China: living wills

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The article interviews retired cardiologist and writer Luo Diandian who feels that the rapid development of life-support treatment “makes it possible to keep a patient from death, but it is only technically being alive, with no quality or dignity of life.” Luo is actively advocating living wills that provide patients with the opportunity to specify their wishes for the end of their lives. Luo has set up a website promoting the US  ‘Five  Wishes’ legal document – the document lets people record how they want to be treated if they become seriously ill and unable to speak for themselves.

The article points out that whilst the concept of the living will has gained acceptance worldwide, notably in the US and Europe, there remains controversy and debate over whether to prolong a person’s life out of medical duty or to shorten their life in order to prevent pain. According to the article in Singapore and Chinese Taiwan, the government always takes the lead in implementing living wills by encouraging citizens to fill in the standard living will document, and by passing regulations to guarantee it will be obeyed if signed.

Attempts by Luo Diandian to introduce the living will document in hospitals have been turned away by staff fearing they will bring bad luck.

“We just can’t talk about death, as it makes the families feel we are not giving our all out to rescue their loved ones.” said Liu.

Furthermore the article reports that only 37% of medical staff in a Peking hospital knew about living wills – lack of palliative treatment training in most of China’s medical schools makes it hard to push the concept forward.

According to Luo “The teachers only try to teach how to save a person’s life, but not how to help dying patients leave the world in a comfortable way with dignity.

In 2010 Xi Xiuming, the president of Fu Xing Hospital started the practice of encouraging dying patients to sign a decision allowing doctors to withdraw or withhold medical treatment allowing them to die in peace. He feels that such discussions will become vital as China sees more patients with incurable diseases needing to consider how to spend the end of their life.

This is echoed by  Liu Xiaohong, the director of the geriatrics section of Peking General Hospital: “It should be a topic raised around the table when people are still healthy…it’s very hard to persuade them to give up the lives of their beloved ones in an environment like the ICU, when the priority of doctors should be racing against time to save lives.”

However, Luo still feels confident the concept will be gradually recognised when more and more people pursue a higher quality of life.

Read the full article in the Global Times.

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