Wang
Mingcheng, the first person in China to be prosecuted for
practicing euthanasia, on his mother, Xia Suwen, in 1986, died
August 3 in northwest China's Shaanxi Province. Pu Liansheng, the
physician in charge back then, ordered the administration of
euthanasia on Xia. Both Wang and Pu were arrested after Xia's death
but found not guilty later. In an interview with a local newspaper
before he died of cancer, Wang said he had made the right decision
16 years ago and what he did deserves understanding from other
people. He also urged the state's earliest legislation on
euthanasia.
Euthanasia is the act of assisted painless suicide for medical
reasons (particularly for someone suffering from an incurable
illness).
Pu Liansheng, one of the key men in the landmark 1986 euthanasia
case, was a doctor at the Hanzhong Infectious Disease Hospital in
Shaanxi Province. He was prosecuted for intentional homicide later
that same year. Five years later, the Hanzhong Intermediate Court
acquitted Pu of the charge but the local procuratorate immediately
appealed for a retrial. One year later, the Hanzhong court issued
its final decision, again finding Pu not guilty.
Pu recalled, "In 1986, I treated a patient named Xia Suwen. She
was very agitated at that time, groaning and crying without
stopping, banging her head on the bed. She was also anuric. Her son
and daughter knelt down on the floor and begged me to let their
mother go soon. So I wrote a prescription: 100 mg of compound
wintermin. I gave the prescription because the son asked to let his
mother die soon and they had knelt down before me, after all. I
wrote 'The patient's family requests euthanasia,' on the
prescription and her son, Wang Mingcheng and daughter Wang Xiaolin
signed beneath what I wrote. Later they asked me how soon their
mother would die and I answered it might happen around midnight. We
waited till 3 am when a nurse visited me, saying that the patient
was dying. Xia died at about 5 am. It took 19 hours for her to
reach the end. "
"The investigation began on July 3 and I was arrested on
September 20. The procuratorate charged me with intentional
homicide. I spent 492 days in custody, yes, I remember this the
most clearly. I think I was wronged because I just performed my
duties as a doctor, to ease the patient's sufferings. What crime
did I commit? It's now hard for me to recollect the past."
Reporter: ?Is euthanasia really
painless?
Pu Liansheng (abbreviated to Pu): No pain in it
and it's kind of a happy death.
Reporter: ?How should we understand the
word "happy" here?
Pu: I meant that there is not any pain. People
die in their sleep.
Reporter: But "happiness" should be
relative.
Pu: No, there is just no pain, absolutely. It's
not relative.
Reporter: But you are not a patient and cannot
know their aches and pains.
Pu: The injection's usefulness makes its taker
painless, to be sure. Euthanasia just means assisted suicide
without pain in pharmacology. A patient dies painlessly and happily
in euthanasia.
Reporter: What methods are now available in
medical euthanasia?
Pu: Vein or muscle injections.
Reporter: What drugs are used?
Pu: Wintermin 1 and wintermin 2.
Reporter: Are such drugs available in small
hospitals?
Pu: They are available in most hospitals
because it is commonly used medication.
Reporter: How do you obtain such knowledge?
Pu: I learnt this from medical journals. Issues
of euthanasia first arose in Japan in the 1970s and the country
hosted an international convention on the topic in 1975.
Reporter: What would have happened to her if
the patient (Xia Suwen) hadn't received euthanasia 17 years
ago?
Pu: She would have eventually died, no matter
if she had received euthanasia or not. She was in the throes of
death. At that time the whole third floor rang with her cries all
through the first night she was hospitalized. The Doctor Li on duty
wasn't able to help but give her an injection of 10 ml of
Valium.
Reporter: It didn't work?
Pu: No. I used compound wintermin only the next
day.
Reporter: Who carried out the injection?
Pu: A student intern from the provincial
nursing school, named Cai Jianlin.
Reporter: Why an intern was assigned to such an
important job?
Pu: The hospital's head nurse saw my
prescriptions and asked why I gave the drug. I just said in reply
that everything was clearly stated on the prescription. So she told
me that no nurse would give an injection of the drug I
prescribed.
Reporter: Why did they refuse to give the
injection? They were afraid, weren't they?
Pu: Yes. They feared to take the
responsibility, in a word, they just feared to take the
responsibility.
Reporter: Then who ordered the intern to do the
job at last?
Pu: I did.
Reporter: What did he say?
Pu: He hesitated for quite a while, and then I
told him, "If you refuse to do this maybe it's time for you to go
back to school. I will no longer be your tutor doctor."
Reporter: Were you coercing him?
Pu: Yes, somewhat. I was using the authority of
both a doctor and a tutor.
Reporter: What would you have done if he had
eventually refused your order?
Pu: In that case her son would have to find
another person outside the hospital to do the job. She had been
discharged from the hospital by that time anyhow.
Reporter: Would you give the injection on your
own in that case?
Pu: No, I wouldn't.
Reporter: Why?
Pu: It sounds reasonable that I should give the
injection myself: You write the prescription and you should execute
it -- that's perfectly justified. But I was at the hospital where a
dual liability system existed. There would have been no witness if
I had given the injection. What drugs were injected? What was the
dosage? The person giving the injection could well act as a
supervisory force over the doctor.
Reporter: Did you expect to ease the suffering
of the patient?
Pu: My purpose was to alleviate her pain. For a
doctor relieving patient pain is part of his/her duty.
Reporter: If everybody else had refused to give
the injection, would you still have been reluctant to give it on
your own?
Pu: It isn't that I was unwilling to do it.
Maybe you know little of workplace relationships in hospitals.
Doctors mean authority there. Nurses must carry out doctors' orders
and safeguard the doctors' authority. You have to find a reason if
you don't want to obey an order.
Reporter: So you dared to give the order but
dared not to give the injection?
Pu: I was afraid that I would not be able to
explain the fact clearly when embroiled in possible dispute later.
I didn't record our talk when they knelt down to beg me to let
their mother go earlier to ease her pains.
Reporter: You were arrested three months after
the euthanasia had been implemented. Who reported you?
Pu: The patient's eldest daughter.
Reporter: Had you expected this day when you
made the decision to implement euthanasia on the patient?
Pu: No, I never expected that.
Reporter: The public prosecutor charged you
with intentional homicide and five years later a verdict came out
ruling that you were innocent. Were you prepared to face a death
sentence during those five years?
Pu: My faith was very strong then. I have said,
I neither have hatred for the patient nor took bribes from her. Why
should I kill her? That's impossible.
Reporter: The incident that happened 17 years
ago has changed your life. Though you have been set free with a
verdict of "not guilty", you are no longer welcome outside the
jail: your family resent you, so does your former employer
hospital; some people avoid you, some people curse you and label
you as a lunatic, and you no longer earn as much as before. Do you
regret it all now?
Pu: Well, surely I regret those things when I
recall them. Just thinking about my former colleagues who began
their career in the same year as I did: their lives are all better
than mine now.
Reporter: So you wouldn't have done that if you
had known the result beforehand, would you?
Pu: There is something in what you say and I
often test myself with that question. But I think people don't
understand everything one does and sometimes sacrifice is
inevitable. I have suffered all possible tribulations, except
death, I think.
Reporter: Your local court pronounced you not
guilty twice and their decision must have affected many other
doctors and hospitals. Are there any doctors, as you see it, doing
the same thing today?
?
Pu: (Yes.) Implementing euthanasia secretly. It's
not on prescription or medical record.
Reporter: Is this secret open to many people?
You just said many doctors are doing this in secret.
Pu: No. Certainly few people know about it.
Reporter: All of them must be in medical
circles.
Pu: In medical circles and in patients'
families -- they must know about it.
Reporter: Is it right that so many doctors are
secretly doing that because many patients need it?
Pu: They need to die in that way, to end their
suffering.
Reporter: Problems usually tend to arise easily
from things performed illegally and privately. For instance, how to
distribute liability between both parties, and who will protect the
party when it is indeed harmed?
Pu: This is an indeterminable issue now. People
will know what you did sooner or later, if only you did it.
Reporter: If the incident 17 years ago
recurred, a patient or his/her family members asked you to
implement euthanasia, would you do what you did again?
Pu: I will never do it again even if they kneel
down before me and offer me one million bucks.
Reporter: But how about if the patient suffers
too much? You are a doctor anyway.
Pu: If I encounter such patients again, I will
ask my super-ordinate doctors, the bureau of health in charge and
the local judiciary for instructions.
Reporter: How about if the judiciary
agrees?
Pu: That's OK, the three-party collegiate bench
is able to settle it.
Reporter: I noticed that many locals in
Hanzhong have egged you not to accept this interview but you are
now here. Why did you choose to accept to do this interview?
Pu: Because I want to offer a piece of advice
to my colleagues: Don't do something before the state legislates on
it or you will unfortunately follow my path. I also want to appeal
to authorities to make a law to settle this issue as soon as
possible.
(Huashangbao August 18, 2003, translated by Chen Chao
for china.org.cn, September 1, 2003)
