Shenzhen passes regulation respecting patients’ end-of-life decisions, becoming first Chinese city to allow death with dignity
Published: Jul 05, 2022 12:15 PM Updated: Jul 05, 2022 12:07 PM
Shenzhen Photo: VCG
Shenzhen Photo: VCG

Shenzhen in South China's Guangdong Province has recently passed a regulation on a person's "right to die," making it the first city in the Chinese mainland to allow critically ill patients to refuse "excessive life-saving treatment".

According to the revised medical regulations of Shenzhen Special Economic Zone, if a patient doesn't want medical staff to "perform unnecessary resuscitation," the hospital should respect that wish and allow the patient to die peacefully.

A "right to die" or DNR order is a document that a person signs in advance, while conscious and aware, specifying what kind of medical care he or she wants or does not want at the end of an incurable illness, said the regulation.

Shenzhen becomes the first place in the Chinese mainland to implement the "right to die" legislation, after only the Hong Kong Special Administrative Region and the island of Taiwan had passed similar resolutions.
Observers noted that it is a major breakthrough in China's medical legislation and will help promote the concept of "dying with dignity" in the whole society.

When patients enter the final stage of life, they may undergo unnecessary suffering when rescue and resuscitation efforts are carried out. With the introduction of the DNR order, a dilemma that has long plagued dying patients and their families will finally be solved.

Shenzhen's "right to die" legislation has turned people's abstract rights enshrined in Article 130 and Article 1002 of China's Civil Code into a specific embodiment, said Liu Ruishuang, a deputy director of the Department of Medical Ethics and Law of the School of Health Humanity in Peking University. 

Liu told the Global Times that by allowing critically ill patients to decide whether to have life-extending treatments, the legislation safeguards their right of self-determination and dignity of life. 

Liu said that unlike euthanasia, in which the patients may be "deprived" of life by other people such as relatives or friends, it is the patient himself who makes the decision whether to continue medical treatment in the case of this legislation.

On Monday, the hashtag "Shenzhen's legislation respects patients' right to make end-of-life decisions" went viral on Chinese social media platforms, with many netizens expressing support for the move and saying it is worth promoting.

"Some patients are in such pain at the end of their lives, it is good to respect their final choice," one netizen said. "The words 'dignity of life' have a profound meaning. Lingering on in a gradually and irreversibly worsening condition may not always be the best choice," another netizen commented.

However, some netizens questioned the idea, saying that if the system is not perfect, some people with evil intentions could take advantage of it.

According to the Xiaoxiang Morning Herald, before the "right to die" was written into Shenzhen's local bylaw, there had been other attempts in the Chinese mainland to legislate it. Yin Huiming, a 70-year-old retired teacher, signed a ''right to die'' contract at a geriatric hospital in Jiangsu Province that allows patients to decide how they want to be treated at the end of their lives. After talking with the director and the doctor, Yin held a meeting with her family and signed the contract with her friends, relatives and doctors around her.

Despite these precedents, many people still have a lot of concerns about the regulation. Li Ying, the president of the Shenzhen Association for Promotion of Right to Die, suggested that adults who have the capacity for civil conduct can sign the ''right to die'' contract, preferably in a conscious and relaxed state, with family, friends, a doctor or a lawyer or related people around so they can discuss and understand the situation better and then make a decision. Two witnesses are required to sign the document.

Experts explained that the contract is intended for palliative care patients only, and by definition, this kind of care is used at the end of an incurable illness, when the patient's condition is irreversible even with the use of the most advanced modern medicine available.

Admission to palliative care is subject to strict criteria and requires assessments by at least two medical practitioners. The hospital will never give up the treatment and rescue of patients with treatable acute medical conditions, such as acute myocardial infarction, cerebral hemorrhage and tumor patients.

In addition, it is worth noting that "right to die" contracts can be changed at any time, even at the very end of life.

Despite the positive effect brought by the legislation, Liu noted that it requires more detailed and specific rules for practical implementation. "For instance, how does one define 'the final stage of a critically ill patient's life'? Maybe we can have medical experts list the circumstances under which patients can refuse life-extending treatment," said Liu.