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A combination of an underdeveloped palliative care system, lawsuit fears and limited resources means China's terminally ill patients are largely being left to a slow, often painful end to their suffering.
由于中國相對較為落后的臨終關懷政策，人們害怕有限的資源將讓那些生命垂危的病人陷入一個更加痛苦，緩慢的死亡過程。
Chen Xiaolu and Luo Diandian, children of celebrated senior Communist Party members Chen Yi and Luo Ruiqing, watched their parents die in unnecessary pain, due to political norms decreeing the officials were to be kept alive as long as possible. In recent years, they have led the first awareness movements for the concept of dying with dignity, founding the Beijing Living Will Promotion Association in 2013 to advocate palliative care.
陳小魯和羅點點是老一輩革命家陳毅和羅瑞卿的孩子，父親的死亡都經歷了一些不必要的傷痛，由于政治原因，人們必須要盡可能的留住他們的生命。最近幾年，他們剛開始意識到了什么叫作有尊嚴的死亡，以至于他們在2013年成立了北京生前預囑推廣協會，從而來促進臨終關懷。
Palliative care is a variation of end-of-life care that focuses on providing relief from symptoms and helping families cope through the illness and bereavement process. Palliative care is only just debuting in China. Unlike the U.S., where use of palliative sedatives like morphine has been given guidelines, publishedby the U.S.-based National Comprehensive Cancer Network, doctors in China do not have access to such guidelines. In light of the already tense doctor-patient relationships, many doctors would not dare to promote the remedy due to fear of the potential legal and professional consequences.Resources for community health care or in-home hospice care are even scarcer. Patients who cannot undergo further surgery, chemotherapy or radiotherapy are often unable to stay in large hospitals but a 2013 hospice care study in Shanghai found the city's hospitals are only equipped to provide alternative hospice careto 0.28 percent of cancer patients per year – 234 patients out of hundreds of thousands.
臨終關懷是一種生命晚期的治療手段，這種治療方式注重的是減緩病人痛苦，并幫助家人處理好善后事宜。這樣的臨終關懷在中國才剛剛開始。不像美國，根據美國國家綜合癌癥網絡所發表的文章，人們可以使用像嗎啡等鎮定劑，這也是一項指導方針，而在中國卻沒有相關的方針政策。就緊張的醫患關系而言，許多醫生不敢實施這樣的治療，這是因為他們害怕牽扯到法律糾紛之中。對于社區醫療中心以及家庭臨終關懷的資源更是非常稀缺。病人無法進行進一步的手術，化療和放射性治療都無法在大醫院中進行，但是在2013年，上海的一項有關臨終關懷的研究發現上海醫院只能提供一些可替代的臨終關懷，每年能夠接收0.28%的癌癥病人，幾萬病人中只能夠接收234人。
Beijing's Desheng Community Health Care Service Center is the only community health center in Beijing thatprovides palliative care and its organisational and funding difficulties encapsulate the lack of structural support.Only two full time doctors provide in-home and in-patient care for 300 patients, primarily with untreatable, advanced-stage cancer and other chronic diseases. The Beijing government disregards hospice care services in official doctor assessments, meaning the exhausting workload is almost never adequately compensated, thus reducing incentive for more doctors to contribute. The center charges the Beijing government's standard 40 yuan for house calls but in-home pain assessments, grief counselling and other services are provided for free by trained volunteers because there is no government-mandated fee standard.However, Lu Qi, one of the doctors at Desheng, says they are in dire need of support and that their current expenditure is quickly becoming unsustainable.Government support for hospice care at a community level could also reduce strain on hospital resources, resulting in economic benefits. The average 3,100 yuan for in-patientdaily fees at smaller Beijing hospitals are priced at about 250 yuan at the Dasheng center, forthe same services.
北京的德勝社區衛生服務中心是北京唯一一家提供臨終關懷的社區醫療中心，這家中心在組織結構和資金上都十分困難，并且缺乏支持。只有兩名醫生提供在家臨終關懷，他們還要救助醫院中的300名患者，這些病人大部分都是無法治愈，癌癥晚期，或者是其他一些慢性疾病。北京政府忽視了臨終關懷的服務，意思是醫生的繁忙工作已經無法增加，所以許多醫生就無法顧及臨終關懷的服務。家庭救護會收取人們40元錢，而一些咨詢，和減輕痛苦的咨詢都是由志愿者提供的免費治療，因為政府沒有對其進行價格制定。但是，德勝醫院的陸琪醫生說我們急需支持，我們目前的資金快要無法維持了。政府對社區的臨終關懷的支持也會減少醫院資源的緊張感，這也將導致經濟增長。北京小醫院平均每天3100元的住院治療費在德勝大約是250元。
According to researchers at Shanghai's Fudan University, China is expected to have over 400 million seniorcitizens by 2050, the world's largest ratio of seniors to the overall population. The need to re-evaluate the care given to those struggling towards the end grows more dire, as the population continues to age andhealth demands rise.
根據上海復旦大學的研究結果，到2050年，中國預計將有超過4億老年人，這也將達到全球人口比例的最高值。隨著人口老齡化以及醫療衛生服務的增加，人們對臨終關懷的關注應該有所增加。
For Caixin Online, this is Christina Guo.
這是克里斯提娜·郭為您帶來的財新報道。
譯文屬可可英語原創，未經允許，不得轉載。
