of care or death, spiritual support and religious or cultural practices. Healthcare providers should facilitate these wishes where this is feasible and appropriate.
A living will is also broader than a do not resuscitate decision. A DNR deals specifically with whether cardiopulmonary resuscitation should be attempted, while a living will can cover a wider range of end of life healthcare wishes.
Medical advice may be helpful when preparing a living will, particularly if you want to be clear about the treatments you would accept and those you would refuse. The aim is to make your wishes clear enough to guide doctors without trying to anticipate every possible medical situation.
Who Decides if You Cannot Speak for Yourself?
The Ministerial Regulation allows you to appoint another person to act as a proxy in connection with your living will.
If questions arise about your wishes, the proxy may explain what actions should be taken or make healthcare decisions on your behalf. They must act in accordance with the directions and wishes you have already expressed.
If you appoint a proxy, their identifying information and signature should also be included in the living will.
This role is more than simply naming an emergency contact, but it should not be confused with a UK Health and Welfare Lasting Power of Attorney or a healthcare power of attorney in another country. A Section 12 proxy does not have unrestricted authority to make every medical decision for you. Their role is tied to clarifying and implementing the wishes recorded in your living will.
If you cannot communicate, healthcare professionals may also need to discuss your condition and living will with your proxy or a relative. This does not mean family members automatically have the right to override a valid living will, but disagreement can make an already difficult situation harder.
For that reason, it is sensible to discuss your wishes in advance with your partner or close family, your appointed proxy and anyone else likely to be involved in your care.
Does a Thai Living Will Have to Be Written in Thai?
The legislation does not appear expressly to require a living will to be written in Thai.
However, the document needs to be understood by the healthcare professionals who may eventually rely on it, potentially at a time when you cannot explain your wishes yourself.
For most foreign residents, a bilingual Thai and English living will is therefore likely to be more practical than an English only document.
The Thai and English versions should be carefully checked to make sure they express the same wishes.
What Are the Signing and Witness Requirements?
A living will should clearly identify you, record the healthcare you wish to refuse, be dated and include the required signatures.
The unofficial English translation hosted by Thailand’s National Health Commission Office refers to ‘a witness (or witnesses)’ and does not state that two witnesses are mandatory. This differs from an ordinary Thai will, which has separate witness requirements under succession law.
Even where one witness may be sufficient, using two suitable witnesses can still be sensible, particularly if questions later arise about whether the document genuinely reflected your wishes.
If you appoint a proxy, their identifying information and signature should also be included.
Do You Need a Lawyer to Make a Living Will?
Thai law does not appear to require a living will to be prepared by a lawyer, notarised or approved by a court.
Professional help may nevertheless be useful if you want a bilingual document, already have an overseas advance directive or power of attorney, expect possible family disagreement or want the living will coordinated with wider succession planning.
The more complex your cross border circumstances, the more important it becomes to make sure the different documents work together rather than create uncertainty.
Making Sure Your Living Will Can Be Found
A carefully drafted living will is of limited value if nobody can find it when it is needed.
The Ministerial Regulation says that when a person is admitted to a healthcare facility, the living will should be provided to healthcare practitioners as soon as possible.
In practice, consider keeping the original somewhere secure but accessible, giving copies to your appointed proxy and close family and asking your regular hospital whether the document can be added to or flagged on your medical record.
Thailand also has an official e-Living Will system operated through the National Health Commission Office. It became available in May 2024 and is designed to help people create and share living wills electronically with participating healthcare providers.
For some foreigners, access may be a challenge because the public system relies on Thai digital identity and identification credentials. For many expats, a written living will may therefore remain the more practical route.
Do not assume that a document held by one hospital or hospital group will automatically be visible to another. If you regularly use more than one hospital, check how each one records living wills.
What if You Already Have an Overseas Advance Directive or LPA?
Many expats already have an advance directive, Health and Welfare Lasting Power of Attorney or similar document from another country.
You should not assume that a foreign document will operate in Thailand exactly as it does in the country where it was made. It may still provide important evidence of your wishes, but its legal status and practical operation in Thailand can differ.
If Thailand is where you are likely to receive medical treatment, it may be sensible to consider a living will prepared specifically for use here. Where documents exist in more than one country, they should also be reviewed together so that one does not create uncertainty about the other.
Can You Change Your Living Will?
Yes. A living will can be amended or revoked, and the Ministerial Regulation provides that the most recent version takes precedence.
Review it if your health, treatment preferences, family circumstances, proxy, country of residence or hospital arrangements change. If you replace the document, make sure the people and healthcare providers holding copies receive the current version.
Should Expats Have Both a Thai Will and a Living Will?
For many expats, it is worth considering both because they deal with different issues.
A Thai last will deals with what happens to your estate after death, including who receives your assets and who administers the estate. A living will deals with certain healthcare decisions while you are still alive.
Having one does not replace the other. Both can form part of wider planning that may also need to consider overseas assets, foreign wills, powers of attorney and family arrangements.
If you already have a will in another country, you should also consider how that document works alongside any Thai will you put in place. Read our guide to having both a Thai will and a foreign will.
Practical Living Will Checklist for Expats
If you are considering a living will in Thailand:
- Understand when a Section 12 living will applies and what treatment choices matter to you.
- Consider using a clear bilingual Thai and English document.
- Decide whether to appoint a proxy and discuss your wishes with the people closest to you.
- Make sure the document is properly dated, signed and witnessed.
- Give copies to the people who may need them and ask your regular hospital how it records living wills.
- Review any overseas advance directives or powers of attorney alongside the Thai document.
- Keep the living will up to date and replace old copies when your wishes or circumstances change.
Planning Beyond a Will
Good succession planning is about more than deciding what happens to your assets after you die. It can also mean making sure your wishes are understood if illness or incapacity leaves you unable to make decisions for yourself.
For expats, this can involve bringing together a Thai will, a living will and any existing overseas wills or powers of attorney so that the different arrangements work together.
If you would like help with your succession planning, our team would be happy to talk through the arrangements you may wish to put in place and help you understand the options available.
