This essay analyzes the major outcomes of a survey that we conducted on 400 Chinese individuals of different ages, occupations and levels of education. Our method was to send to every subject a specifically designed form in which the subject faces three types of cases: the terminally ill cancer patient, the persistent-vegetative-state patient, and the severely defected newborn. The subject was required to make a choice among (1) offering treatment at any cost, (2) giving comfort treatment only, and (3) performing euthanasia. Although the survey was made in 1987, new evidence shows that its outcomes remain an accurate index of the Chinese values regarding the matter of euthanasia.
The survey indicates that a great proportion of Chinese peasants do not support performing euthanasia in the given three cases. 45.5 percent of the peasant subjects advocate treatment at any cost. Only 27 percent of them accept euthanasia. In contrast, many more workers, government employees, and medical professionals living in urban areas support euthanasia. This contrast, from our perspective, demonstrates the significant influence of traditional Chinese values on life and death in the rural areas of China. According to the popular traditional values, life in this world is sacred and death should be avoided at any cost. Although such ideas have been significantly discredited in the urban areas, they are still heavily influential in the rural areas.
However, given that only 44 peasants participated in our survey, we do not believe that, based on this survey, we can draw a general conclusion about what percent of the Chinese peasants support or oppose euthanasia. We need more detailed investigation regarding this issue.
The most interesting outcome of this survey is that only about 26 percent of the subjects think that the patient him/herself should decide whether or not to accept euthanasia. 55 percent of the subjects believe that the matter should be decided by the family and the physician. The Western reader might be shocked by this outcome. After all, what is at stake is the matter of life or death of the patient. However, this outcome is no surprise for us. Whereas individualism (with strong emphasis on self-determination) is a basic feature of Western society, familism (with a clear orientation of family-determination) characterizes everyday Chinese lives. Familism, as the foundational ideology and value of Chinese people, has gone through the history of Chinese society for about three thousand years. The Chinese individual takes it for granted that one’s family is an automatic unit apart from the rest of society. Everyone is born to a family, is brought up in a family, and lives one's life inseparably from the family. Hence the medical problems of one family member are usually taken as the problems of the entire family. According to Chinese values, when one family member falls ill, the entire family should be involved in making decisions and taking actions in the best interests of that member.
Why not allow the individual patient to make an exclusive decision on the matter of euthanasia for him/herself? Chinese people are afraid that, if this is allowed, patients may very well demand euthanasia primarily for the sake of reducing the economic and spiritual burden of their families in taking care of them. Most Chinese believe that the best decision on euthanasia can only be made by the family in consideration of the physician's information and/or suggestion. This is why 55 percent of the subjects in this survey supported the united determination made by the family and physician.
Does this imply that the family and physician are allowed to accept euthanasia on behalf of the patient without consulting the patient even when the patient is competent? The answer is definitely no. The family would not accept euthanasia for a family member unless the member clearly demands it. In reality, Chinese euthanasia practices occur only upon the frequent and strong requests of the patients. However, given the possibility of abuse, it should be made very clear that morality requires that euthanasia may not be performed on any competent patient unless it is demanded by the patient. In China, it should be a unanimous decision made by the family, the physician, and the patient (if competent).