Most of the patients received by the physician have an expected lifespan of two weeks or less. With just six beds available for terminally ill patients, they have no option but to impose the time limit. Some patients die while waiting for a bed. Despite the high demand for palliative care, there are only a few dedicated hospices in the country, and they are struggling to survive.
Having worked as a cancer specialist for more than 30 years, she has witnessed many terminally ill patients die in the hospital while attached to tubes and drips, even though there is no medical reason for them to suffer.
Unlike intensive treatment is given to terminally ill patients in the hope of prolonging life, palliative care uses just enough medication to alleviate pain so people can die in a gentle, dignified way.
Sense of mission
However, the hospice, one of China's first end-of-life care centers, was forced to change location seven times in 16 years because of people's unease about having such an institution near their homes.
Despite these age-old cultural inhibitions, demand for palliative care is growing as China's population ages. The hospice currently has about 300 patients, with ages ranging from a 2-month-old baby to centenarians. Though national health regulations stipulate that the maximum time a person can stay in a hospice is 15 days, the average stay at Songtang is 56 days.
Lack of access
Authorities are aware that demand for palliative care is rising rapidly. In March last year, 13 hospice pilot projects were established by the Beijing government by central government guidelines. The yearlong pilot was intended to explore the introduction of widespread palliative care, but no directions for follow-up programs have been set out so far.
A hospice ward received only half of the 125,000 yuan in subsidies that the Beijing government was supposed to provide last year. It also has to share a nursing team with the hospital's Oncology and Hematology Department, meaning there are just four nurses for every ten beds. Meanwhile, private hospitals have no incentive to establish hospice wards because palliative care generates far less revenue per patient than the provision of treatment to prolong life.
The problem is compounded by the fact that most Chinese consider it their filial duty to pay to keep their elderly parents alive for as long as possible, regardless of the quality of life. Li said many families run out of money while paying for such treatment. That means they are unable to afford palliative care at the end, even though it is relatively cheap.
Nobody wants to provide hospice care because it means investing energy while losing money, adding that the hospice is struggling to pay bills, but it doesn't have to pay rent because he owns the three-story building in which it is located.
Low rate of change
The move could help change the mindset of doctors who are only used to providing treatment to prolong life.