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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.
由于中国相对较为落后的临终关怀政策，人们害怕有限的资源将让那些生命垂危的病人陷入一个更加痛苦，缓慢的死亡过程。
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.
陈小鲁和罗点点是老一辈革命家陈毅和罗瑞卿的孩子，父亲的死亡都经历了一些不必要的伤痛，由于政治原因，人们必须要尽可能的留住他们的生命。最近几年，他们刚开始意识到了什么叫作有尊严的死亡，以至于他们在2013年成立了北京生前预嘱推广协会，从而来促进临终关怀。
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.
临终关怀是一种生命晚期的治疗手段，这种治疗方式注重的是减缓病人痛苦，并帮助家人处理好善后事宜。这样的临终关怀在中国才刚刚开始。不像美国，根据美国国家综合癌症网络所发表的文章，人们可以使用像吗啡等镇定剂，这也是一项指导方针，而在中国却没有相关的方针政策。就紧张的医患关系而言，许多医生不敢实施这样的治疗，这是因为他们害怕牵扯到法律纠纷之中。对于社区医疗中心以及家庭临终关怀的资源更是非常稀缺。病人无法进行进一步的手术，化疗和放射性治疗都无法在大医院中进行，但是在2013年，上海的一项有关临终关怀的研究发现上海医院只能提供一些可替代的临终关怀，每年能够接收0.28%的癌症病人，几万病人中只能够接收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.
北京的德胜社区卫生服务中心是北京唯一一家提供临终关怀的社区医疗中心，这家中心在组织结构和资金上都十分困难，并且缺乏支持。只有两名医生提供在家临终关怀，他们还要救助医院中的300名患者，这些病人大部分都是无法治愈，癌症晚期，或者是其他一些慢性疾病。北京政府忽视了临终关怀的服务，意思是医生的繁忙工作已经无法增加，所以许多医生就无法顾及临终关怀的服务。家庭救护会收取人们40元钱，而一些咨询，和减轻痛苦的咨询都是由志愿者提供的免费治疗，因为政府没有对其进行价格制定。但是，德胜医院的陆琪医生说我们急需支持，我们目前的资金快要无法维持了。政府对社区的临终关怀的支持也会减少医院资源的紧张感，这也将导致经济增长。北京小医院平均每天3100元的住院治疗费在德胜大约是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.
根据上海复旦大学的研究结果，到2050年，中国预计将有超过4亿老年人，这也将达到全球人口比例的最高值。随着人口老龄化以及医疗卫生服务的增加，人们对临终关怀的关注应该有所增加。
For Caixin Online, this is Christina Guo.
这是克里斯提娜·郭为您带来的财新报道。
译文属可可英语原创，未经允许，不得转载。
