Scholars who support dignity in dying believe that the right to life is a fundamental right of citizens, which includes the right to freely choose life and death^[10]. When a patient's decision to forgo medical treatment does not infringe upon the lawful rights and interests of society, the collective, or others, the law should guarantee the freedom of such behavior. However, some scholars argue that citizens do not have complete dominion over their life interests, and their control over life interests should be reasonably restricted by social responsibility^[11]. Moreover, even respecting a patient’s decision to refuse treatment might acknowledge their autonomy, but it also neglects other important values, such as the sanctity of life^[12]. The crux of the debate between the two sides lies in how to understand the content of the right to life. The core legal interest protected by the right to life is the citizen's life, which aims to highlight human life dignity and personal dignity. Article 1002 of the "Civil Code of the People's Republic of China" (hereinafter referred to as the "Civil Code") stipulates: "A natural person enjoys the right to life. The life safety and life dignity of a natural person are protected by law." This article clearly identifies life dignity as one of the main contents of the right to life and incorporates it into the scope of legal protection. Regarding whether dignity in dying respects the citizen's right to life, what needs to be considered is whether dignity in dying expresses respect for human life dignity.

Some scholars have pointed out that the content of life dignity includes the dignity of life and the dignity of death. However, since people often do not have the right to choose to be born, maintaining the dignity of death has become the core content of realizing the value of life dignity. In terms of maintaining the dignity of death, dignified death is one of the important contents ^[13]. In the case of Airedale NHS Trust v. Tony Bland (hereinafter referred to as the Tony Bland case), the court rejected the view that life must be preserved at all costs and believed that life can only be preserved when it is in the best interest of the patient ^[14]. However, considering that a dignified death involves the individual's disposition of their own life, and the right to life is strictly protected by law, if the dignity of death is embodied in a dignified death and externalized into a "piece of paper" signed by the patient, is it appropriate? Could a dignified death be abused in practice and become an interest "tool" for intentionally depriving others of their right to life? Besides, a dignified death also involves the abandonment of medical treatment, which relies on professional knowledge judgment. Does the patient possess the rational analysis, judgment, and decision-making ability to give up their own prudent life interests? Due to the asymmetry of medical information, does the patient have corresponding cognitive biases? In this process, should doctors participate? And what role should they play? Will the implementation of a dignified death trigger professional ethical risks? Affect the doctor-patient relationship? All these issues require serious and meticulous consideration.

In principle, the object of protection of human dignity is the personal interests of citizens. According to Article 990 of the Civil Code, the personal interests enjoyed by citizens include not only specific personal elements such as life, name, body, portrait, honor, reputation, privacy, etc., but also other personal interests generated based on personal freedom and human dignity. Thus, the scope of protection of citizens' human dignity is relatively broad, including both the content of specific personality rights and abstract personality rights. Moreover, in terms of protection time, the personal interests enjoyed by citizens do not cease with the end of one's life. Even after the loss of life, their personal interests are still protected by law. For example, Article 994 of the Civil Code stipulates: "If the name, portrait, reputation, honor, privacy, remains, etc. of the deceased are infringed, the spouse, children, and parents have the right to request the actor to bear civil liability according to law; if the deceased has no spouse or children and the parents are already dead, other close relatives have the right to request the actor to bear civil liability according to law." Article 302 of the Criminal Law stipulates: "Whoever steals, insults, or intentionally destroys corpses, skeletal remains, or ashes shall be sentenced to fixed-term imprisonment of not more than three years, criminal detention, or public surveillance." For scholars who support dignified death, it helps maintain citizens' human dignity by responding to their inner wishes and respecting their right to freely choose death. In the case of Tony Bland, the court held that "the sanctity of life" must give way to "patient autonomy," and people must be allowed to decide their own fate. When deciding whether to stop providing unnecessary medical care measures to end-of-life patients, courts follow the "best interest principle of the patient"^[15]. However, dignified death also faces the same criticism as euthanasia, which is most evident in the religious field. Christianity holds that human life is given by "God," and death is decided by "God"; only earthly monarchs have the authority to represent "God" in determining the life and death of commoners. Physical pain, including the suffering before death, is often seen as "God's" punishment. Therefore, allowing suicide, euthanasia, or dignified death is considered an usurpation of "God's" power^[16]. Additionally, in secular law, many countries historically issued regulations banning suicide^[17]. Advances in modern medical technology have further intensified a contradiction contained in the basic principles of medical ethics: on the one hand, medicine is required to alleviate patients' suffering, improve the quality of life, and uphold the dignity of life; on the other hand, it is required to prolong patients' lives, increasing the length of life. However, in reality, extending patients' lives and increasing the length of life cannot always be consistent with alleviating patients' suffering, improving the quality of life, and upholding the dignity of life. For instance, for terminally ill cancer patients, they often require medical means such as intubation and dialysis to help extend their lives, and the use of these medical measures often causes great physical and mental suffering to the patients. If there is a conflict between extending the patient's life and alleviating the patient's suffering, improving the quality of life, and maintaining the dignity of life, how to make a choice between the two is a practical challenge.

Scholars who support dignity in dying believe that it is a concentrated manifestation of respecting citizens' medical autonomy rights^[18]. Moreover, some scholars have explicitly pointed out that citizens have the right to refuse treatment^[19]. In today's China, where aging is continuously intensifying, attempting to provide the elderly with high-quality and equal medical services within the widest possible scope has become a common realistic demand for national and social development. The starting point of dignity in dying is to focus on patients at the end of life, by responding to their inner needs, promoting the development of hospice care for the elderly. However, some scholars believe that in clinical practice, the "medical autonomy" of patients is often difficult to measure, and there are challenges in specific operations^[20]. A dignity in dying agreement is a medical directive record signed in advance by a citizen, and whether it can accurately and in real-time reflect an individual's inner wishes raises significant doubts. In clinical practice, generally speaking, when patients are tormented by illness, their will to live decreases, and when their condition improves, their desire to live greatly increases. How to ensure that the signing process of dignity in dying fully complies with the patient’s inner wishes? If during this process, the patient is driven by the illegal purposes of a third party, they can easily be exploited as a "tool" to harm themselves^[21]. Additionally, when patients or their families make decisions about accepting or not accepting a particular medical service, should the attending physician's wishes also be respected? When there are conflicts between the handling opinions of both parties, how should an appropriate decision and plan be made^[22]? These are all challenges encountered in the implementation process of dignity in dying.

Traditional Chinese society was deeply influenced by Confucian culture. Renowned modern scholar Liang Shuming pointed out in "The Essence of Chinese Culture" that traditional China was an ethics-centered society where every individual bore corresponding obligations for their ethical relationships in all directions; simultaneously, those who had ethical relationships with him also bore obligations towards him^[23]. In traditional Chinese society, the emphasis on patriarchal clan rules and rites was a distinct characteristic. Contemporary sociologist Zhao Dingxin also noted in his book "The Confucian-Legal State: A New Theory of Chinese History" that since the Western Han Dynasty, traditional China gradually formed a highly stable crystallization - the "Confucian-Legal State," which is a governance system that integrates political power and ideological power, strictly controls military power, and marginalizes economic power. In this governance system, the entire nation was managed relying on Confucian ethics as well as Legalist laws and ruling techniques^[24]. In the traditional Confucian-Legal state, ceremonial norms were deeply embedded in the legal system of the state, and violating the socially established ceremonial norms would result in punishments more severe than ordinary crimes. In China's traditional ceremonial norms, "filial piety" was placed in a very high position. "Filial piety" advocates that as children, one should respect and care for parents over the long term. Even if parents suffer from serious illnesses, active treatment should be sought. If treatment is abandoned before parents have completely lost vital signs, it would be considered inappropriate under the backdrop of traditional Chinese ethical culture.

Moreover, the clinical implementation of death with dignity also involves the content of abandoning medical rescue, which may conflict with the doctor's duty of "saving the dying and healing the wounded". The earliest physician's oath in the world - the "Hippocratic Oath" states: "Adhere to the creed of serving the patient's interests, and restrain all behaviors that are harmful to people". The "modern Hippocratic Oath" - "The Geneva Declaration" also makes the following pledge: "The health of the patient shall be my first consideration". These programmatic documents of medical ethics regard "do no harm to others" and "save patients" as the basic duties of doctors. In the general concept of people, doctors always appear as the image of saving the dying and healing the wounded, they are also affectionately called "white angels". If doctors can neglect the life and health rights of patients in clinical practice, does it conflict with the professional ethics of doctors? In the increasingly fragile doctor-patient relationship, will the non-action of doctors in clinical practice make the already fragile doctor-patient relationship even more embarrassing? If doctors abuse their professional and technical power, will it put the life and health rights of patients in an extremely uncertain state? Considering that death with dignity may have a tense relationship with traditional culture and professional ethics, its social implementation will inevitably encounter significant practical resistance.

In 1976, California enacted the Natural Death Act, which was the world's first legislative draft concerning dignified death. This act allows citizens to sign a dignified death agreement in advance to handle their core life rights and interests^[25]. In 1990, the U.S. federal government passed the Patient Self-Determination Act, which also aims to respect the medical autonomy of patients by establishing an advance directive system to protect the end-of-life medical decisions of patients. Subsequently, Canada, Australia, Singapore, and other countries have also successively issued specific laws to promote domestic legislation on dignified death^[26]. In 2000, Taiwan passed the Hospice Palliative Care Regulations, which grants adults with full civil capacity the ability to sign an advance hospice care will to freely arrange their own end-of-life medical matters. However, as a new concept of life and death, dignified death challenges traditional Chinese views on death and contradicts the clinical curative concept, so it has not received support from mainland China’s legislation for a long time.

In recent years, with the deepening of China's aging population, the concept of death with dignity has been gradually introduced to mainland China and gained considerable momentum among the populace. In 2013, a large group of experts and scholars, represented by Luo Yuping, established the Beijing Living Will Promotion Association, which launched the first civilian living will document in mainland China, "My Five Wishes" [which are: (1) What medical services I want or do not want; (2) Whether I wish to use or not use life support treatment; (3) How I hope others treat me; (4) What I want my family and friends to know; (5) Who I wish to assist me]^[27]. Applicants can freely arrange their end-of-life matters by selecting "yes" or "no" for each item under the living will. On June 23, 2022, the newly revised "Shenzhen Special Economic Zone Medical Regulations" were officially promulgated, marking the first time mainland China legally recognized the legal effect of death with dignity. Article 78 of the regulations contains a brief provision on the relevant content of death with dignity. However, this article only provides a principle regulation on death with dignity, and the specific operational procedures remain incomplete. For instance, who is the applicant for death with dignity? Can a third party be authorized to handle it on behalf of the patient? How should we determine whether a patient is in the "end-stage of an incurable illness or injury" or in the "terminal phase," and what clinical standards should be used? Should the application for death with dignity appropriately consider the opinions of the patient's close relatives and attending physician? Can the patient withdraw the application? What about the legal responsibilities of related parties? These questions all await the summation of practical experience and subsequent legislative refinement.

Dignity in dying aims to improve the quality of life during the end-of-life stage and safeguard human dignity. It does not intentionally accelerate death but provides any necessary treatment measures to alleviate patient suffering under full respect for the patient's inner wishes, making the patient feel physically and mentally comfortable and pleasant. This more "humanized" medical care measure for patients is known in academia as palliative care^[28]. The World Health Organization defines palliative care as follows: "Preventing and alleviating the physical, psychological, social, and spiritual suffering imposed on patients and their families by life-threatening diseases, to help patients and their families achieve the best quality of life"^[29]. As a form of "spiritual" care, palliative care places greater emphasis on the content and quality of medical services. Therefore, this also imposes higher requirements on the country’s medical service supply capacity. In December 2023, the Ministry of Civil Affairs of China and the National Working Committee on Aging released the "2022 Annual Bulletin on the Development of National Aging Affairs," which showed that by the end of 2022, the population aged 60 years and above in China was 280,040,000, an increase of more than 10 million from the previous year, accounting for 19.8% of the total population. The population aged 65 years and above reached 209,780,000, an increase of more than 9 million from the previous year, accounting for 14.9% of the total population^[30]. On February 29, 2024, the National Bureau of Statistics of China released the "Statistical Bulletin on National Economic and Social Development in 2023," which showed that by the end of 2023, the population aged 60 years and above in China was 296,970,000, an increase of more than 16 million from the previous year, accounting for 21.1% of the total population^[31]. With the continuous increase in the total number of elderly people in China and the deepening degree of aging, the demand for palliative care has also increased simultaneously. According to the "China Statistical Yearbook 2023," malignant tumors ranked second in the composition of main disease causes of death among urban residents in some regions in 2021, accounting for 24.61%. This indicator ranked third in rural areas, accounting for 22.47%^[32]. For patients with malignant tumors who endure both physical and psychological pain at the end of life, improving the supply capacity of palliative care services appears particularly urgent in clinical practice. However, compared to China's large elderly population base and medical service needs, the domestic supply capacity of palliative care services shows evident insufficiency. According to statistical yearbook data, in 2021 and 2022, the number of beds in urban and rural medical and health institutions in China were 9,450,110 and 9,749,900 respectively, with the number of medical and health beds per thousand people being 6.70 and 6.92 respectively, the number of health technicians per thousand people being 7.97 and 8.27 respectively, the number of practicing physicians per thousand people being 3.04 and 3.15 respectively, and the number of registered nurses per thousand people being 3.56 and 3.71 respectively^[32]. The mismatch between supply and demand in palliative care has gradually become prominent and urgently needs to be addressed.

Human life is finite, and death is the inevitable final destination. Sima Qian, a Western Han dynasty historian, once said in his letter "Reply to Ren An": "Everyone must die, some deaths are as weighty as Mount Tai, others as light as a feather, depending on what they strive for." In Sima Qian's view, death is unavoidable, and the most important aspect of life lies in its value and significance. Indian poet Rabindranath Tagore also wrote: "Life is like the brilliant bloom of summer flowers, death like the tranquil beauty of autumn leaves." Under poet Tagore’s pen, death no longer fills one with sorrow but instead can be as serene and beautiful as autumn leaves. Artist Edward Munch also wrote poignantly: "With my decaying body, I nourish the growth of flowers, and in their fragrance, I find eternity." For Edward Munch, death not only loses some of its sorrow and fear but gains an element of nobility and elegance. The narratives of these scholars and writers about death and life enrich our understanding of them.

Indeed, death is unknown, but if we have more understanding and respect for death and life, then we will increase the serenity and peace when facing death. At this stage, China is in the initial exploration of the dignified death system, and the "implementation" of a new social system requires good social environment support. In view of this, it is particularly necessary to appropriately strengthen civic education on life and death culture. Specifically: on the one hand, the education administrative department must fully recognize the practical significance of life education work, formulate feasible implementation plans, promote the construction of life education systems, curriculum, and teaching staff, actively broaden educational channels, establish a collaborative mechanism for schools, families, and communities to jointly nurture life, and comprehensively promote the scientific, orderly, and healthy development of life education. On the other hand, primary and secondary schools should also be encouraged to offer courses related to life education, guiding students to establish an awareness and concept of respecting and valuing life from an early age. Improve the talent cultivation mechanism for life education and accelerate the training of high-quality, professional life education personnel. Meanwhile, it should also call for the combination of education and practice, paying attention to small things in life, learning to respect and care for every living being. Whether they are our parents or relatives with strong blood ties, or friends and strangers with weak blood ties; whether they are large-bodied elephants and lions, or smaller bees and ants; whether they are cats and dogs that we may like, or rats and snakes that we may dislike; whether they are blooming flowers or slender blades of grass, we can strive to respect their living space and needs, learn to understand and share, and make efforts to treat them kindly and care for them. In addition, medical, educational, news media, and other departments should also actively change their previous "outdated" or "backward" views on life and death culture, advocate a richer, more diverse, positive, and inclusive narrative way of life and death, create a better life cultural environment, and promote the formation of a good social ethos of respecting life, loving life, and treating life kindly.

Although the "Shenzhen Special Economic Zone Medical Regulations" for the first time legally recognized the legal effect of advance directives in legislation, due to the limitations of the legal hierarchy and scope of application of this regulation, it cannot replace the unified legislation within the country, nor can it effectively constrain the unified clinical practice domestically. Moreover, the lack of specific operational procedures in this regulation has further led to significant difficulties in the "implementation" of the advance directive system. To change this current situation, the state needs to strengthen the top-level design of policies and regulations related to a dignified death, and improve the specific operational procedures for implementing a dignified death.

In view of the important significance of maintaining the dignity of the dead for the protection of the right to life, it is necessary to fully consider that the signing of dignified death is related to the most core life rights of individuals and the dignity of individual life when designing the specific procedures for dignified death. It is essential to focus on the true intentions of individuals, continuously promoting the improvement of the generation, revocation, exit procedures, and guarantee mechanism construction regarding the legal effect of dignified death. Furthermore, the law should also pay attention to preventing the risk of dignified death being illegally abused, avoiding dignified death becoming a "tool" for intentionally depriving others of their life and health rights, and explicitly stipulating the justification reasons for excluding the application of dignified death to safeguard the life dignity of citizens.

Specifically: Regarding the signing and application subject of dignity death, considering that the rights and interests disposed of by dignity death are related to the most core life and health rights of an individual, reasonable restrictions should be imposed on its application subject. The applicant must be a natural person with full civil capacity, and the applicable standards can refer to Articles 17, 18, 21, and 22 of the Civil Code. This is also reflected in comparative law, such as Article 2, Item 9 of South Korea's Act on Decisions for Life-Sustaining Treatment (also known as the Euthanasia Act), which stipulates that the applicant for the advance directive on life-sustaining treatment must be an adult who is at least 19 years old^[33].

In terms of application methods, to express respect for the medical autonomy of patients at the end of life, and also to highlight a prudent attitude towards handling life rights, allowing every terminally ill patient to make careful decisions regarding personal health matters, the signing of a dignity death should primarily be in written form. Only when the applicant has difficulty writing, can it exceptionally allow applications to be made orally or through audio or video recordings, but with a witness present to testify.

In terms of witnesses, in comparative law, there are national legislations stipulating that at least two parties with full civil capacity must be present to witness, and at least one of them should be a doctor^[34]. Domestic legislation can use this as a reference and impose requirements on the number and capability of witnesses in the signing and application process of dignified death. Meanwhile, to prevent triggering related ethical and moral risks, the witnesses cannot be the patient's spouse, close relatives, heirs, or other entities that have conflicts of interest with the patient.

In terms of application content, a dignity death is a document signed by a patient in the end stage of life to indicate "yes" or "no" to certain medical care measures. Its content must reflect the patient's true intention. If the applicant regrets later, they can change or revoke their medical care instructions at any time, and will not be treated unfairly due to the change or revocation.

In respect to the filing and examination, in order to ensure the legitimate and reasonable exercise of dignified death, the implementation of dignified death needs to be filed with and reviewed by a notary organization. The state should establish a special regulatory body for the implementation of dignified death (which can also delegate relevant organizations or social public welfare organizations to supervise the implementation), acting as an independent third party with no vested interest to oversee the social implementation of dignified death.

In terms of the execution application, the applicant should be a patient at the end of life. However, when it is legally necessary (such as when the person falls into a state of impaired consciousness), a medical agent can be entrusted to act on their behalf. A legitimate and authentic written authorization document must be presented, and the basic principle of adhering to the best interests of the patient must be followed. In recognizing and safeguarding the best interests of the patient, the Tony Bland case adopted four protective measures: first, every effort should be made to carry out rehabilitation for at least six months; second, the diagnosis of irreversible vegetative state can only be confirmed at least 12 months after the injury; third, the diagnosis should be agreed upon by two additional independent doctors; fourth, the wishes of the patient's immediate family should generally be given certain consideration^[35].

When determining whether the applicant for enforcement is in the end-of-life stage, it is essentially a medical issue, and corresponding medical standards should be clarified. To avoid legal risks in the enforcement process and prevent the patient's close relatives and agents from infringing on the patient's life and health interests under the guise of death with dignity, it is more appropriate to leave such judgment to the attending physician. At the comparative law level, New Zealand’s euthanasia law stipulates that euthanasia is only applicable to terminal patients who are likely to die within 6 months. To qualify, applicants must be in an irreversible state of physiological decline and feel "unbearable suffering" that cannot be alleviated by any other tolerable means^[36]. Similarly, Victoria’s euthanasia law in Australia imposes the same restrictions: only those Victorians who cannot endure the pain and have less than 6 months to live are entitled to request to end their lives; for those suffering from neurodegenerative diseases, this period is extended to 12 months^[37]. Article 2, Paragraph 3 of South Korea’s Act on Decisions for Life-Sustaining Medical Care stipulates that when determining whether the applicant is in the end-of-life stage, the attending physician and one expert in the relevant field should comprehensively make the judgment from a medical perspective^[33].

In terms of the follow-up supportive treatment measures provided, for patients who are undergoing dignified death, it does not mean a complete cessation and abandonment of all clinical diagnostic and nursing measures. Instead, while fully respecting the patient's inner wishes, the focus is on alleviating the physical and mental suffering of patients in the end-of-life stage, abandoning some unnecessary life-extending treatments, and striving to provide holistic care for the patient, taking care of not only their physical needs but also their emotional, spiritual, and psychological needs.

In terms of legal responsibility, if the hospital executes the dignity death agreement as stipulated in the contract, it does not need to bear adverse legal consequences. Conversely, if the hospital breaches the contract or improperly fulfills the agreement, infringing on the patient's personal or property rights and causing personal or property loss to the patient, it should bear corresponding liability for breach of contract or tort.

In 2014, at the 67th World Health Assembly held in Geneva, Switzerland, a resolution on "Strengthening Palliative Care as a Component of Comprehensive Care throughout the Life Course" was adopted. This resolution called upon the World Health Organization and member states to improve the accessibility of palliative care as a core component of health systems, with a focus on primary health care and community/home care. To this end, the World Health Organization actively made the following adjustments: first, incorporating palliative care into all relevant global disease control and health system plans; second, assessing the development status of palliative care services; third, formulating comprehensive palliative care guidelines and tools across disease groups and levels of care, addressing ethical issues related to the provision of palliative care; fourth, supporting member states in improving access to palliative care medications by improving national regulations and providing systems; fifth, paying special attention to palliative care for people living with HIV infection, including developing guidelines; sixth, promoting increased opportunities for children to access palliative care (in collaboration with UNICEF); seventh, monitoring global access to palliative care and evaluating the progress of palliative care programs; eighth, developing indicators to assess palliative care services; ninth, encouraging adequate resources for palliative care planning and research, especially in resource-limited countries; and tenth, providing evidence for effective palliative care models in low- and middle-income settings.

As a member state of the World Health Organization, China should respond to the call of the World Health Assembly and promote the realization of the requirements of the World Health Organization's resolution on hospice care. With the continuous increase in the total number of elderly people in China, the demand for hospice care will also continue to grow, making it highly necessary to enhance the supply capacity of hospice care services. In 2015, the General Office of the State Council forwarded the "Notice on Promoting the Integration of Medical and Health Services with Elderly Care Services," proposing the establishment of a cooperation mechanism between medical and health institutions and elderly care institutions, integrating medical, rehabilitation, elderly care, and nursing resources to provide the elderly with integrated health and elderly care services including hospitalization during treatment, nursing during rehabilitation, daily care during stabilization, as well as end-of-life care^[38]. In 2016, the State Council issued the "13th Five-Year Plan for Health and Wellness," clearly stating the need to increase the proportion of rehabilitation and nursing beds in grassroots medical and health institutions, and encouraging the addition of geriatric care and hospice beds based on service demands^[39]. In 2017, the former National Health and Family Planning Commission successively promulgated the "Basic Standards for Hospice Care Centers (Trial)," "Management Standards for Hospice Care Centers (Trial)"^[40], and the "Practice Guidelines for Hospice Care (Trial)"^[41], setting requirements for the entry standards, service management, and operational norms of hospice care centers, explicitly stating that hospice care practices should be patient- and family-centered, carried out in a multidisciplinary collaborative model, providing holistic care and services to patients, controlling the suffering and discomfort symptoms of patients, and improving their quality of life. In July 2024, the National Health Commission issued the "Standards for Setting up Geriatric Hospice Care Wards," which stipulates the basic requirements and quality management requirements for setting up geriatric hospice care wards in medical institutions at all levels and integrated medical and elderly care institutions^[42]. Additionally, practical pilot programs for hospice care have been unfolding vigorously. In 2017, the country launched the first batch of hospice care pilot programs, identifying Haidian District of Beijing, Changchun City of Jilin Province, Putuo District of Shanghai, Luoyang City of Henan Province, and Deyang City of Sichuan Province as municipal-level hospice care pilot cities and regions^[43]. In 2019, the country launched the second batch of hospice care pilot programs, identifying Shanghai and Xicheng District of Beijing among 71 cities (districts) as hospice care pilot cities (districts)^[44]. In 2023, the country launched the third batch of hospice care pilot programs, identifying Beijing, Zhejiang Province, and Hunan Province as the third batch of national hospice care pilot provinces (cities), and Nankai District of Tianjin among 61 cities (districts) as the third batch of national hospice care pilot cities (districts), marking the practical exploration of hospice care entering a new stage of development^[45].

The above indicates that China has taken a solid step in the exploration of hospice care practice. Subsequent work requires the national health system to integrate hospice care into the ongoing care for people with chronic and life-threatening diseases, and link it to early prevention, diagnosis, and treatment plans. Specifically: First, incorporate hospice care services into the structural and funding health policies of national healthcare systems at all levels; Second, emphasize the construction of human resources for hospice care, including training existing healthcare professionals, especially strengthening palliative care skills training for caregivers, and incorporating hospice care into the core curriculum for all new healthcare professionals; Third, formulate pharmaceutical policies to ensure the provision of essential medicines for symptom control, especially opioid analgesics used for pain relief and respiratory distress; Fourth, the provision of hospice care needs to adhere to the basic principles of universal health insurance, and all citizens, regardless of their income, type of illness, or age, should be entitled to hospice care services provided by the state, with the national financial and social security systems needing to consider the basic rights of impoverished and marginalized populations to access hospice care; Fifth, combine specialized hospice care with primary healthcare, community and home care, as well as supportive care providers such as family and community volunteers, to build a sustainable, high-quality, and accessible hospice care service system.