Core Insights - Shandong Province has pioneered the establishment of palliative care standards and service norms, creating a network of over 1,500 institutions and 11,000 beds, serving more than 130,000 individuals [1][10][12] - The implementation of a pricing standard for palliative care aims to enhance service accessibility and encourage medical institutions to invest in this field, addressing the gap in end-of-life care services [10][12][13] Group 1: Palliative Care Development - Palliative care focuses on providing comprehensive care for terminally ill patients and their families, emphasizing symptom management, psychological support, and spiritual care to improve the quality of life [3][4] - The national policies have positively influenced the overall development of palliative care in China, although challenges remain for practitioners, including low compensation and psychological stress from working with terminal patients [3][7][12] Group 2: Pricing and Accessibility - The daily cost for palliative care services is set at 260 yuan, and currently, families bear the full cost, which can be a burden for economically disadvantaged households [7][10] - Shandong's medical insurance bureau has led the implementation of palliative care pricing, with 16 cities in the province establishing their pricing regulations [10][11] Group 3: Training and Talent Development - There is a significant shortage of trained professionals in palliative care, which limits service capacity; efforts are being made to establish training bases and increase the number of trained personnel [4][12][28] - The province has initiated various training programs, with over 2,000 participants annually, and has integrated palliative care into national training projects for geriatric medicine [12][28] Group 4: Innovative Service Models - The "one body, multiple sources" model in Hangzhou's Xihu District integrates community health services, hospitals, and social resources to create a comprehensive palliative care system [27] - This model emphasizes resource integration and the collaboration of various stakeholders, including volunteers and social organizations, to enhance service delivery [27] Group 5: Future Directions and Challenges - The future of palliative care is promising, but it faces challenges such as the need for quality standards, certification processes, and public awareness to change perceptions about palliative care [28] - Establishing a long-term talent cultivation and incentive system is crucial to improve the attractiveness of careers in palliative care [28]

Core Viewpoint - The "One Body Multi-Element" palliative care service model launched in Xihu District aims to provide a warm and supportive environment for end-of-life care through a systematic and diversified approach [1] Group 1: Service Model - The "One Body Multi-Element" palliative care service model is centered around community health service centers, supported by comprehensive hospitals and supplemented by private institutions and social resources [1] - Xihu District has achieved full coverage of home-based palliative care across 11 community health service centers, with inpatient palliative care wards established in two centers [1] - The service network integrates "inpatient + home" and "public + private" care, utilizing platforms like "Family Doctor Appointment" and the "Health Xiao Xi" app for online and offline support [1] Group 2: Human Touch in Care - A touching performance based on a true story highlighted the emotional aspect of palliative care, showcasing the importance of human connection and dignity in the final days of patients [2] - The care team employs pain management, comfort care, and traditional Chinese medicine to alleviate physical discomfort while providing emotional support [2] - A birthday celebration for a patient exemplified the compassionate care approach, emphasizing the significance of creating meaningful moments for patients [2] Group 3: Resource Integration - The establishment of a special fund of 200,000 yuan for palliative care training and projects demonstrates effective resource integration [3] - Collaboration with private hospitals and various elderly care institutions enhances the service offerings, supported by volunteers and wellness coaches [3] - The integration of resources from health, civil affairs, charity, and volunteer organizations aims to break down barriers and create a connected service network that meets community needs [3]

Core Viewpoint - The article emphasizes the urgent need for improved palliative care in China, highlighting that nearly 30,000 people die daily, which underscores the importance of making "good death" a public concern and accessible service for all [3][8]. Group 1: Current State of Palliative Care - Palliative care, also known as end-of-life care, aims to provide comfort and support to patients in the terminal stages of illness, focusing on symptom control and emotional support for both patients and families [4][5]. - The World Health Organization's principles of palliative care stress the importance of recognizing death as a normal process and providing relief from pain and discomfort without hastening or delaying death [5]. Group 2: Policy and Regulatory Framework - The Chinese government has initiated policies to promote palliative care, including the inclusion of palliative care centers in the medical institution directory, which marks a significant step in legal support for the industry [6][9]. - The "Healthy China" initiative has laid the groundwork for palliative care development, with specific guidelines and standards established for palliative care centers since 2017 [6][9]. Group 3: Challenges and Obstacles - Despite policy support, the quality of end-of-life care in China remains low, with issues such as inadequate pain management and lack of psychological support being prevalent [7][9]. - Payment mechanisms pose a significant challenge, as current reimbursement systems may not adequately cover palliative care services, affecting accessibility and sustainability [9][10]. Group 4: Future Directions and Opportunities - The recent national planning documents emphasize the need to enhance the care system for elderly individuals, including expanding palliative care services [11][12]. - The integration of palliative care into public health strategies is deemed necessary to address the growing demand due to an aging population and to fulfill ethical responsibilities [13]. Group 5: Company Initiatives - TaiKang has established a comprehensive palliative care model, providing multidisciplinary services across 10 facilities in 9 cities, with plans to expand to 15 facilities and increase bed capacity to nearly 150 by next year [14]. - The company focuses on a four-in-one model of palliative care, which includes comfort care, humanistic care, and grief therapy, with dedicated staff for each aspect, contrasting with the reliance on volunteers in many hospitals [14].

Core Viewpoint - The article emphasizes the importance of palliative care in improving the quality of life for terminally ill patients, highlighting its role as a public welfare initiative in China, especially in the context of the 20th National Congress of the Communist Party of China which advocates for enhancing people's livelihoods [1][2]. Group 1: Current Status of Palliative Care - Palliative care is not about "giving up treatment" but involves systematic relief of physical pain and psychological distress for terminal patients, focusing on improving their quality of life [3][4]. - As of now, palliative care services are rapidly developing in China, with various pilot programs initiated since 2017, and a growing number of hospitals establishing specialized palliative care units [3][4][6]. Group 2: Multidisciplinary Approach - A multidisciplinary approach is crucial for effective palliative care, involving pain management and understanding patients' emotional needs, with collaboration among medical professionals, social workers, and volunteers [4][6]. - Recent guidelines in Beijing have included medical social workers in core service teams, promoting shared decision-making between patients and families [4][7]. Group 3: Community and Home-Based Care - Community and home-based palliative care is increasingly recognized as essential, aligning with cultural values of dying at home and addressing practical needs [5][6]. - Innovative models are being explored, such as the integration of hospital, community, and family support systems to enhance palliative care accessibility [6][7]. Group 4: Challenges and Opportunities - There are significant challenges in palliative care, including uneven resource distribution, insufficient professional training, and a lack of standardized practices across regions [8][10]. - The demand for palliative care is expected to rise, with estimates suggesting that around 7 million patients annually require such services, yet only about 600,000 currently benefit [7][10]. Group 5: Future Directions - The establishment of industry standards and training programs for palliative care professionals is essential to improve service quality and accessibility [9][10]. - Ongoing efforts to develop comprehensive guidelines and training initiatives aim to enhance the skills of healthcare providers in palliative care [9][10].

Core Insights - The article highlights the urgent need for palliative care services in response to the aging population and the prevalence of chronic diseases among the elderly in China [1][2][3] Group 1: Palliative Care Development - The training session on palliative care was organized by the Bao'an District Health Bureau to enhance service capabilities and establish standards for palliative care units [1][2] - Professor Chen Yongyi discussed the integration of palliative care from policy to practice, addressing service norms, practical guidelines, and ethical considerations [2] Group 2: Institutional Developments - Five institutions in Bao'an District have been recognized as the first batch of palliative care service providers in Guangdong Province, part of a larger initiative involving 214 institutions across the province [3] - Bao'an District is implementing a three-tiered model of care that includes hospitals, community health organizations, and home care, with plans to develop palliative care units in three major hospitals by 2025 [3]

Core Viewpoint - The Guangdong Provincial Health Commission has officially announced the first batch of 214 palliative care institutions, achieving full coverage across all 21 cities in the province, aimed at enhancing the level of palliative care services [1] Group 1: Palliative Care Implementation - Palliative care focuses on terminally ill patients and their families, providing integrated care and humanistic support through multidisciplinary collaboration, helping patients to live their final days comfortably and with dignity [1] - By the end of 2024, the number of palliative care service institutions in Guangdong is expected to increase to 574, with over 5,000 palliative care beds, ensuring coverage across urban and rural areas [1] Group 2: Regulatory Framework and Guidelines - In July, the Guangdong Provincial Health Commission issued the "Guangdong Province Palliative Care Service Project Guidelines," detailing and standardizing 13 service items, including symptom assessment and survival period evaluation [1] - This guideline is the first provincial-level palliative care service guideline in the country, providing a comprehensive and precise "manual" for palliative care practices in the province [1] Group 3: Continuous Improvement Efforts - The notification emphasizes that health departments at all levels will enhance palliative care services through institution regulation, system construction, capacity building, and public awareness campaigns, ensuring quality care for every life’s final journey [1]

Core Viewpoint - Palliative care, particularly through the integration of medical social workers and volunteers, is evolving to provide more personalized and comprehensive support for patients and their families, enhancing the quality of life even in the final stages of life [1][8][10] Group 1: Development of Palliative Care - The implementation of the local standard "Palliative Care Service Specification" in Beijing in April 2025 emphasizes the inclusion of medical social workers in core service teams, promoting a collaborative model of care [1] - The palliative care team at Tsinghua University Beijing Tsinghua Changgung Hospital has evolved from specialized medical staff to a multidisciplinary collaboration, integrating social workers and volunteers for enhanced support [1][10] Group 2: Role of Medical Social Workers - Medical social workers are crucial in providing psychological support, repairing social relationships, and connecting families with community resources, thus facilitating personalized care approaches [1][8] - They play a vital role in addressing the emotional needs of both patients and families, helping them navigate the complexities of illness and end-of-life issues [8][9] Group 3: Volunteer Contributions - Volunteers are trained to provide various services, such as haircuts and music therapy, which significantly enhance the comfort and happiness of patients in palliative care [9] - The involvement of volunteers not only meets the practical needs of patients but also fosters a sense of community and support for both patients and their families [9] Group 4: Future of Palliative Care - There is an increasing demand for palliative care services, and the future will see an expansion of service areas, with community and home-based care becoming primary settings [10] - The development of more standards and guidelines based on practical experiences will aid in the training of palliative care professionals and improve service levels to meet diverse patient needs [10]

Core Points - The National Health Commission has revised the "Palliative Care Practice Guidelines (Trial)" issued in 2017, resulting in the "Palliative Care Practice Guidelines (2025 Edition)" to further promote the development of palliative care across regions [1] - The guidelines focus on a patient and family-centered approach for terminally ill patients, utilizing a multidisciplinary collaboration model [1] - Key areas addressed in the updated guidelines include pain and symptom control, comfort care, psychological, spiritual, and social support [1] Summary by Categories - **Guideline Revision** - The updated guidelines aim to standardize palliative care practices and provide a reference for local implementation [1] - The revision includes updates on symptom control, comfort care, psychological support, and humanistic care [1] - **Content Focus** - The guidelines emphasize the importance of pain and symptom management, comfort care, and comprehensive support for patients and families [1] - Specific areas such as assessment and observation points, treatment principles, nursing key points, support points, and precautions have been optimized and refined [1]

Core Insights - The article discusses the challenges and compromises in hospice care in China, emphasizing the struggle for dignity at the end of life within an imperfect system [1][7] - It highlights the increasing aging population in China and the associated healthcare challenges, particularly in end-of-life care [2][6] Group 1: Aging Population and Healthcare Challenges - China is experiencing an unprecedented aging era, characterized by a rapid increase in the elderly population and a rising average life expectancy [2] - As of 2018, the average life expectancy in China was 77 years, but the average healthy life expectancy was only 68.7 years, indicating that elderly individuals spend an average of 8.3 years living with illness [2] - The prevalence of chronic diseases such as cancer, diabetes, and neurological disorders is increasing, raising questions about health and medical care in the context of aging [2] Group 2: Hospice Care and Dignity - The concepts of "hospice care" and "end-of-life care" aim to help the elderly accept their reality and achieve a dignified death [5] - In the U.S., patients can choose hospice care if two physicians determine they have less than six months to live, allowing them to forgo curative treatments [5] - Recent legislative efforts in China, such as the Shenzhen Medical Regulations, have begun to address the need for advance directives, marking a step towards ensuring dignity in end-of-life care [6] Group 3: Cultural and Systemic Challenges - The practice of hospice care in China predates the establishment of formal systems for ensuring patients' rights to self-determination at the end of life [7] - The article raises critical questions about how patients perceive and advocate for their dignity in the current cultural and systemic context [7] - It emphasizes the need for a deeper understanding of the complexities and compromises involved in providing dignified end-of-life care, reflecting on the various personal needs and choices that arise in this context [8]

Group 1 - The article discusses the impact of war and trauma on individuals, focusing on the works of author Zhang Ling, who is also a hearing rehabilitation specialist. Her experiences with veterans have influenced her writing, particularly in her stories that explore the aftermath of war and personal loss [4][5]. - Zhang Ling's novella "Xiao Han Ri Fang Cheng Ye" portrays a female journalist visiting a veteran, revealing the contrast between the veteran's heroic past during the war and his current struggles with isolation and silence in old age [4]. - The second novella, "Yi Hu Ji," reflects on the COVID-19 pandemic, depicting two women from different backgrounds who find solace in each other's company while caring for a limping fox, symbolizing the search for connection in a changed world [5]. Group 2 - The book "Notes toward a Supreme Fiction" by Wallace Stevens is highlighted as a significant work in modernist poetry, emphasizing the role of poetry in creating meaning in a world lacking ultimate beliefs. Stevens proposes three principles for poetry: abstraction, change, and the provision of pleasure [8][9]. - The collection includes over 150 representative poems from Stevens' career, showcasing his rich imagination and philosophical depth, often drawing inspiration from everyday life [8][9]. Group 3 - "The Geographer Drank His Earth" by Alexei Ivanov is noted for its portrayal of post-Soviet Russian life, focusing on a former biologist turned geography teacher who navigates personal and societal challenges with humor and resilience [12][16]. - The novel reflects on the courage and humility required to maintain a "living soul" amidst life's adversities, emphasizing the importance of love and conscience in daily life [12][16]. Group 4 - "The Iron Industry and the Converging Network of the Han Dynasty" by Lin Yongchang explores how iron production was intertwined with the political and economic systems of the Han Dynasty, revealing its role in the empire's governance and social structure [17]. - The book discusses the significance of iron in creating a vast network of communication and logistics that connected various political and economic regions, highlighting the impact of iron production on the empire's stability and growth [17]. Group 5 - "The Silver-haired Ferryman" by Chen Hui examines the phenomenon of "old drifting," where elderly parents move to cities to support their children's families, shedding light on their daily lives and emotional struggles [19][20]. - The book analyzes the complex adjustments of the "old drifting" group in terms of parenting, family relationships, and personal identity, illustrating their role in the evolving family structure amid rapid urbanization [19][20]. Group 6 - "Facing the End of Life: Compromises and Harmonies in Hospital Palliative Care" discusses the challenges of palliative care in China, emphasizing the need for improved definitions and practices in end-of-life care [22][23]. - The book presents case studies that highlight the difficult choices faced by patients, families, and healthcare providers in the context of limited resources and traditional views on death [22][23]. Group 7 - "In the Age of Great Disasters" reflects on Japan's historical earthquakes and the societal responses to disaster recovery, emphasizing the tension between restoring the past and creating a better future [25]. - The author, who participated in post-disaster reconstruction efforts, outlines the phases of disaster response and the ideological conflicts surrounding recovery efforts [25]. Group 8 - "The Orchid Phenomenon" by Jim Endersby explores the cultural significance of orchids in Western history, linking them to themes of sexuality, death, and beauty [27][28]. - The book discusses the commercial popularity of orchids and their symbolic meanings throughout history, while also addressing the threats they face due to human activities [27][28].