Hospice care to grow amid push for education on death

More hospice care services are expected to be provided in China to improve the quality of life for the elderly and people in the terminal stages of diseases, according to a written response from the National Health Commission to a former national political adviser.

In the response, discussed with other departments and released on the commission's website in December, the commission said it supports the establishment of large-scale and chain hospice care centers.

Hospice care services are relatively few in China, despite its aging population.

Initiated in the United Kingdom in the 1960s and 1970s, hospice care has expanded to many other countries. By the end of 2020, China had 510 hospitals with hospice care departments, data from the commission showed. Some nursing homes also offer such services.

"For patients with incurable diseases or who are dying, it is often better for them to spend the last part of life in peace and comfort," Mo Changying, a member of the China Economic and Social Council, former vice-chairwoman of the Guangxi Zhuang Autonomous Region Committee of the Chinese People's Political Consultative Conference, and member of the Standing Committee of the 11th, 12th and 13th National Committee of CPPCC, said in her proposal last March.

"Hospice care, as a special service, doesn't involve fierce or meaningless treatment that may increase pain and suffering for patients. Instead, it aims to help patients ease pain and face death calmly, with his or her final dignity retained."

However, hospice care in China faces a few challenges from a cultural standpoint. For most families, even though they know that a family member's life cannot be saved, they think that being alive is the most important thing. Despite the potential extended suffering, they spend a lot of money, and even run into debt, hoping to extend the life of a loved one.

Currently, there are no related laws or regulations for hospice care in China. Even if terminally ill patients and their family members wish to give up meaningless treatment, they are often not able to, which wastes medical resources and places a heavy burden on families, according to the proposal.

As of the end of 2020, there were 260 million people aged 60 or above in China, including 35.8 million aged over 80. Most hospice care services are offered in inpatient wards in general hospitals or community hospitals, and have no special government funding. There is also a shortage of related professionals.

In a step toward remedying this, universities will be encouraged to open death education and hospice care courses, as well as organize medical students to provide volunteer terminal care services, to meet the country's demand for high-caliber professionals in the sector, said the NHC response.

"Hospice care is a systemic program that needs the joint effort and participation of the government and the whole society," Mo said in her proposal submitted at the fifth session of the 13th CPPCC National Committee.

She suggested strengthening public awareness and education to help the public build a scientific and correct view of life and death, promulgating related laws and regulations, formulating examination and appraisal standards and specific operational behaviors, to avoid doctor-patient disputes.

Mo also suggested more social power to open hospice care institutions, with preferential policies offered in tax, land use and other charges, adding that the government should increase the input of financial funds for hospice care, and encourage companies and institutions to participate, such as by establishing a charity fund.

Related training should also be enhanced among medical students, medical workers and volunteers, to benefit the elderly with low incomes, the proposal said.

The Healthy China 2030 guidelines mention that the elderly should be offered complete health services including hospice care. In the commission's 13th Five-Year Plan (2016-20) and 14th Five-Year Plan (2021-25) for national nursing work, hospice care was a key area to be promoted, according to NHC.

The commission, together with eight departments, released a document in 2019 to include life education in courses for primary and middle schools.

It released a hospice care handbook in 2017 to regulate medical principles, main points for nursing and matters needing attention, such as the use of painkillers.

Contact the writers at chenmeiling@chinadaily.com.cn