Fertility clinics drive thriving black market in eggs

Young Chinese women are risking their fertility by selling off their eggs to unscrupulous fertiliy clinics, a CCTV program has claimed.

As part of an investigation into the "human egg black market" CCTV found that high school students and university students were selling their eggs to agents for a few thousand yuan. The clinics then offer these eggs to infertile women who pay 30,000- 100,000 yuan (US$5000-$15,000).

The report said young girls were picked because of their looks, education and health and had to endure a series of injections with fertility hormones to stimulate ovulation so their eggs could be harvested by clinics. The young women said they used the cash to pay off credit card debts, but most were unaware of the serious risks of the procedures, including infertility.

Commentators said the commercial transactions of human eggs were illegal and banned, but there was little enforcement of the rules in practice. They said illegal clinics and the doctors who worked in them made large amounts of money, offering infertile women the chance to select a donor egg based on looks, intelligence and other personal characteristics of the donor. Despite being illegal, the egg black market was a thriving market and barely concealed  with advertisements by agents common on the internet.

The report said the fertility agents and their networks also offered infertile women other services such as surrogate mothers, as part of packages that could cost as much as 400,000 yuan.The trade was very lucrative and many young women saw nothing ethically wrong with what they were doing, it said.
The commentators said there was a need for a widespread crackdown to enforce the regulations on artificial reproductive technology. There was also a need to better regulate reproductive clinics and promote legitimate egg donation rather than the commercial practices, they added.

Can you legislate to make better doctors?

 
by Michael Woodhead
New draft legislation released by China's National Health and Family Planning Commission seeks to make doctors practise medicine in a more humane and 'patient-centred' way. The new regulations will make it a criminal offence for a doctor to neglect to treat a patient, and will force doctors to take responsibility for the adverse outcomes of any patient that they fail to treat in a reasonable and timely manner.
Released at the behest of the State Council, the "Medical Treatment Quality Management Regulations (Draft)" is a wide ranging document that aims to improve the quality of medical treatment by spelling out the doctor's duties and also highlighting prohibited practices.
The new rules state that it will be a criminal offence for medical staff to refuse to take responsibility for patients in need or treatment, and staff must bear the consequences of any damage or injury that results from failing to provide treatment. The NHFPC says the new legislation also requires health providers to have mechanisms in place to accept and respond to medical complaints in a timely manner. It says medical staff must act in a humane and patient-centred way to carry out the core responsibility of "healing the wounded and rescue the dying". Staff must show respect to the patient and uphold their rights. The new rules also require medical personnel to use medications responsibly and to have a good knowledge of how they work and their efficacy. They also make it a criminal offence to use non-approved drugs, medical procedures, equipment.

How much does the average Chinese doctor earn?

by Michael Woodhead
Much of the recent highly-publicised violence against doctors by patients has been triggered by resentment and mistrust of the medical profession, especially in relation to their earnings. 
In theory, doctors have only a modest salary, but everyone in China knows that many doctors make a lot of money through the so-called 'grey channels'. This week the People's Daily mounted an investigation to discover the true earnings of a typical doctor and the sources of their income.

After speaking to doctors off the record and also to other people working at senior levels in hospital management and in industry, it soon became clear that doctors have many additional and unofficial (but often legal) sources of income. The phrase "drug-dependent doctors" describes the reliance of doctors on prescribing for their income. Another well know rhyming phrase in hospitals is 'physicians rely on commissions, surgeons rely on operations' (it sounds better in Chinese - 'Neike kao huikou, waike kao shoushu').
A typical doctor at a large tertiary level hospital in Beijing will officially earn about 46,000 yuan (US$7500) a year. In reality, doctors earn more than three times that - about 180,000 yuan ($29,000) a year. The additional income comes from four areas:

1. Bonuses  - from hospital, for meeting patient number and performance quotas
2. Commissions for prescribing drugs and ordering tests
3. Red envelopes - from patients to get preferential treatment
4. Moonlighting - doing 'outside clinics' at weekends - often in regional cities and towns

One orthopaedic surgeon said that without the 10,000 yuan ($1600) monthly bonus from his hospital, most doctors in his department would leave. The basic monthly income of a doctor is only about 2-3000 yuan ($320-480), and no-one would work for that. The surgeon said all doctors depend on their monthly bonus for much of their income, and also the annual bonus, which can be several thousand yuan. The real income for a hospital specialist is about 180,000 yuan ($29,000) a year, and for a head of a department as much as 250-300,000 yuan ($40,000-48,000) a year. The income varies between departments and specialities. Some areas such as orthopaedics, surgery and cardiology are the highest paying. Others, such as paediatrics, have a lower income because doctors in these specialities prescribe fewer drugs and use fewer tests. A doctor in a  regional hospital would also earn less - maybe only 10,000 yuan ($1600) a month.

Doctors also get commissions from the sales of drugs. It is well known that hospitals rely on commissions on drug sales, which make up 50-60% of their income. Doctors also individually benefit from drug sales, says a drug company representative. Whether they agree or not, doctor's income is related to how many drugs they prescribe. Companies reckon that 10-30% of drug sales income goes to doctor.s for choosing them and prescribing them. Surgeons do not prescribe as many drugs but they make money from 'red envelopes' in prioritising patients. Surgeons along with anaesthetists and theatre nurses also make commissions on the use of disposable medical items and the use of medical devices and tests.

Another overlooked source of doctors' income is moonlighting. At weekends, Beijing Airport is said to be a social meeting place for the medical profession as doctors fly off to do their 'outside clinics' in other parts of the country. For the top specialists in any field this is a lucrative source of additional income and they can make tens of thousands of yuan from just a single session - and millions of yuan a year. However the junior and low level doctors make much less than the top specialists. A doctor at a community clinic, for example, would get only 4-5000 yuan ($640-800) as a basic salary and would not get much income from prescribing or surgical work.

These kinds of grey income are a contradiction in the health system and are the underlying reason for doctor-patient tensions - it is all to easy for misunderstandings to occur and to flare up into trouble - like 'a minor incident sparking a war' as the Chinese saying goes.

One of the fundamental underlying problems is that the doctor's time is undervalued. Take a knee replacement operation, for example. Such an operation will require two surgeons, two theatre nurses and two anaesthetist and last at least an hour - possibly three hours of their time. And yet the 'doctor's fee' for the operation is only a few hundred yuan - where is all the money to come for the doctor's expertise - let alone for the equipment, drugs, gas and blood and dressings?  There are doctors with a conscience who will add a reasonable and standard markup for their time - and yet there are other 'business minded' doctors who add a lot more. And there are some doctors who use foreign disposable equipment which might cost 200 yuan ($32) to buy, but is billed to the patient at several times that amount.

"There are some bold doctors who when it comes to prescribing always choose the most expensive, not the most appropriate drugs," says one pharmaceutical  supplier. "And when a new drug comes out they all rush for it in a show of excessive and unnecessary prescribing," he says. It is the same with tests - patients are told they must have numerous complex and expensive tests that they don't need, because the doctor gets a commission, he says.

The situation in hospitals also has a rhyming slogan: "Getting to see the a doctor is hard (kanbing nan): registering is hard (guahao nan),  waiting is long (houzhen chang), time with the doctor is brief (kanbing duan), doctor's fee is expensive (kanbing gui), tests are many (jiancha duo), prescriptions are many (chufang duo) and drug costs high (yaofei duo). All in all it is a volcano waiting to explode - no wonder 70% of doctors have experienced violent disputes with patients.

It is hoped that the Chinese government's new health reforms - including those on drug pricing and supply arrangements, will help straighten out this situation. What is also needed to 'restore the honour of the doctor's white coat'? According to leading physician Dr Huang Jiefu, the answer is a turn to the free market. By giving doctors the freedom to practice where and as they wish - as set out in new government policy -  doctors will be able to set a true market value for their services. When they do this they will no longer need to rely on unethical and unfair 'grey market' channels to maintain their income.  The People's Daily ends by saying that new health insurance schemes should allow patients to afford private doctors by encouraging the public to pay in premiums and have a policy that they can use when they need it most.

New code of medical ethics released – and why it is meaningless

by Michael Woodhead
The most surprising thing about China’s new code of medical ethics released this week is how unsurprising it is.
The 39-item code of practice developed for medical practitioners by the Chinese Medical Doctors Association is a long list of banalities and the bleeding obvious.
It includes basic standards on doctor-patient communication and interactions that you would think should not need spelling out.
“The doctor should respect the patient and revere life,” the code states.
“The doctor should listen attentively to the patient and pay attention to their concerns and questions ... the doctor should ensure good communication with the patient, and respect the patient’s rational requests and choices” it says.
According to the CMDA, the code should be regarded as the 'Doctor’s Bible' and deserves to be studied continually.
The CMDA says doctors should understand that doctors and patients look at things from different angles, and doctors should try put themselves in patient’s position when in the consultation.
"The doctor is thinking about the diagnosis and the course of treatment. The patient however, is worrying about the cause of their illness, how long it will last, what effect it will have on their life and how much the treatment will cost," says CMDA director Li Feng.
If the patient does not listen to the doctor’s advice or does not agree with the doctor’s diagnosis, the doctor should ask questions to clarify the patient’s doubts and worries, she says. Patients should be asked to ensure they understand what is happening and asked if thy have further questions, she suggests.
Li Feng says doctors have a duty to show compassion to the patient and provide them with appropriate care.
Medical ethics means having 'charitable feelings of compassion and solicitude in the heart'. Doctors should have 'great love and warmth for patients in their hearts', she says.
This is all very well, and who would disagree with notions that doctors should respect the patient, listen to their concerns, care for them as best they can and maintain good communication? The real question is how doctors can be expected to do this in an environment where they have to see 60 patients in a single shift and can only spend a maximum of three minutes with each one? And how can the code address situations where doctors have a financial conflict of interest, such as when doctors work for hospitals where their employment contracts link  salary to the number of patients seen?
The code may useful in setting out the basic expectations of a doctor in black and white. But many of the 'standards' it sets are not only related to medical ethics or morality, but also to the health environment in which a doctor works. Respect, communication and attention to the patient are not only determined by a doctor's personal ethics - they are also dictated by the system in which they work. Perhaps China also needs a code of practice for the health system as well as the health provider.

China's media lauds the "4 cent prescription doctor"

The Chinese-language version of the China Daily is lauding a Henan doctor who prescribed a treatment for a child's rash (an antihistamine) that cost only 4 cents. The cheap cure is seen as big news at a time when many Chinese are complaining about the high costs of medical treatment. The story is based on the overwhelming web response to the Weibo posting of a mother of a two-year-old child, who posted that she couldn't believe how cheap it had been for her child's treatment.
The Weibo post described how she took her child to see a doctor at the Zhengzhou People's Hospital No 3 paediatrics department. The female doctor there told her the rash was due to an allergy and she would prescribe an antihistamine called chlorpheniramine. Based on her previous experience with hospitals, the mother expected to pay several hundred yuan for a long course of medicines - and so she was very surprised when she only had to pay 4 fen for 4 tablets of the antihistamine. She was so impressed that she took a photo of her hospital bill. She was also doubtful that such a cheap treatment could work, and so was again surprised when her child made a quick recovery from the rash.
When she posted this on Weibo, her story and photo was immediately re-posted thousands of times, with netizens starting an online discussion about the high cost of treatment and the difficulties of getting to see a doctor. Many praised the doctor at the children's hospital and said such doctors were hard to find these days.
When a China Daily reporter tracked down Dr Qin Ruijuan, she said her 4 cent prescription was nothing special and that she had only been doing her duty. "Any other doctor in my position would have done the same thing," she said. Dr Qin said the antihistamine was the most appropriate drug for the condition and only a short course was needed.
Dr Qin said some patients believed that doctors made a lot of money in commissions when prescribing drugs and treatments, but this was not the case. She said there was no link between doctors' incomes and treatments ate her hospital, nor were there any targets or quotas.
The China Daily reporter wrote that this was supposed to be the case at all hospitals and a new directive from the National Health and Family Planing Commission issued in December had re-iterated this rule. This included a new series of prohibited practices in healthcare, known as the 'Nine Forbiddens' included taking commissions or kickbacks from prescribing and having quotas  or targets for treatments and prescriptions.
However, the reporter noted that there was a trend for hospitals to stock newer and more expensive medications at the expense of cheaper medicines . This led to a situation where it was impossible for doctor to prescribe affordable medicines because they were not stocked by the pharmacy. And because the profits were so tiny with cheap drugs "manufacturers don't want to make them, pharmacies don't want to sell them and doctors don't want to use them".

Hangzhou Resolution commits China to ethical organ donation

Just a month ago, Xia Qiang, a surgeon from Shanghai Renji Hospital, and his team made history by completing the first two transplant operations using organs donated by residents in the city.
Such operations are taking place with increasing frequency across China, showing a determination to move from sourcing organs from executed prisoners to acquiring organs from citizens willing to donate.
China is the top country in the world in terms of carrying out organ transplants as well as for having the most patients waiting for transplants. According to official figures from Chinese health authorities, more than 1.3 million patients wait for organ transplants each year while only 10,000 are lucky enough to get one. The rest try their luck in the underground black market.
Prior to 2010, the majority of Chinese organ transplants came from executed prisoners, prompting criticism from the international community.

Viewpoint: Financial compensation for deceased organ donation in China

by Dr Qiang Fang, Intensive Care Unit, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou.
In China, about 1.5 million Chinese patients are placed on organ transplant waiting lists each year, yet less than 1% of them have managed to receive an organ.
The gap between the need for and the supply of organs is large—and growing. The Regulation on Human Organ Transplantation strictly stipulates that living organ donation is limited to relatives. The number of organs from executed prisoners is decreasing. In March 2010, the Red Cross Society of China (RCSC) and the Ministry of Health of China jointly launched a pilot programme of deceased organ donation in 10 provinces and cities.  This programme marks a turning point in the transplant history of China. By March 2012, there were 207 deceased donors in total. However, with the country's population of 1.3 billion, the deceased donor rate remains significantly lower than in Spain and other Western countries.
In China, the shortage of deceased organ donors is due to a belief that the body should be left intact, a lack of incentive policy to increase the donation rate, and the weakness of programmes promoting voluntary organ donation. Traditional cultural beliefs about the proper disposition of a corpse constitute the major obstacle to deceased organ donation in China. The Confucian tenet of filial piety requires that a body be returned to the ancestors in an intact state and declares that every part of the body that is given by the parents deserves respect. People have also believed for thousands of years that keeping the dead body intact is a way of respecting the dead. These beliefs produce resistance to organ donation. Although nowadays cremation is carried out in many parts of China, most people still insist that the dead body be kept intact before being taken to cremation.
In order to provide incentive for deceased organ donation, five pilot provinces and cities (Zhejiang, Tianjin, Jiangxi, Jinan and Liaoning) have launched a financial compensation policy. We will take Zhejiang Province as an example. Zhejiang Red Cross established the Human Organ Donation Compensation Foundation in March 2012. From March 2010 to March 2012, there were 20 donors.  From April 2012 to the end of July, there were 23 donors. During these 4 months, Zhejiang organ donation witnessed rapid growth. Zhejiang Province, with 43 donors, is now rated number 2 of the pilot provinces and cities.
Organ donation can proceed only if one of the following conditions is met: the deceased has expressed a willingness to be an organ donor in either a living will or another written form, and his or her closest relative provides written consent for organ donation, or the potential donor has not expressed opposition to donation before his or her death, and his or her closest relative provides written consent for organ donation.
A characteristic of organ donation in China is that the Red Cross acts as the third party non-profit organisation in implementing the donation policy with the authority of law. In Zhejiang, the Red Cross is responsible for raising and managing funds for financial compensation, thus ensuring that money is used in a fair and legal way. Transplant hospitals are not allowed to be involved in management of the funds. Government appropriation, transplant hospital contributions and charitable donation are the usual sources of funds.
Financial compensation can be considered to include two main forms, the ‘thank you’ form and the ‘help’ form. ‘Thank you’ compensation includes three aspects. First, Zhejiang Red Cross Society will pay for basic funeral expenses, which cover body transportation, cremation and ash urn storage. Then the Society will offer the donors’ families USD 1600 for the cost of purchasing a grave plot. In addition, the donors’ families will be provided with USD 3200 allowance. This kind of compensation is gratitude on behalf of the Society for consenting to donation. If the families of deceased donors face hardship, Zhejiang Red Cross will offer them extra compensation, which can be no more than USD 4800. The family is eligible to apply for extra compensation only if one of the following conditions is met: the family has been designated a low-income family by the local Bureau of Civil Affairs and receives dole from the government every month, or the income of the family is at the level of local per capita income before the donor's death and the deceased donor was the family's main earner. The committee of Human Organ Donation of Zhejiang Red Cross will assess applicants’ eligibility. Then the committee will discuss how much money should be offered to a donor's family. The amount of compensation offered to a family is not according to the number of procured organs, but according to the degree of the family's suffering. However, there is no formal criterion to estimate the degree of suffering. Generally, the committee will make enquiries into the family's financial situation, assessing such factors as how many dependants the family supports, and whether the donor's spouse has the ability to support the family. Then the final decision will be made by the committee. This kind of compensation is social welfare support for needy families.
Those who consent to donation out of altruism deserve social appreciation and respect. Chinese social ethics not only upholds the moral value of benevolence, humaneness and mutual aid, but also advocates rewarding a good deed. In 1993, China established the China Foundation for Justice and Courage aiming to carry forward traditional Chinese virtues, foster healthy social trends, commend justice-upholding volunteers, and provide legal protection and financial assistance for those who take up the cudgels for a just cause. In July 2012, a Good Samaritan regulation was placed on the legislative agenda to protect those who lend a hand. A good deed itself might not have any economic value. However, the reward could be offered in spiritual and material form. A survey of 463 people of different educational level showed that 87.96% supported financial compensation.  Financial compensation could express society's gratitude for altruistic spirit and ease the financial pressure of voluntary donors’ families in needy circumstances.
In January 2012, a student from Hubei Province died from carbon monoxide poisoning in Shenzhen city. The grieving parents donated their daughter's organs and body. Meanwhile, they were unable to pay USD 11 200 for medical expenses, which is a heavy burden for a blue-collar family. As Shenzhen has not yet implemented the financial compensation policy, the organisation's charitable donation provided the family with the means to meet these expenses. China is a developing country with a gross national product of USD 5432 per capita in 2011. There are 128 million citizens, accounting for 10% of the country's total population, living below the poverty line (per capita income for living expenses of urban households less than USD 368 a year). The majority of them live in the country. In addition, medical expenses are a heavy burden for rural residents because of the lack of a good medical insurance system. If a donor's family is faced with financial problems, financial compensation will give timely assistance to that family.
Although China needs a financial compensation programme for deceased organ donation, undesirable consequences have emerged. Of the 207 deceased donors, the proportion of poor donors is much higher than that of other donors. The vice minister of the Red Cross, Zhao Baige, said in an interview that 90% of 207 deceased donors’ families faced financial difficulties. This indicates that some of these families consented to donation because they were in need of financial assistance. With the developing economy, the continued increase in deceased organ donation rate dependent on this policy is doubtful in the long run. In addition, some donors’ families in needy circumstances have suffered great stress, as they were thought to have sold organs of their deceased loved ones.
Financial compensation for deceased organ donation is not unique to China. In 2000, the US state of Pennsylvania implemented a programme of offering USD 300 to the families of organ donors to defray funeral expenses. In 2010, Israel launched a new policy to offer compensation to the families of deceased organ donors. The Israeli Ministry of Health stipulates that families who agree to donate the organs of deceased loved ones will receive USD 13 400. However, China differs from other countries with similar programmes by offering extra compensation for needy families of deceased donors.
In July 2012, the State Council of China issued a guideline for promoting the development of the RCSC. According to the guideline, the government will help the RCSC found provincial organ donation foundations that can sponsor donations and transplants. Financial compensation programmes will be implemented in other pilot provinces and cities. To promote the healthy development of deceased organ donation, programmes promoting voluntary organ donation should be operated extensively to encourage altruism and raise the proportion of donors other than poor ones.
Source: Journal of Medical Ethics

China reveres the author of its first Hippocratic Oath

Sun Simiao

He is the author of China's first medical textbook and of its code of ethics. Produced in AD 652, "Qianjin Yaofang," or "Essential Prescriptions Worth a Thousand Pieces of Gold," was a milestone in the history of traditional Chinese medicine. Its title reflects a firm belief of its author, Sun Simiao (circa 581-AD 682), known as China's King of Medicine.
Sun once said: "Human life is of paramount importance, more precious than a thousand pieces of gold; to save it with one prescription is to show great virtue."
Sun was born in a place called Huayuan in today's Yaoxian County, Shaanxi Province in northwestern China. However, it was not a healthy place in which to live at that time, as many locals contracted unusual illnesses.
Sun's father was afflicted by night blindness and his mother suffered from a swollen thyroid gland. Sun himself did not escape ailments and was a sickly child.
Surrounded by so much illness, the boy studied hard as he was determined to become a doctor to help treat his parents, relatives and neighbors in his home village.
In addition to various Chinese classics, the young Sun dug deep into every medical treatise he could lay his hands on. He also traveled to various places to collect folk and family medicine recipes and study the medicinal effects of thousands of herbs. He was particularly interested in the identification and preparation of herbs. Sun began his medical practice at the age of 18.
In time, thanks to his exceptional skills and the deep care he showed his patients, Sun was able to cure his parents and treat many other people in his home village.
As Sun's renown spread, it earned him the name King of Medicine and he began work on the 30-volume traditional Chinese medicine encyclopedia "Qianjin Yaofang."
The book contains a total of 5,300 prescriptions and covers topics such as gynecology, pediatrics, cold-induced disorders, internal diseases, detoxification, diet therapy, acupuncture and herbs themselves.
In addition, "Qianjin Yaofang" contain commentaries on clinical practice and treatises on how to keep in good health. Handy hints include tips for a healthy diet and exercises such as combing your hair, rolling your eyeballs and walking.
Sun's "Qianjin Yaofang" not only summarized all pre-Tang Dynasty (AD 618-907) medical achievements, but also laid the foundations for traditional Chinese medicine ethics.
In the first volume, Sun detailed his views on TCM ethics in an essay called "Dayi Jingcheng" or "Absolute Sincerity of Great Physicians."
Sun wrote: "When a great physician treats patients, he must maintain his inner serenity, pay no attention to personal desires or demands and feel great sympathy for the patients."
"He should vow to save people from their sufferings, no matter whether they are nobles or ordinary people, rich or poor, old or young, attractive or unattractive, friends or enemies, Chinese or foreign, educated or uneducated. He must treat them all on equal grounds and as his own close kin."
Later, Sun's views on medical ethics were recognized as the first code of conduct for physicians in China.
Soon after finishing "Qianjin Yaofang," Sun went to live in seclusion on Panyu Mountain in his home province in northwest China. The mountain later became known as Medicine King Mountain.
There, Sun studied Taoism, and later integrated Taoist principles with Buddhism and Confucian doctrines.
Years later, summing up his clinical experiences and medical classics, Sun wrote a second medical book, entitled "Qianjin Yifang" or "Supplement to the Prescriptions of a Thousand Pieces of Gold." This second book, also written in 30 volumes, contains about 2,000 recipes for medicines.
The two books were later translated into many other languages and were once used as textbooks in Japanese medical schools.
Source: People's Daily

Oncologists and palliative care doctors meet to discuss dying with dignity

"Death with dignity has been almost absent in the final stage of medical treatment in China."

by Zhou Heyang
A group of top doctors in the fields of oncology and palliative care have gathered in Beijing Oncology Hospital to discuss the future development of hospice care in China. One important issue on their agenda is publicizing the idea of hospice care and death with dignity to the general public.
When the final curtain call draws, how should you greet it? Some patients in the last phases of a fatal disease choose to not receive final treatment and plan a peaceful and comfortable farewell to the world. This decision is called death with dignity.
The term applies to a doctor's actions in agreeing to withhold medical treatment from a terminally ill patient. The patient can decide on details, such as to spend the last days at home and who should be present. A written agreement called Advanced Care Planning is signed in such situations in many Western countries. In other cases, this decision is made by a family member.
Ning Xiaohong, Doctor of Internal Oncology at Xiehe Hospital talks about this blank that needs to be filled in China:
"We see severe pain in cancer patients, such brutal pain inflicted on the human body that it makes us doctors feel their pain, too. Death with dignity has been almost absent in the final stage of medical treatment in China. Modern medical methods cannot alleviate the suffering in many of these cases. Doctors don't have a protocol to follow. And the public does not know death does not always have to be so painful and scary. The public needs to know it is an option."
Death is seen as a taboo subject that people are afraid to face or even discuss in China. In fact, death with dignity focuses on bringing comfort, self-respect, and tranquility to people in the final stage of their life. Patients' symptoms and pain are controlled, goals of care are discussed and emotional needs are supported.
Chen Zuobing, after discussing the issue with his severely ill father who preferred death with dignity, decided to fulfill the old man's wish. His father returned to his hometown and lived his final days without the disturbance of modern medicine.
"There is no right or wrong in making this decision. If the person receives full-scale treatment to the last moment, it is great that his family can hold on to him for another second. But if one refuses the extensive treatment, he can pass without the pain brought by medicine and in a dignified manner. Isn't it better this way?"
Death with dignity should not be confused with euthanasia which is the intentional termination of the person's life with consent to relieve pain. Death with dignity allows natural death without medical intervention during the last stage of a fatally ill patient.
Doctor Liu Duanqi at Beijing Oncology Hospital is an oncology expert says 99 percent of patients who suffer from last stage pancreas or liver cancer pass away. He explains that death with dignity touches on the core of medical care.
"Doctors and medicine are only capable to help and assist the patient. In many terminally-ill medical cases especially the chronic and consumptive diseases, doctors can't change the course of nature. The preoccupation is for the doctor to act according to the will of the patient."
Death with dignity is about giving the patient back the freedom of choice to decide on what treatment to receive at the final moment. In this way, dignity is upheld for the sufferer. It includes a written agreement stating the patient's decision prior to treatment. Such a document is called an Advance Care Plan, which is not formally introduced in China yet. It includes a living will and the durable power of attorney for health care. It allows another person to have a say in the health care treatment one will receive if one is too sick to speak for him or herself. By discussing and documenting one's wishes, the family and health care team will be better able to act on the person's behalf.
When one's wishes are fulfilled, one can wave goodbye without regret. Family and friends will feel less distress as well.
Source: CRI

Medical officials sacked for unethical GM rice clinical trial

Clinical trial was run without informed consent by officials from the Zhejiang Academy of Medical Sciences

Three officials who had approved and conducted a controversial test of genetically modified (GM) rice on school children in central China's Hunan Province had been sacked, authorities said on Thursday.
The officials were punished for "violating relevant regulations, scientific ethics and academic integrity," according to a statement jointly released by Chinese Center for Disease Control and Prevention (China CDC), Zhejiang Academy of Medical Sciences, and Hunan provincial CDC.
The officials include Yin Shi'an from China CDC, Wang Yin from Zhejiang Academy of Medical Sciences and Hu Yuming from Hunan provincial CDC.
Earlier, the Ministry of Health ordered China CDC to investigate whether dozens of children in Hunan were used in 2008 as test subjects in a U.S.-China joint research project that included GM food Golden Rice.
Greenpeace broke the news on the controversial test in late August this year, saying that the joint research involved feeding Golden Rice, which is genetically modified to be rich in beta carotene, to 25 children aged between six and eight in Hunan.
It cited a paper published in the August edition of The American Journal of Clinical Nutrition.
The paper claimed that Golden Rice is effective in providing vitamin A to children.
The research, approved by the National Institutes of Health of the United States in December 2002, was led by Tang Guangwen, director of the Carotenoid and Health Laboratory of Tufts University in the United States. It was intended to explore ways in preventing deficiency of Vitamin A in children.
Tang conducted the research in cooperation with Yin Shi'an from China CDC and Wang Yin from Zhejiang Academy of Medical Sciences.
In 2008, the test was conducted on 80 pupils in Hengnan County of Hunan Province, with 25 of them being fed 60 grams of Golden Rice on June 2.
The research team had informed parents of the tested children about the experiment but withheld the truth that GM rice would be used.
Source: China Daily