On March 22, 2025, Thai PBS hosted a significant forum titled "Policy Forum: Intending To Die Well, Note: I’m In Bangkok" at the Impact Exhibition Hall 6, as part of the larger initiative, 'Death Fest 2025: Better Living, Better Leaving.' This event was a call to action addressing the critical issue of end-of-life care, particularly amidst alarming statistics surrounding the access to quality palliative care in Thailand, especially within bustling urban centers like Bangkok.
A striking 80% of Thais express a wish to pass away peacefully in their homes, a desire deeply rooted in cultural values and the quest for dignity in death. However, the reality paints a starkly different picture for residents in the capital. Only 30% of individuals in Bangkok report wanting to die at home, and disconcertingly, a mere 3% have access to comprehensive palliative care services, highlighting a severe urban-rural divide.
During the forum, caregiver Arpana Chaiyasut shared her poignant experiences, shedding light on the pervasive challenges surrounding palliative care. "Many patients only receive pain relief, and some may not even understand what palliative care is," she emphasized, articulating the struggle many face when navigating the complex healthcare system.
The financial strain of securing adequate healthcare is another thorny issue for families. While basic palliative care services can cost around 600 baht per month, comprehensive care can skyrocket to as much as 50,000 baht monthly—an expense that is far beyond the reach of many families. This financial disparity restricts access and forces families into difficult choices, intensifying the emotional strain during an already distressing time.
The forum implemented a discussion that revealed the pressing need for systemic change regarding palliative care provision. Attendees underscored the importance of enhancing public understanding of palliative care and increasing awareness about available resources. Health professionals called for more training and development programs targeting caregivers and healthcare workers, aiming to improve service delivery and empathy toward patients and their families.
The challenges discussed at the forum are not merely individual stories but reflect the broader societal inadequacies in healthcare provision for end-of-life scenarios. Families often feel isolated and unsupported, left to navigate their care needs without adequate information or resources.
As the day progressed, participants collaborated on actionable solutions to reshape the landscape of palliative care, envisioning a future where every individual, irrespective of their economic standing or geographical location, can access appropriate end-of-life care. Suggestions ranged from implementing community outreach programs to foster better understanding and communications regarding palliative services to advocating for policy reforms that can support quality care initiatives.
In the coming years, addressing these disparities is essential for Bangkok to attain its goal of offering dignified end-of-life care to all its citizens. It is a journey that requires collaboration across various sectors—government agencies, healthcare providers, and community organizations must come together for a shared mission.
The government, represented by officials at the forum, acknowledged that despite the challenges, initiatives like the "Bureau of Palliative Care" offer hope for improvement. Innovative policies and ethical considerations in healthcare are being driven forward, with an emphasis on integrating these practices into everyday healthcare routines.
Moving forward, the commitment to a well-rounded approach to end-of-life care remains crucial, ensuring that urban Bangkokians will one day know they can have access to what they want most— the chance to die well, surrounded by loved ones in the comfort of their home.
Where we go from here will depend on our collective understanding and responsiveness to the deep-rooted needs of those in critical situations. This forum marks just the beginning of necessary conversations and the start of substantive changes needed to fulfill the promise of dignified end-of-life care for all.
