Right-to-die campaigners say legal status must be clarified

Li Yan's body may be weak, but her will to choose the day of her death remains firm.

"I can't do anything without help from my parents - eating, bathing, anything," said the 34-year-old, who has muscular dystrophy. "I need to consider what it will be like when my health deteriorates and no one will take care of me.

"I want the choice of a painless ending when I am ready."

Li is an advocate of euthanasia, also called assisted suicide or mercy killing. Li said she believes that a person should be allowed to decide when, where and how their life ends, even it involves enlisting the help of a relative or health professional.

Euthanasia is illegal in China, but since 2007, Li has been campaigning for a change in legislation that would see her country follow the Netherlands, Switzerland, Belgium and some US states in allowing some form of euthanasia.

"When that day comes, I'll be able to reach my destination in peace, without fear," said Li, speaking over the phone from her home in Yinchuan, the Ningxia Hui autonomous region.

The issue of euthanasia divides public opinion, particularly among lawyers and health experts. However, even opponents agree that introducing a lawful process for euthanasia can prevent well-intentioned parents and spouses of people with terminal illnesses from ending up in court.

In October, 38-year-old farmer Jia Zhengwu was tried for intentional homicide after he pushed his wife, who was paralyzed with rheumatism, off a riverbank in Lanzhou, capital of Gansu province.

Zhang Xiaojun, also 38, died on April 21, 2011. According to an interview Jia did with China Central Television, she had repeatedly asked him to end her life. "That day (in April), she cried and said she will never be cured, even after we had spent all our money," he said.

The court that heard the case has yet to hand down a verdict.

Jia could well receive a similar punishment to Deng Mingjian, a migrant worker in Guangzhou who in May was sentenced to three years in prison, suspended for four years, after he admitted assisting in his mother's suicide.

Deng Mingjian walks out of the Panyu District People's Court in Guangzhou, Guangdong province, in this May 30 file photo. Deng, a migrant worker from Sichuan province, was sentenced to three years in prison, suspended for four years, after he admitted assisting in his mother's suicide. [Photo/Provided to China Daily]

"She was in great pain," Deng told China Daily, adding that he had cared for his mother for two decades because she had rheumatoid arthritis. "That day, she grabbed me so hard. Seeing her in agony, I had to say yes."

He said he bought her pesticide and helped her drink it. "My mind just went blank as I did it," he recalled.

China does not have any official data on incidences of euthanasia nationwide, or how many people use it as a defense in court. However, Hong Daode, a professor at China University of Political Science and Law, said he has noticed an increasing number of cases.

He said their actions can "absolutely be classed as intentional homicide" but explained that judges may give more lenient sentences - three to 10 years - due to mitigating circumstances.

However, as Tang Chengkui, the attorney that defended Deng, pointed out: "Even if someone says theirs was an act of mercy, it's extremely hard for a court to rule out the possibility of murder."

A merciful law

Qiu Renzong, an expert in medical ethics and an advocate of legal euthanasia, said legalizing euthanasia can help people living in pain find peace and prevent murder.

He suggested the government pilot a system at selected hospitals in which patients can be assessed for their suitability and receive professional help.

"These (trials for so-called mercy killings) are happening purely because there is no legislation that decriminalizes assisted suicide and sets strict conditions on how it can be conducted," said Qiu, a researcher at the Chinese Academy of Social Sciences. "I suggest letting a few hospitals try it, so they can assess patients properly. Otherwise it's possible that some people will take advantage and attempt to get away with murder."

To qualify, he said a person must have a terminal illness and be in "unbearable pain" that cannot be alleviated by medication. There must also be an official record showing the person has repeatedly insisted on euthanasia. "Any application would have to be appraised by a medical professional and conducted in a painless way."

Zhai Xiaomei, a professor of medical ethics at Peking Union Medical College, agreed: "This is a very serious matter, so the prerequisites need to be designed very carefully."

In a petition circulated online by Li Yan in 2007, she said euthanasia does not only free the terminally ill, but also their families.

"The torture for the family taking care of the patient is no less than that of the patient," she wrote. "Most families can't afford the huge medical costs and may fall into debt, even though there is no cure for the patient's illness."

This was the case for Zhang Xiaojun's family, which had spent more than 170,000 yuan ($27,300) on her treatment, according to her husband's brother.

"By late February 2011, my brother had sold his farm cattle and everything else he could to take his wife to hospitals in Lanzhou. Still, the doctors told them there was nothing they could do," Jia Shengli said.

Likewise, Deng said at the time of his mother's death he and his wife were making 1,000 yuan ($160) a month but spending 500 yuan a month on medicine for his mother.

"I don't have health insurance, and with the rent for our apartment, we barely had any money left," he said. "My son is 19 years old and needs money to get married, while the family home (in Sichuan province) needs to be repaired."

However, the financial burden is one thing that health experts say should not enter the equation.

Yu Fei at the China University of Political Science and Law wrote in a recent opinion piece for Legal Daily that euthanasia should only be used to free a patient from unbearable pain.

"Public health insurance is far from sound in China right now. The system to take care of elderly people and the disabled is not well established. We must not rush to legalize euthanasia, otherwise it will cause many problems," Yu wrote. "It's a tragedy when underprivileged people have to turn to euthanasia to free themselves from the guilt they feel for their family."

Qiu expressed similar concerns. "To assist a suicide because of ignorance or a difficult financial situation instead of seeking treatment is not euthanasia," he added.

wangqingyun@chinadaily.com.cn