WHEN Wang Mingcheng, a terminal cancer patient in West China's Shaanxi Province was refused euthanasia to end his agony-filled life, mercy killing was once again in the news across China.

Supporters believe the legalization of euthanasia is not only good for patients to give them release from unbearable pain but is also a measure of the level of civilization in a society.

Opponents believe China is not yet ready to legalize euthanasia which, if allowed, would cause serious social problems.

Euthanasia, in its narrow sense, means terminating a person's life painlessly by medical means when the person is suffering from an incurable and painful disease.

It goes beyond being just a medical topic but involves many areas including ethics, the law, economics and other areas. So, even after lengthy consideration and discussion since 1980s, the issue is still a controversial one across the country.

"I definitely support euthanasia for it is pushing medical research on diseases into the integration stage of researching physical, mental and social aspects," said Zhang Bin, professor of Shanghai Second Medical University and lawyer of Shanghai Kangzheng Law Firm.

Die with dignity

Gao Chengxin, a professor at the Shanghai Chest Hospital has treated many patients suffering incurable diseases in his more than 40 years of medical practice so he is also a strong supporter of euthanasia.

"If the patient has to die in extreme pain and all medical devices and drugs have been failed to prolong his or her life, they would choose to die with dignity rather than be forced to maintain life," said Gao.

The pain cancer patients suffer is unbearable and can't be eased by present drugs. In some cases, when the most effective pain killer such as dolantin can only help the patients for only half an hour, they have to take extreme actions to end the torture including committing suicide, which is not rare in the ward for terminal patients.

"I saw the patient in the bed next to me suddenly jump out of bed and climb to the window. Everyone in the room, including nurses and his relatives, were shocked when he jumped," said Lu Rongjie, a survivor of breast cancer.

Recalling the tragedy, Lu added: "I can understand his deed because he could not lie peacefully even for half an hour as the pain was everywhere and came at anytime."

The terminal ailment not only tortures patients but also drains their family members and medical staff.

"They are dying as painfully as if in hell, so why not help them to spend their last days in a peaceful and relaxing situation. Doctors' responsibility is more than treating diseases and saving lives," said Gao.

The terrible experiences of terminal-stage patients also scars the lives of family members and the mental shadow will be a lifelong memory. The children of cancer patients would be extremely afraid and more fragile than others if they become cancer victims, medical experts say.

Another reason for advocating euthanasia is to save the limited medical resources for other patients. Take Shanghai for example, the annual average medical resource for residents is about 8 yuan (US$0.97), but the basic need to support the city's medical insurance system is about 22 yuan (US$2.65) each. "Since the shortage is so big, why not save the limited medical sources for more in need," said Zhang.

Ethical pressure

"Nothing is more special than one's life, we didn't give up our loved one's life until the last second," said Wendy Huang whose family had looked after her grandfather and aunt, both cancer patients, for several years.

Huang strongly opposes to euthanasia, as she said that nothing was more precious than to keep her aunt and grandpa alive even just for one more hour.

According to Chinese ethics, one's life and every part of the body are all given by parents and can't be damaged by oneself, so ending one's life in an unnatural way is regarded as immoral.

Family members would be under great social pressure if they helped a relative seek euthanasia. If the children agreed with their parents to seek euthanasia - such as in Wang's case (See STORY on Page 6) - they would be criticized as violating filial piety.

Doctor Li Qingyu of Ruijin Hospital doesn't think that it's practical to carry out euthanasia in China having regard to the Chinese attitude towards death and doctors' professional morality.

"During my clinic experience, I found the eagerness to maintain a life is so strong. Patients sometimes can't bear the disease and they ask doctors to end their life as soon as possible, but actually they cherish their life much more than anyone else," said Li.

In some religions, death is not so terrible if it means stepping into paradise. But that concept is not accepted widely in China although its most influential religion-Buddhism supports such a belief.

Legal aspects

The most heated argument raised by opponents of euthanasia is that any legislation in favour of mercy killing will infringes upon people's right to life and violate China's Constitution.

Opponents also believe that to end one's life may deprive scientists and medical research of the chance of finding a possible treatment or cure for the disease.

But advocates say that just as people have the right to live, they also enjoy the freedom to choose death.

Some opponents think that euthanasia would be abused and misused in such a big country as China where the legal system seems weak in rural areas.

Supporting law experts say that any wrongdoing could be avoided through strict implementation of the law.

In big cities such as Shanghai, Beijing and Guangzhou, where medical techniques are comparatively advanced and the legal situation is rather good, legalization of euthanasia is possible and could be pioneered in those cities, said Zhang.

Doctors say it's impossible to do so without legal support as they are at high risk of being involved in medical disputes.

However, legal and medical experts pointed out that procedures for allowing euthanasia would be very strict and the medical teams diagnosing patients as candidates for euthanasia would be staffed by senior doctors only.

As well as physicians and surgeons, psychologists would also be required to be part of the decision-making team to assess whether the patient was willingly choosing euthanasia.

"Those selecting euthanasia patients should hold special licences issued by the State Ministry of Health, and they should not be the doctors of treating that patient," said Zhang and Gao.