Section 230 of the Constitution of the Kingdom of Thailand, B.E. 2560 (2017) stipulates that the Ombudsmen have the duties and powers as follows:
(1) to recommend the relevant State agencies to revise any law, rule, regulations, rules or order or any operative procedure that causes grievance or unfairness or imposes an unnecessary or undue burden on the people;
(2) to conduct fact-finding when it is found that there is a person affected by grievance or unfairness arisen from non-compliance with the law or acts that lie beyond the authority of a State agency or State officials in order to recommend the relevant State agencies to eliminate or deter such grievance or unfairness;
(3) to submit to the Council of Ministers for acknowledgement that a State agency has not yet correctly and completely complied with Chapter 5 Duties of the State
In the case where a relevant State agency has not implemented the recommendation of the Ombudsman under (1) or (2) without reasonable justification, the Ombudsman shall notify the Council of the Ministers to further consider the issuance of an order as deemed appropriate.
With respect to the performance of duties of the Ombudsmen in the past, a study on a systemic solution to the issue of water safety was conducted with the aim of enhancing life and travel safety. One of the important safety measures for persons experiencing sudden cardiac arrest that can lead to death is to provide the Automated External Defibrillator (AED) – the device for basic life support, and to focus on life support with Cardiopulmonary Resuscitation (CPR). If a patient with sudden cardiac arrest immediately and correctly receives emergency assistance according to the chain of survival by using the compression-only CPR, the aforesaid method will increase a patient’s chance of survival by 5 percent. Moreover, if the CPR is administered in combination with the AED device, the chance of patient survival rate will be increased by up to 50 percent. The AED is a device using an electric shock to help the heart return to its normal rhythm. In addition, it has a function to give step-by-step instructions for the rescuer and is able to automatically detect the life-threatening arrhythmia – an abnormality of the heart’s rhythm.
When considering the Master Plan under National Strategy on law and justice process, laws are set to be one of the significant factors for the development of the country and used as a mechanism for the implementation of the National Strategy. The law should be more adaptable to accommodate the evolving context and the needs of the people. Moreover, the country’s justice process should be enhanced with due consideration for human rights and equality, upholding its neutrality, reliability, transparency and verifiability. The Master Plan under National Strategy on law and justice consists of 2 sub-plans as follows:
- Development of laws: It is necessary to revise, modify or repeal the laws only to the extent of necessity, in accordance with existing circumstances, and in the manner that does not hinder the development of the country driven by digital technology and legal innovation and involves actual public participation. The integration of laws at all levels into unified and consistent framework, according to hierarchy of laws, is a crucial mechanism to ensure efficient and transparent enforcement of the laws and equal access to the justice process.
- Development of justice process: The development goal is to uphold justice by following the principles of equity, transparency, fairness, inclusiveness and equal treatment, together with cooperation with entities related to justice system to work in an integrated and supportive manner with the intention to resolve conflicts and disputes effectively
The primary goals of performing functions in accordance with the National Strategy in the area of laws and justice process are to have laws as a tool to equally and fairly provide all sectors with the benefits gained from the development of the country, as well as to uphold justice that involves equity, transparency, fairness, inclusiveness and equal treatment. Hence, the Ombudsman’s initiative on revision and enforcement of laws, rules and regulations regarding the use of Automated External Defibrillator (AED) device in performing basic life support and Cardiopulmonary Resuscitation (CPR) exhorts both public and private sectors to place an importance on providing AED devices in public areas and the provision of training on basic life support using CPR, culminating in the improvement of health-related quality of life.
Places such as dwellings, piers, ferryboats, airports, stadiums, sports venues, public parks, tourist attractions, convention centers, hotels, shopping malls, etc. are required to be equipped with AED devices in order to meet public safety standards. Additionally, trainings must be provided to personnel whose jobs involve interactions with a large number of people such as tour guides, public transit drivers, information center staffs and hotel personnel to allow such personnel to be able to administer a CPR and AED equipment. The Ombudsman’s recommendation is an important part in fostering country’s equitable, just, and fair development, promoting people’s access to public health services for basic life support, and enhancing country’s reputation regarding safe tourism since reliability in health and safety is crucially important.
With regard to the implementation of the abovementioned strategies, integration of methods is required. This includes cooperation with various agencies, e.g., Ministry of Public Health, Marine Department, Ministry of transport, Department of Local Administration, Ministry of Interior, Ministry of Education and National Institute for Emergency Medicine to consider modes of cooperation; establish terms and conditions; review the effectiveness of existing laws and needs for legislations regarding location for installing AED devices and CPR trainings provided for relevant personnel; and engagement of the people and volunteers to raise their awareness of the importance of saving lives in emergencies.
Thereby, the Ombudsman’s initiative to promote the use of Automated External Defibrillator (AED) device in performing basic life support and Cardiopulmonary Resuscitation (CPR) not only reinforces both public and private sectors to place emphasis on obtaining AED devices and performing CPR to reduce mortality rate, but also equally and fairly provides people with access to public health services for basic life support, as well as enhances country’s image regarding safe tourism since tourism industry contributes substantially to the Thai economy and therefore reliability in health and safety are critical. Notwithstanding the fact that people and societies recognize the significance of the AED device and CPR technique, laws and public policies should be amended in order to facilitate rescuers to perform such basic lifesaving on a cardiac arrest victim to improve the chance of survival before sending the patient to the hospital.
Consequently, the Ombudsmen have proposed their recommendations to the Prime Minister as follows:
- Even though the provision of AED devices in high-rise and large buildings has already been made mandatory, it is necessary to extend this mandate to other locations where substantial numbers of people congregate. However, when formulating laws concerning installation of AED devices in other places, it is crucial to consider the existing rules and regulations of the relevant agencies and a thorough examination of current laws should be conducted to identify limitations and areas for revision in order to ensure the effective enforcement of these laws.
- Specific agencies or officials should be designated to maintain and monitor AED devices. Additionally, the installation of a GPS system on the AED devices would facilitate tracking and monitoring. The development of mobile application would serve as a platform to keep the officials informed of technical problems requiring attention. Moreover, it would be beneficial to seek cooperation from the communities in reporting any damaged or missing equipment.
- As the AED has been legally defined as “first aid equipment”, it is essential to enhance public awareness and understanding regarding its safety for both users and patients. Moreover, the AED device is equipped with a user-friendly feature that voices step-by-step instructions. Furthermore, the devices’ signs and instruction manuals should be prominently displayed and easily accessible. A global positioning system for the AED devices should be created and linked to the responsible operating units or agencies. The locations of the AED devices should be identified in Google Maps. Relevant information should be disseminated to the public to ensure efficient utilization in emergencies.
- It is essential to integrate a guide to AED equipment usage and CPR administration into the curriculum of educational institutions. In addition, public relations should be implemented to effectively communicate the advantages and to encourage the adoption of AED devices.
The Ombudsman’s recommendations emphasize the importance of AED devices installation in various locations and the revision and enforcement of legislations regarding AED devices in order to enhance country’s reputation in public health and elevate the overall quality of life for the citizens.
