The Chinese adage has it that one should be born in Suzhou, live in Hangzhou, eat in Guangzhou and die in Liuzhou. Actually, suggests a new study: London may be the place to die。

China is near the bottom of a 40-country "Quality of Death" index ranking nations by the care provided to those late in life, published by the Economist Intelligence Unit and commissioned by Lien Foundation. At the top of the index is the United Kingdom, followed by Australia, New Zealand and Ireland. Those nations score well on indicators such as public awareness, training availability, access to painkillers and the heavily weighted category of doctor-patient transparency。

Globally, average ages will continue rising, particularly in rich countries. But filling out the bottom ranks of the Quality of Death index were the populous, fast-growing BRIC countries - Brazil, Russia, India and China, along with Uganda and Mexico. "Death and dying are stigmatized in some cultures to the point where they are taboo - as in Chinese culture."

With doctor-patient transparency contributing 40 percent of the overall index score, it isn't hard to see why China would do poorly. In China, it isn't uncommon for doctors, often in cahoots with families, to lie in the face of a terminal illness to a patient about his chances, out of fear the truth would be too upsetting, to avoid his calls to continue with costly treatments and even to avoid association with spirits of the afterlife。

China has virtually no discussion of end-of-life care, such as hospice, according to the study. "Most family members of the patients can’t fully understand it," says Ma Ke, director of the Third People's Hospital of Kunming Hospice Department, in the study. (The report says around 30 hospitals in China offer hospice care。)

But in addition to traditions about death, China's one-child policy may be worsening things for the roughly 9.38 million Chinese who die each year, or just over 0.7 percent of the population. (2008 figures) "The ratio of working people to dependents is shrinking rapidly, particularly in China, where the one-child policy will leave parents with fewer offspring to care for them in old age," the report says。

美國《華爾街日報》網站7月14日文章，原題：住在杭州，死在倫敦。中國有句俗話，“生在蘇州，住在杭州，吃在廣州，死在柳州”。但一項新研究顯示，其實倫敦才是“好死”之地。

連氏基金會委托英國經濟學人信息部發布的“死亡質量”指數顯示，按臨終護理水平排名，中國在40個國家中幾乎墊底。排名最高的是英國，其次是澳大利亞、新西蘭和愛爾蘭。這些國家在公眾意識、相關培訓、止痛藥品覆蓋面和所占權重最大的醫患關系透明度等指標上均得分較高。

隨指數一道發布的報告稱，全球平均年齡將繼續提升，尤其在富國。但在死亡質量指數中墊底的是人口眾多、發展迅速的“金磚四國”，還有烏干達和墨西哥。報告說：“死亡和瀕死在某些文化中被視為禁忌，比如說中國文化。”

在該指數的總分中，醫患關系透明度占了40%的比重，從這點不難看出為何中國表現如此之差。在中國，面對絕癥患者，醫生會就其生存幾率說謊，經常是和家屬一道，因為他們害怕真實信息讓病人太難受，以此避免病人要求持續昂貴治療，甚至是因為想避免病人死后鬼魂的糾纏。

研究顯示，中國人幾乎從不討論臨終看護問題。昆明第三人民醫院臨終看護部主任馬克(音)說，大多數家庭對此問題都沒有充分了解。報告說，中國只有約 30家醫院提供臨終關懷服務。

除了關于死亡的文化傳統問題，獨生子女政策也可能讓每年去世的938萬中國人晚境更加凄涼(2008年數據)。“就業人數與負擔人數之比正快速縮小，這在中國尤其突出，獨生子女政策讓父母年老體邁時得不到足夠的關懷，”報告稱。
 

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