Talking about a “good” departure is more common today than it has been in the past. Although not everyone believes there is life after death, an increasing number of people are advocating for the right to leave well.

To most people, the term “leave well” seems to imply death with less suffering and a desirable departure. If one could choose, it would almost certainly be a peaceful death with dignity. However, not everyone dies of illness nor can he/she predict their death. There are still many cases of sudden deaths caused by accidents and acute diseases. So a good departure has more to do about preparing for a peaceful death.

Capt. M.D. Pornsak Phoncharoensomboon aka Dr. Daeng, the founder of the page “Mor Daeng Tee Prueksa Khonkai Raya Sudtai” (Dr. Daeng, advisor on palliative care) on Facebook is an advocate of the right to depart well. “The natural way is short and with less suffering which is a good death,” he tells his followers.

Having been involved in advising palliative care for many patients, Dr Daeng strongly advocates patient rights. “No one should choose on behalf of patients – not children deciding for parents or a husband for a wife or vice versa.”

In the very last stage of one’s life, it should be clear that a patient should decide for his/herself how and when to go. Many people focus on palliative care to keep the pain to a minimum. But each person’s needs are different. Dr Daeng cites the example of a young patient with cancer who refused morphine as she wanted to endure the pain so that she would be more conscious and maximise her time with loved ones.

Dr. Daeng gave another example of a patient with lung cancer that had spread to the bone. “I gave him morphine to help with the pain, but he said afterward that he wanted to live with pain rather than having morphine because his mind was calmer. Different people want different things. It’s clear that departing well for one person is not the same for another.

As a palliative care adviser, the doctor has witnessed that a decision made patients by their loved ones is sometimes based on incorrect understanding and this can cause more pain and suffering. For example, people always want to give oxygen and water but the disease their loved one has might mean these are not needed. “Sometimes, no oxygen helps them to be in a more natural state so they will eventually face no pain. Water is important but at a certain stage, water intake may cause more harm than good.”

The truth will set them free

In addition, Dr. Daeng does not recommend hiding the truth from patients so they can spend the rest of time preparing for “leaving well”. He believes that everyone has the right to get what they desire during the limited time they have left. “Whatever they want, provided it’s not illegal, nor against religious principles, we should support them on this.”

Nitichai Kruawan, father of Nam Kaeng – a young girl who suffered cancer from the age of 6 and departed peacefully – said that his daughter knew at the beginning that she had cancer. “We taught her to be courageous to face the truth. Families don’t lie to each other. She was strong and fought well.”

As Buddhists, the Kruawan family believes that the mind in the last minutes of life is important. It must be at peace. So they did everything to prepare for a peaceful departure. “We taught her to understand the truth of life – the fact that no one can control their body and neither could she. The pain was in the body.”

The father also explained to her that leaving well meant sending her mind to a good place. “It’s not the end but just a transformation. I told her “If you want to be able to communicate with Papa again, you have to go to a good place”.

The girl did well and was strong spiritually as fans of her Facebook page could see. Fifteen hours before her departure, she talked to her parents and thanked everyone including her guardian angel. She found the strength to give everyone a last smile.

All religions teach that death is not the end. What goes around comes around. At the end of life, we are all confused. We do not have much time left. So who are still living need to know how to prepare for it.

“In a way, people with a terminal disease can be considered lucky because they know their time and prepare themselves for it,” Nam Kaeng’s father said.

The Nam Kaeng case has helped broaden the talk about good departure. It has taught those in the medical field – palliative care in particular, as well relatives of patients and patients themselves.

Ms. Kanittha Tangvoraphojvithan of Cheevamitr Social Enterprise Co. Ltd that aims to help people to “depart well” in all aspects said that the increasing knowledge about palliative care was a great help though people should not think too much about choosing euthanasia as a solution.

“If the patients receive good care and moral support from those around them, they can be prepared for the greatest journey of life,” she said.

Preparation to depart well

By Veena Thoopkrajae