the chinese adage has it that one should be born in suzhou, live in hangzhou, eat in guangzhou and die in liuzhou. actually, suggests a new study: london may be the place to die。
china is near the bottom of a 40-country"quality of death" index ranking nations by the care provided to those late in life, published by the economist intelligence unit and commissioned by lien foundation. at the top of the index is the united kingdom, followed by australia, new zealand and ireland. those nations score well on indicators such as public awareness, training availability, access to painkillers and the heavily weighted category of doctor-patient transparency。
globally, average ages will continue rising, particularly in rich countries. but filling out the bottom ranks of the quality of death index were the populous, fast-growing bric countries - brazil, russia, india and china, along with uganda and mexico."death and dying are stigmatized in some cultures to the point where they are taboo - as in chinese culture."
with doctor-patient transparency contributing 40 percent of the overall index score, it isn't hard to see why china would do poorly. in china, it isn't uncommon for doctors, often in cahoots with families, to lie in the face of a terminal illness to a patient about his chances, out of fear the truth would be too upsetting, to avoid his calls to continue with costly treatments and even to avoid association with spirits of the afterlife。
china has virtually no discussion of end-of-life care, such as hospice, according to the study."most family members of the patients can’t fully understand it," says ma ke, director of the third people's hospital of kunming hospice department, in the study. (the report says around 30 hospitals in china offer hospice care。)
but in addition to traditions about death, china's one-child policy may be worsening things for the roughly 9.38 million chinese who die each year, or just over 0.7 percent of the population. (2008 figures)"the ratio of working people to dependents is shrinking rapidly, particularly in china, where the one-child policy will leave parents with fewer offspring to care for them in old age," the report says。
美国《华尔街日报》网站7月14日文章,原题:住在杭州,死在伦敦。中国有句俗话,“生在苏州,住在杭州,吃在广州,死在柳州”。但一项新研究显示,其实伦敦才是“好死”之地。
连氏基金会委托英国经济学人信息部发布的“死亡质量”指数显示,按临终护理水平排名,中国在40个国家中几乎垫底。排名最高的是英国,其次是澳大利亚、新西兰和爱尔兰。这些国家在公众意识、相关培训、止痛药品覆盖面和所占权重最大的医患关系透明度等指标上均得分较高。
随指数一道发布的报告称,全球平均年龄将继续提升,尤其在富国。但在死亡质量指数中垫底的是人口众多、发展迅速的“金砖四国”,还有乌干达和墨西哥。报告说:“死亡和濒死在某些文化中被视为禁忌,比如说中国文化。”
在该指数的总分中,医患关系透明度占了40%的比重,从这点不难看出为何中国表现如此之差。在中国,面对绝症患者,医生会就其生存几率说谎,经常是和家属一道,因为他们害怕真实信息让病人太难受,以此避免病人要求持续昂贵治疗,甚至是因为想避免病人死后鬼魂的纠缠。
研究显示,中国人几乎从不讨论临终看护问题。昆明第三人民医院临终看护部主任马克(音)说,大多数家庭对此问题都没有充分了解。报告说,中国只有约 30家医院提供临终关怀服务。
除了关于死亡的文化传统问题,独生子女政策也可能让每年去世的938万中国人晚境更加凄凉(2008年数据)。“就业人数与负担人数之比正快速缩小,这在中国尤其突出,独生子女政策让父母年老体迈时得不到足够的关怀,”报告称。