It must have been a harrowing choice when Zhang Jianbo jumped out of the five-story window of Shuguang Hospital in Changsha, Hunan Province, on October 20, and ended his life.

He had been suffering from late-stage throat cancer, and had pleaded with doctors for assisted suicide but to no avail. So he took matters into his own hands.

Zhang is not alone. There are many patients who are going through intense physical pain caused by incurable diseases and pray for a dignified end to their lives. Yet hospitals find themselves in a legal vacuum when it comes to euthanasia.

"Our job is to save lives, and we don't have the right to mercy killing," said an official at the Changsha hospital.

The right-to-die debate has been brewing in China for some years. Many people argue that it is a rational choice for human dignity when a patient is terminally ill and the pain afflicting him is unbearably agonizing. It should be the patient's right to make such an end-of-life decision. Denying him this right is inhumane as it prolongs the suffering, exacerbates the situation for the family and results in a waste of medical resources, they contend.

Opponents counter that it is against human nature to prescribe assistance to suicide. When patients are fighting for their lives, they need encouragement. Besides, a patient is not in the best position to make this decision when he is engulfed by excruciating pain.

More importantly, euthanasia is prone to abuse, they assert. Given China's current underdevelopment in medical care, there is no safety net for poor patients. Medical staff is not well trained to make such a judgment, technically or morally. And the law regarding this issue is murky or nonexistent.

For all the concerns, a consensus is emerging among the general public. A survey by Beijing Youth Daily found that over 80 percent of respondents regard euthanasia as an act of mercy rather than cruelty. A Health News survey concluded 85 percent favor legalizing it.

Yet obstacles remain on the way to legalization. It is reflected in one special case that goes back 17 years.

In 1986, Wang Mingcheng implored with Dr Pu Liansheng to help end the life of his critically-ill mother; and the doctor obliged. Both were later charged with murder but were acquitted after spending 492 days in detention. Seventeen years later, the 49-year-old Wang came down with cancer. His application for euthanasia to the hospital was denied. Unlike his mother, he did not die peacefully. It was a losing battle for him, both literally and figuratively.

Media reports reveal that many doctors, out of sympathy, still assist suicides. But, to avoid a legal quagmire, they shy away from leaving any documents and prefer to operate in the gray area instead.

Some experts are gunning for a compromise. Zhu Tiezhi, a media commentator, suggests the right-to-die prerequisites: the applicant must have a terminal illness that causes agonizing pain, and the diagnosis must be verified by at least two doctors; the applicant must be in a clear state of mind when he applies for it, and the application process should be repeated at least twice to make sure it is not a spur-of-the-moment thought.

If this sounds too complicated, some are suggesting decriminalization as a first step. The courts should be lenient when it comes to these cases, they argue. In a country where the aphorism "To save a life is like building a seven-story Buddhist tower" is deep-rooted, the right to die will always be an ethical dilemma.

(China Daily October 27,2003)