If your family made a living will, choosing not to take traumatic rescue measures before dying, and say goodbye to the world peacefully, would you understand and support this "end-of-life decision right"?

  On June 23, the 10th meeting of the Standing Committee of the 7th Shenzhen Municipal People's Congress voted to pass the revised draft of the "Shenzhen Special Economic Zone Medical Regulations", which for the first time in the country included patients' "end-of-life decision rights"-living will into the local government. Regulations, which will come into force on January 1, 2023.

The move sparked heated discussions in the community.

  "Affirmative support", "Is it a guarantee of the dignity of life", "I still hope to extend the time of relatives as much as possible"... Recently, a reporter from China Youth Daily and China Youth Daily learned in a street interview that many young people expressed their willingness to sign the Will, but in the face of the dying choices of family members and relatives, it is inevitable that there will be "struggles" and "entanglements" in my heart.

  What is a Living Will?

Is a Living Will the same as "giving up treatment"?

How does a Living Will work?

How to determine the legal validity of a living will?

Whether it is expected to be promoted nationwide... Around these hot issues, the reporter conducted multiple interviews.

  In life and death, who has the right to decide?

  In order to let the grandson who was rushing back all night see the last time, with the repeated insistence of the family members, the elderly in their 90s was put on a ventilator, and the medical staff performed chest compressions for more than half an hour to keep the heartbeat.

"Occasionally, I hear the cracking sound of the old man's body, which is really distressing." Yu Cong, deputy director of the Nursing Department of Shenzhen Second People's Hospital and vice president of Shenzhen Living Will Promotion Association, said this scene, tears in his eyes Spin around.

  As a medical staff, Yu Cong has dealt with some terminally ill patients all the year round. "We often have patients who tell us that they really don't want to suffer again, but some family members are reluctant, and some family members feel in a dilemma."

  During the street picking, Qianqian, a post-90s girl, recalled a sad event.

Two years ago, Qianqian's grandmother was sent to the hospital for treatment due to a cerebral hemorrhage caused by a lung infection.

"When I saw my grandmother again, she was covered with tubes all over her body, and she felt like she was tied up with five flowers and couldn't speak." She was wearing a ventilator, a feeding tube, a urinary catheter, and a drainage tube for effusion...

  The elderly are seriously ill, rescue or give up?

To this end, Qianqian's family held 3 family meetings successively and decided to "spend money to prolong her life" for her grandmother.

  Unexpectedly, one night, grandma struggled to get rid of the ventilator and left in this way.

"She almost suffocated herself to death." Qianqian sighed, "We asked for the opinions of all the family members, but we didn't ask her own attitude. If there was a will before her death, grandma might not be so painful to leave. ".

  Article 78 of the "Shenzhen Special Economic Zone Medical Regulations" stipulates that medical institutions shall respect the requirements of the patient's living will, and after receiving the living will from the patient or his close relatives that meet the prescribed conditions, at the end of the patient's incurable injury and illness Or at the time of death, medical institutions shall respect the will of the patient in carrying out medical treatment measures.

  "The essence of a living will is to respect the patient's right to make a final decision." Zhou Shihong, member of the National Committee of the Chinese People's Political Consultative Conference, chairman of the Anhui Lawyers Association, and chairman of the Hefei Lawyers Association, said that a living will is signed by people when they are healthy or conscious, indicating that A document indicating whether or not to require certain medical care at the terminal or dying stage of an incurable injury to oneself.

"This new regulation is a great boon for dying patients who can't bear the pain of excessive resuscitation."

  Yu Cong once met a patient with kidney disease in his 80s. When faced with the choice of hemodialysis, the family members of the old man insisted on his treatment.

Due to the long-term pain and suffering, the whole body of the old man was swollen and itchy. During each 4-hour hemodialysis process, two or three people were needed to hold down the old man's hands and feet, and the patients and their families were in great pain.

  "Let me live one more day is to make me suffer, please spare me!" With the old man's constant struggle, the family finally respected the old man's choice and let him spend the last time of his life peacefully and dignifiedly.

  Zhou Shihong believes that according to the relevant provisions of the "Shenzhen Special Economic Zone Medical Regulations", when making a living will, the parties should be healthy and conscious, and be able to accurately express their own wishes and choices.

Living wills shall be notarized or witnessed by two or more uninterested witnesses, and the names, portraits and other legal elements of the testator and witnesses shall be completely recorded in writing or in the form of audio and video recordings.

  Living Will Does Not Mean "Abandoning Treatment"

  For the first time he entered the law with the will before his death, the post-90s young man Xiao Zhao expressed his understanding, "The first is filial piety. If it can reduce the pain of the relatives, they should respect their choice." Another interviewee, Liu Yu, couldn't bear it. " As a child, I hope that the old man can live one more day, and try his best to continue his life.”

  Yang Lixin, a professor at the Law School of Renmin University of China, said that Article 1002 of the Civil Code stipulates that "the safety and dignity of life of natural persons shall be protected by law".

Living will is the embodiment of the right to life dignity in the Civil Code.

"The right to the dignity of life is to protect the dignity of life and the dignity of death. We cannot decide how to live, but we can choose the way of death and say goodbye to the world naturally and with dignity."

  Zhou Shihong said that the living will is the respect and protection of the patient's right to life and health.

Respecting the patient's self-determination at the end of life can alleviate the pain of the patient and the psychological torment and struggle of the family.

  Yu Cong emphasized that signing a living will does not mean "giving up treatment". In practice, specialist doctors and palliative care professionals will conduct a comprehensive assessment of the patient's physical condition, only to confirm that it is "incurable end of life". Only ineffective and painful medical treatment is abandoned by palliative care, and at the same time, it is more active to control various physical symptoms, improve the quality of life of patients in the end-stage, and allow patients to die comfortably and dignifiedly.

  Yu Cong told reporters that, in fact, living wills have been popularized among the people for many years.

  "I don't want pain of any kind" "I give up using feeding tubes" "I want someone to be with me when I die" "I want a drawing or photo I like to hang on the ward near my bed"...2009, "Choice and Dignity", the first public welfare website advocating "death with dignity" in China, launched my country's first living will text "My Five Wishes". The texts are: I want or don't want any medical services; Not using life support; how I want others to treat me; what I want my family and friends to know; and who I want to help me.

  In 2013, the Beijing Living Will Promotion Association was established, becoming the first social organization in my country to promote living wills.

In April 2021, the Shenzhen Living Will Promotion Association was established, becoming the second non-profit organization in the country to promote living wills.

"This time, the living will was entered into law in Shenzhen, and the authority of the law guarantees the implementation of the living will." Yu Cong said.

  Huang Qi, member of the National Committee of the Chinese People's Political Consultative Conference and part-time vice chairman of the Shanghai Women's Federation, pointed out that a living will is a will for the treatment plan during the treatment process, and the purpose and content of a living will are different.

"A living will is an arrangement for the disposal of my property after my death, and it protects property rights and inheritance rights."

  Can Living Wills Spread Nationwide?

  Accompanying the living will is palliative care.

  In April 2011, the 78-year-old father of Chen Zuobing, MD, chief physician and MD of the First Affiliated Hospital of Zhejiang University School of Medicine, was diagnosed with advanced malignant tumor, which had metastasized to the whole body.

Just after the Spring Festival in 2012, Chen Zuobing's father was seriously ill and was admitted to Zhuji People's Hospital.

According to his father's wishes and Chen Zuobing's suggestion, he refused chemotherapy and radiotherapy, and only took ordinary fluid replacement, symptomatic treatment, and pain relief.

A month later, my father left.

  Some people were puzzled by his approach. Chen Zuobing said: "If time comes again, I will do it again." What remains in his memory is that his father "always smiled and was very peaceful" until the later stage of his life.

  In the face of the family's living will, many young people in the street are more worried about the outside world's vision and opinions, "I am afraid that people around them will feel unwilling to spend money to rescue their relatives, and there will be greater psychological pressure and burden."

  Huang Qi mentioned that writing the pre-living will into the "Shenzhen Special Economic Zone Medical Regulations" can alleviate the suffering of critically ill patients, and at the same time allow "instructions" to follow in the end-of-life care, which can reduce the conflict between doctors and patients to a certain extent.

  "Returning the decision-making power of life to me through a will before death is a huge social progress, and it is only a matter of time before it is promoted nationwide." Zhou Shihong said.

  (The youth interviewed in the article are all pseudonyms)

  China Youth Daily and China Youth Daily reporter Han Yang and Liu Fangxian Oujie