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Abstract

Advance directives (AD) are playing an increasingly important role in end-of-life medical care and treatment in ageing societies. A growing number of jurisdictions have introduced AD-related laws as a component of their medical and health care regulatory frameworks. This article presents an analytical account of why specific regulation on ADs has yet to develop in China, the most populous ageing society in the world. We argue that the regulatory vacuum to date can be partly explained by limited public demand, which can be further accounted by relatively low public awareness as well as the influence of traditional views on life-and-death and family relationships. Finally, we suggest that there may be a “coming of age” for Ads in China in the near future, given the growing importance of patient autonomy in medical decision-making, promotion of the concept by advocacy groups, expansion of hospice and palliative care, and emergent discussions among policymakers.

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