Chinese Doctor Fights for Right of Terminally Ill to Die

Dr. Wu Zhaoguang, 72, ambles through the unlighted halls of Zhongshan Hospital, stopping to see patients crowded four to a room, to perform the art of healing. He guides the insertion of a catheter into a stoic man gritting his teeth who is recovering from his third operation. He places a callused hand on the throat of a woman with a thyroid tumor.

“Relax. Don’t be worried about it,” he tells her in low tones as she anxiously touches the spot where his hand lay. “It’s not cancer.”

That’s a rare bit of good news Wu can deliver this day. Inevitably, many patients he sees have a terminal disease, and his benedictions and surgeries can’t help their suffering. That’s when he wishes he could offer anlesi--literally, a tranquil death.

Aspiring to be Shanghai’s own Jack Kevorkian, the Michigan physician whose name has become synonymous in the United States with “assisted suicide,” Wu for 10 years has petitioned the central government to start carefully regulated euthanasia clinics here. Campaigning for the right to die can seem a morbid preoccupation, he concedes, and arouses complicated ethical and emotional questions in a land that has venerated the elderly and feared death.

But the alternative to euthanasia--needless suffering--is worse, he argues, and people’s attitudes about “mercy killing” are changing.

In Wu’s four decades at the hospital, he has witnessed patients’ desperate bids to end their unbearable pain.

“Some of those poor guys just went--whoops--off the balcony or out the window,” he says, pointing his thumb back over his shoulder. “Some did a good job of it. Some not so good. They just broke their bones and suffered more than before.”

Wu is careful to outline the controls: The patient must request anlesi, have his or her condition confirmed as incurable by a team of specialists and have family members’ complete support.

“We’re not proposing to knock off people right and left,” he says. “We don’t intend to do that. Our first duty as doctors is to cure a patient. But we can’t cure everything. And when we can’t, we must also relieve their suffering.”

China, as a result of its “one-child policy,” has become the world’s fastest-aging population. Each day, 20,000 Chinese turn 60, adding to 100 million people already 60 or older. And declining family size means there are fewer children to care for failing parents, foreshadowing an overload of the social welfare system. Even 1,000-bed Zhongshan Hospital, one of the better facilities in Shanghai, has so few nurses that it relies on relatives to feed and care for patients.

That’s part of the reason that in China’s large cities, euthanasia has surprisingly solid support. In April, the nation’s official news agency reported that a survey conducted in three of the largest cities found 78% support for “mercy killing” of the very sick, with 73% of respondents saying the choice between life and death is a human right. Approval reached 90% in a separate poll in Shanghai, where nearly one in five people is 60 or older.

“An understanding of euthanasia depends on the level of education and culture,” said Yin Zhigang, the director of Shanghai’s Old Age Committee. “That’s why euthanasia is better supported in big cities like Shanghai than in the country. . . . The level of support for euthanasia, in some ways, signals the progress of a society.”

But for 10 years, Wu’s proposal has been blocked in Beijing at the National People’s Congress, which has delegates from all over China. Attitudes are very different in the country, where the notion of helping parents die arouses a Confucian conundrum.

“It’s contrary to typical Chinese teaching--[which is] to live as long as you can regardless of the quality of life,” Wu says.

Senior leaders are kept alive as long as possible. A team of doctors attended Chairman Mao Tse-tung around the clock for more than two months after he suffered a heart attack, although the public was told he was healthy until the day after he died in September 1976.

Similarly, a child’s duty is to prolong his or her parents’ lives and then ensure them a comfortable afterlife by sending along paper money, flower wreaths and even clothes when they die.

The idea of arranging a comfortable death still strikes many as utterly unfilial.

Wu says the opinion polls are a way to get people to discuss the idea and for the government to build acceptance before legalizing limited euthanasia. Recent court cases have provided additional fodder for public debate.

A Hunan man, Liu Shabo, 54, was convicted last year of murdering his cancer-stricken wife after she asked him to serve her tea laced with pesticide. The court ruled that assisted suicide was the same as murder. But in another recent case, a judge overturned a murder verdict for a doctor in northern China who helped a patient die after being pressured by her relatives to stop treatment.

The cases have a certain resonance for Wu, who watched his wife--they met when both were medical students--die a protracted, painful death 10 years ago.

“The last few months were extremely miserable,” he says. “The doctors taking care of her wouldn’t believe me that she’d rather not go through it. They believed their duty was to prolong her life. But really they just prolonged her suffering.”

And how does he square the idea of euthanasia not only with Confucian teaching but with the Hippocratic oath he took upon becoming a doctor? He paraphrases it--”Do your duty, relieve suffering and do no harm”--but adds: “Medicine cannot be completely harmless. To perform surgery, you’re cutting and destroying something but doing it for the greater good.” Euthanasia can be viewed as the ultimate cure, he says.

Still, it is an option to be offered with great restraint, Wu stresses, as he describes patients who were deemed incurable by country doctors and then cured by simple operations in the Shanghai hospital.

Other observers fear abuse of the option--for example, by patients made to feel burdensome by their relatives or the state. A law providing for euthanasia was briefly considered in 1994, but the measure was never approved.

“Maybe it will happen in my lifetime,” Wu says. “But I’m not going to stick around longer than I have to.”