The long and painful road to a health service the whole nation can trust

What is so important about informed consent, where health care providers ensure patients are properly advised to make a voluntary choice to accept or refuse treatment? It’s a matter of life and death, to start with, and it concerns the fundamental ethics of the medical profession. It’s as simple as that.

The talk of the nation over the past week has been the death of university student Wei Zexi. The 21-year-old died after spending more than 200,000 yuan on immunotherapy treatment at a military hospital in Beijing for synovial sarcoma, a very rare type of soft tissue cancer synovial.

The death of one, unknown young man might have gone unnoticed had it not been for the circumstances of his case. He had used China’s search engine giant, Baidu, to find what he assumed was the best experimental treatment he could find online, not realising that he was looking at a paid listing for the top result.

Media reports revealed that he was unable to seek a second opinion because he had no access to Baidu’s global alternative, Google, and put his faith in what the hospital was touting as “revolutionary” immunotherapy in partnership with Stanford University. The prestigious American institution later denied any connection with the military hospital.

Here in Hong Kong, also over the past week, there’s been widespread public concern about a HK$5 million “alternative” cancer treatment scam. Police arrested 11 women from a beauty salon accused of cheating seven patients, two of whom died shortly after undergoing treatment there. Health minister Dr Ko Wing-man said the authorities were investigating whether unqualified salon staff had conducted illegal medical procedures, and advised the public to seek help only from registered doctors.

People with serious illnesses can be vulnerable and willing to try out experimental or unscientific treatment, at the risk of being misled or cheated. Stringent regulatory scrutiny is thus critical to protect them.

In Wei’s case, we’ll have to wait for the conclusions of a joint investigation by various government bodies into Baidu’s responsibility before we get a complete picture of what cost this promising young computer science student his life.

But the public outcry has already pointed to one major cause: while Wei’s doctor told him that the expensive immunotherapy would buy him another 20 years of life, a Google search later suggested just the opposite – the treatment in question was far from popularly recommended in the United States. Also, as a matter of fact, the treatment had not been officially approved by China’s drug authorities.

While Baidu, in all probability, cannot escape responsibility, there is the bigger issue of limited internet access on the mainland, where Google is banned by the government.

It also concerns a notorious reality in mainland China, which was once highlighted by former premier Wen Jiabao as the “three difficulties” for ordinary people: getting to see a doctor; being prescribed the right treatment and medication; and having proper hospitalisation. Malpractice and corruption in the health service industry is a long-standing problem.

Mainland authorities have been saying they would learn from outside experience, including Hong Kong’s, for the nation’s medical reform. In this regard, even though it has its own share of problems, Hong Kong has a health care system of higher standards, both in the public and private sectors.

This is not to suggest that it’s all good in Hong Kong and the mainland is all bad – it’s only that when it comes to medical services, the professional ethics observed by most in this city can be trusted, and regulatory implementation is transparent. This also explains why more and more rich mainlanders flock to Hong Kong for medical treatment.

Ironically, the problematic situation across the border offers a potential market for Hong Kong’s medical professionals, who can start their own business up north under the Closer Economic Partnership Arrangement. With demand for quality medical services continually growing on the mainland, Beijing has prioritised the provision of proper heath care. Surely that means new opportunities for Hong Kong?

What matters more, though, is maintaining high professional ethics and keeping a sound regulatory regime here in Hong Kong. Hopefully the mainland will gradually follow.