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Asian Bioethics Review

, Volume 11, Issue 1, pp 57–68 | Cite as

Access to Care by Older Rural People in a Post-Reform Chinese Hospital: an Ethical Evaluation of Anthropological Findings

  • Xiang ZouEmail author
  • Jing-Bao Nie
Original Paper

Abstract

This paper examines older people’s access to care experiences in rural China by integrating anthropological investigation with ethical inquiry. Six months of fieldwork in a post-reform primary hospital show how rural residents struggle to access gerontological and nursing care under socially disadvantageous conditions. This anthropological investigation highlights the unmet needs in medical and nursing care for older people, as well as some social, institutional and structural elements that impede access to care. Centring on protecting the vulnerable as informed by feminist ethics scholarship, this paper argues that the failure to meet older people’s dependency needs is unjust, on the premise that it suggests a denial of the inherent value, rights and dignity of older people. This paper appeals for the provision of greater care and support by the state through putting in place social arrangements that better advance older people’s access to care. Some policy recommendations concerning health and social care reform for older people in rural China are also proposed.

Keywords

Access to care Gerontology Ageing Aged care Healthcare reform Rural healthcare China 

Notes

Compliance with Ethical Standards

The Human Ethics Committee of the University of Otago in New Zealand approved the research (Reference No. 15/106).

Informed Consent

All participants involved in this study have given their informed consent in oral form, as participants might have been reluctant to express their experiences and perspectives if they would have been required to sign a written consent form, especially with the research involving personal information. On the one hand, signing a document is a quite serious undertaking in a Chinese cultural context, and on the other hand, oral consent is generally honoured and accepted in Chinese society. Therefore, taking consent orally was helpful in minimising the participants’ fear of identification and establishing their trust in the researcher. Additionally, written consent was impractical given that many of the participants were illiterate.

To protect the confidentiality and privacy of the research participants, all identifying information was removed. For example, the names used in this paper—including those of informants and locations—are pseudonyms.

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Copyright information

© National University of Singapore and Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Bioethics CentreUniversity of OtagoDunedinNew Zealand

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