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Acta Bioethica

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Humanising End-of-Life Care in China: Ethical Reflections on the Barriers to Hospice Development

Authors

  • Zheng Zang Soochow University
  • Ying Hong Soochow University
  • Jianhai Yang Beijing Technology and Business University
Vol. 31 No. 2 (2025): NARRATIVAS BIOÉTICAS
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Abstract

Hospice care represents the ‘last mile’ of a person-centred health system, mitigating physical suffering while addressing existential, psychosocial and spiritual needs at life’s end. China has recently incorporated hospice services into national health strategies; yet provision remains uneven and, in many regions, embryonic. Drawing on an ethical-humanistic framework that integrates principlism with insights from Confucian care ethics, this review examines the principal barriers to a truly humanised hospice system. We synthesise policy documents and empirical literature to map four interlocking impediments: (i) the marginalization of hospice care in national health priorities; (ii) economic constraints in hospice care access; (iii) lack of scientific understanding of death and hospice care in society; and (iv) inadequate investment in hospice infrastructure and education. Ethical analysis reveals that these barriers compromise the core values of autonomy, beneficence and justice, and undermine the Confucian ideal of yang-sheng shan-zhong (caring for life and dying well). To advance a humanistic hospice model with Chinese characteristics, we propose: (1) optimizing top-level design and government-led mechanisms; (2) increasing financial input and reforming medical insurance policy; (3) optimizing hospice care through education and cultural integration; and (4) accelerating supply-side reform in hospice care. Addressing these ethical and structural deficits is essential to honouring patient dignity and realising equitable, high-quality end-of-life care across China.

Keywords:

hospice Care, end-of-life ethics, humanistic care, development barriers, China
How to Cite
Zang, Z. ., Hong, Y. ., & Yang, J. . (2025). Humanising End-of-Life Care in China: Ethical Reflections on the Barriers to Hospice Development. Acta Bioethica, 31(2), 245–260. Retrieved from https://actabioethica.uchile.cl/index.php/AB/article/view/80095
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Acta Bioethica
Centro Interdisciplinario de Estudios en Bioética
Universidad de Chile
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