{"id":1827,"date":"2026-04-18T17:01:02","date_gmt":"2026-04-18T10:01:02","guid":{"rendered":"https:\/\/www.thailawonline.com\/glossary\/palliative-care\/"},"modified":"2026-09-27T22:32:43","modified_gmt":"2026-09-27T15:32:43","slug":"palliative-care","status":"publish","type":"page","link":"https:\/\/www.thailawonline.com\/fr\/glossary\/palliative-care\/","title":{"rendered":"Soins palliatifs et droit de refuser un traitement (Article 12 de la loi nationale sur la sant\u00e9)"},"content":{"rendered":"<p class=\"wp-block-paragraph\"><p><strong>Soins palliatifs<\/strong> (\u0e01\u0e32\u0e23\u0e14\u0e39\u0e41\u0e25\u0e41\u0e1a\u0e1a\u0e1b\u0e23\u0e30\u0e04\u0e31\u0e1a\u0e1b\u0e23\u0e30\u0e04\u0e2d\u0e07, <em>Garder le contact doucement<\/em>, parfois appel\u00e9 <em>soins de confort<\/em> ou <em>soins palliatifs<\/em>) est un soin m\u00e9dical visant \u00e0 soulager la douleur et les sympt\u00f4mes d'une maladie grave ou en phase terminale sans chercher \u00e0 la gu\u00e9rir. En droit thailandais, il s'inscrit dans le droit du patient en vertu de l'article 12 de la loi sur la sant\u00e9 nationale de 2550 (2007) de refuser des traitements qui ne feraient que prolonger l'agonie. Un testament de fin de vie (living will) en vertu de cet article refuse g\u00e9n\u00e9ralement la r\u00e9animation et les machines tout en demandant des soins palliatifs, et les m\u00e9decins qui le suivent sont prot\u00e9g\u00e9s par la loi. Pour un \u00e9tranger confront\u00e9 \u00e0 une maladie incurable ici, c'est la loi qui compte.<\/p><\/p>\n\n\n<div class=\"wp-block-rank-math-toc-block\" id=\"rank-math-toc\"><h2>Table des mati\u00e8res<\/h2><nav><ul><li><a href=\"#the-legal-basis-in-the-national-health-act\">Le fondement juridique de la loi nationale sur la sant\u00e9<\/a><\/li><li><a href=\"#practical-points-for-foreigners-in-thailand\">Points pratiques pour les \u00e9trangers en Tha\u00eflande<\/a><\/li><li><a href=\"#palliative-care-withdrawal-and-euthanasia\">Soins palliatifs, renoncement et euthanasie<\/a><\/li><li><a href=\"#frequently-asked-questions\">Foire aux questions<\/a><\/li><\/ul><\/nav><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"the-legal-basis-in-the-national-health-act\">Le fondement juridique de la loi nationale sur la sant\u00e9<\/h2>\n\n\n<p class=\"wp-block-paragraph\"><p>L'article 12 conf\u00e8re \u00e0 une personne le droit de faire une d\u00e9claration \u00e9crite refusant les services de sant\u00e9 qui ne servent qu'\u00e0 prolonger la vie au stade terminal de la maladie ou \u00e0 mettre fin \u00e0 de grandes souffrances. Le r\u00e8glement minist\u00e9riel de 2010, en vigueur depuis le 20 mai 2011, pr\u00e9cise la proc\u00e9dure : la d\u00e9claration doit \u00eatre faite par \u00e9crit, identifier son auteur, \u00eatre dat\u00e9e et sign\u00e9e, et pr\u00e9ciser les traitements refus\u00e9s. Il confirme \u00e9galement que le refus d'un traitement de maintien en vie ne signifie pas le refus de la prise en charge. L'h\u00f4pital doit continuer \u00e0 soulager la douleur et les sympt\u00f4mes, et le patient peut le demander dans le m\u00eame document.<\/p><\/p>\n\n\n<p class=\"wp-block-paragraph\"><p>A practitioner who complies with a valid declaration commits no offence and is released from liability under the Act. That protection attaches to acting on the declaration: not starting, or stopping, treatment the patient has refused. Pain relief given to control symptoms is ordinary medical treatment, and the regulation itself provides that a patient who refuses life-prolonging treatment continues to receive palliative care (clause 2). What section 12 does not cover is any act intended to cause death, which remains murder under Section 288 of the Criminal Code; see the entry on <a href=\"https:\/\/www.thailawonline.com\/fr\/glossary\/euthanasia\/\">euthanasie<\/a>.<\/p><\/p>\n\n\n<h2 class=\"wp-block-heading\" id=\"practical-points-for-foreigners-in-thailand\">Points pratiques pour les \u00e9trangers en Tha\u00eflande<\/h2>\n\n\n<p class=\"wp-block-paragraph\"><p>Les services de soins palliatifs existent dans les grands h\u00f4pitaux priv\u00e9s de Bangkok, Chiang Mai, Pattaya et Phuket, dans les h\u00f4pitaux universitaires publics, et de plus en plus \u00e0 domicile gr\u00e2ce \u00e0 des \u00e9quipes de liaison hospitali\u00e8re. L'acc\u00e8s commence par le constat d'un m\u00e9decin que la maladie est au stade terminal ; de nombreux h\u00f4pitaux priv\u00e9s demandent \u00e0 un deuxi\u00e8me m\u00e9decin de le confirmer avant d'appliquer un testament de fin de vie. Les opio\u00efdes puissants sont des m\u00e9dicaments contr\u00f4l\u00e9s en Tha\u00eflande, mais ils sont prescrits l\u00e9galement pour la douleur en milieu hospitalier, de sorte que les patients n'ont pas \u00e0 craindre que le soulagement de la douleur ne leur soit refus\u00e9.<\/p><\/p>\n\n\n<p class=\"wp-block-paragraph\"><p>Le document \u00e0 pr\u00e9parer est un <a href=\"https:\/\/www.thailawonline.com\/fr\/living-will-in-thailand\/\">Directives anticip\u00e9es<\/a> dans le formulaire tha\u00eflandais, bilingue si le r\u00e9dacteur ne lit pas le tha\u00ef, sign\u00e9 devant au moins un t\u00e9moin qui n'a aucun int\u00e9r\u00eat dans le <a href=\"https:\/\/www.thailawonline.com\/fr\/glossary\/estate\/\">domaine<\/a>, with copies at the hospital and with the family. It can state a preference for home over hospital and can name a person to explain the patient&#8217;s real wishes where the document is unclear, whom the doctor must inform and consult (Ministerial Regulation of 2010 under section 12, clauses 3 and 6); that person does not make treatment decisions in the patient&#8217;s place. A directive signed abroad is rarely honoured here. Whether insurance pays for palliative care depends on the policy, and long stays are often paid out of pocket.<\/p><\/p>\n\n\n<h2 class=\"wp-block-heading\" id=\"palliative-care-withdrawal-and-euthanasia\">Soins palliatifs, renoncement et euthanasie<\/h2>\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Mesurer<\/th><th>Objectif<\/th><th>Statut en droit tha\u00eflandais<\/th><\/tr><\/thead><tbody><tr><td>Soins palliatifs<\/td><td>Soulager la douleur et les sympt\u00f4mes<\/td><td>L\u00e9gal ; peut \u00eatre demand\u00e9 dans un testament biologique<\/td><\/tr><tr><td>La limitation ou l'arr\u00eat de traitement de maintien des fonctions vitales<\/td><td>Laisser la maladie suivre son cours<\/td><td>Conforme sur la base d'une d\u00e9claration valide au titre de l'article 12<\/td><\/tr><tr><td>euthanasie active ou suicide assist\u00e9<\/td><td>Donner la mort<\/td><td>Infraction p\u00e9nale, le consentement n'est pas pertinent<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n<p class=\"wp-block-paragraph\"><p>Les trois sont souvent confondus, et cette confusion pose de vrais probl\u00e8mes : les familles exigent que tout soit fait car elles craignent que les soins palliatifs ne signifient baisser les bras, ou demandent aux m\u00e9decins d'h\u00e2ter la mort parce qu'elles pensent qu'un testament de vie le permet. Ni l'un ni l'autre n'a raison. Un testament de vie interrompt ce qui prolonge l'agonie ; les soins palliatifs g\u00e8rent ce qui reste ; et rien dans la loi tha\u00eflandaise ne permet \u00e0 quiconque d'avancer la fin. Les patients qui comprennent cette distinction r\u00e9digent des directives plus claires, et les h\u00f4pitaux appliquent ces directives claires plus rapidement.<\/p><\/p>\n\n\n<p class=\"wp-block-paragraph\"><strong>Last reviewed: 27 September 2026.<\/strong> Section 12 of the National Health Act B.E. 2550 and the Ministerial Regulation under it (B.E. 2553, clauses 1 to 7) were read in Thai, as was Section 288 of the Criminal Code. The Supreme Administrative Court decision is cited as reported and was not re-read; availability, insurance and hospital practice are described, not verified against a statute.<\/p>\n\n\n<h2 class=\"wp-block-heading\" id=\"frequently-asked-questions\">Foire aux questions<\/h2>\n\n<div id=\"rank-math-faq\" class=\"rank-math-block\">\n<div class=\"rank-math-list\">\n<div id=\"faq-question-1\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question\">Les soins palliatifs sont-ils accessibles aux \u00e9trangers en Tha\u00eflande ?<\/h3>\n<div class=\"rank-math-answer\">\n\n<p>Oui. Les grands h\u00f4pitaux priv\u00e9s, les h\u00f4pitaux universitaires et certains services de soins \u00e0 domicile le proposent, et l'article 12 de la loi sur la sant\u00e9 nationale s'applique \u00e0 toute personne soign\u00e9e en Tha\u00eflande. Le co\u00fbt d\u00e9pend de l'h\u00f4pital et de la prise en charge ou non des soins de fin de vie par l'assurance du patient.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-2\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question\">Un testament biologique en Tha\u00eflande peut-il demander uniquement des soins palliatifs ?<\/h3>\n<div class=\"rank-math-answer\">\n\n<p>Oui. Une d\u00e9claration en vertu de l'article 12 peut refuser la r\u00e9animation, la ventilation, l'alimentation par sonde et la dialyse tout en demandant le contr\u00f4le de la douleur et des soins de confort, et peut exprimer la pr\u00e9f\u00e9rence de mourir \u00e0 domicile. Elle ne peut pas demander de dose l\u00e9tale ; cette clause serait nulle.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-3\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question\">Un m\u00e9decin est-il responsable de l'arr\u00eat des traitements dans le cadre d'un testament de vie tha\u00eflandais ?<\/h3>\n<div class=\"rank-math-answer\">\n\n<p>Non. La loi sur la sant\u00e9 publique dispose qu'un praticien qui se conforme \u00e0 une d\u00e9claration valide ne commet aucune infraction et est d\u00e9gag\u00e9 de toute responsabilit\u00e9. Le r\u00e8glement de 2010 fixant la proc\u00e9dure a \u00e9t\u00e9 valid\u00e9 par la Cour administrative supr\u00eame en 2015.<\/p>\n\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<p class=\"wp-block-paragraph\"><p>Voir aussi\u00a0: <a href=\"https:\/\/www.thailawonline.com\/fr\/glossary\/terminal-illness\/\">maladie terminale<\/a>, <a href=\"https:\/\/www.thailawonline.com\/fr\/glossary\/euthanasia\/\">euthanasie<\/a>, <a href=\"https:\/\/www.thailawonline.com\/fr\/glossary\/incapacity\/\">incapacit\u00e9<\/a>, et les guides sur le <a href=\"https:\/\/www.thailawonline.com\/fr\/living-will-in-thailand\/\">Testament de vie en Tha\u00eflande<\/a>, le <a href=\"https:\/\/www.thailawonline.com\/fr\/living-will-regulation-in-thailand\/\">r\u00e9glementation de 2010 sur les directives anticip\u00e9es<\/a> ET <a href=\"https:\/\/www.thailawonline.com\/fr\/health-insurance-in-thailand\/\">assurance maladie pour expatri\u00e9s<\/a>.<\/p><\/p>","protected":false},"excerpt":{"rendered":"<p>Palliative care (\u0e01\u0e32\u0e23\u0e14\u0e39\u0e41\u0e25\u0e41\u0e1a\u0e1a\u0e1b\u0e23\u0e30\u0e04\u0e31\u0e1a\u0e1b\u0e23\u0e30\u0e04\u0e2d\u0e07, kan du lae baep prakhap prakhong, sometimes called comfort care or hospice care) is medical care aimed [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":214,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"pmpro_default_level":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center 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ThaiLawOnline","rank_math_description":"Palliative care in Thailand: comfort-focused care for terminal illness, and the right under Section 12 of the National Health Act to refuse futile 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