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)
