Speech/Writing A notice from the Shenzhen Health Commission has brought to the public eye an ambulance "cut-off" incident that occurred 8 months ago: on the early morning of August 5th last year, Ms. Zhang, who lives in Shenzhen, experienced sudden abdominal pain and her family called the 120 emergency hotline. However, the ambulance did not take the patient to the nearest tertiary hospital assigned by the 120 dispatch, but instead headed to the farther Shenzhen Jian'an Hospital, a first-class private hospital to which the ambulance belonged. Ms. Zhang experienced delayed treatment in the eyes of her family here, and after being transferred to another hospital the next morning, she passed away due to ineffective rescue efforts. According to the Shenzhen Special Economic Zone Medical Emergency Regulations, Jian'an Hospital was fined 76000 yuan and suspended its pre hospital emergency qualification for six months.

Half a month later, the report by "People" titled "8 hours after the emergency ambulance cut-off" made the announcement about Ms. Zhang and her family more concrete. She is the mother who reminded her daughter to eat fruits in the WeChat group the day before; Her husband never expected to say goodbye right in front of him when he dialed 120. After all, this is Shenzhen, and the nearest tertiary hospital is only 2.8 kilometers away from home; Her daughter, who was thousands of miles away, witnessed her mother's last moments of powerlessness and despair in the video, crying and shouting 'mom' all the time. More importantly, the details exposed during these 8 hours have shown us systemic vulnerabilities and raised more questions.

Chinese ambulances are divided into two categories, one is the 120 ambulance, which performs pre hospital emergency tasks; The other type is non emergency transport vehicles, responsible for long-distance hospital transfers and other services, and implementing market pricing. Market chaos such as "black ambulance" and "ground based pricing" occur more frequently in non emergency transportation fields. The "cut-off" behavior of Shenzhen ambulance ignoring dispatch instructions may be an extreme case, but it occurred in more urgent and life-threatening pre hospital emergency situations, and its nature is particularly malicious. It directly breaks through the bottom line of people's trust: if even 120 cannot be trusted at the critical moment, what else can be trusted? In this regard, even the reflection on individual cases does not lose its public significance.

Returning to the incident itself, before the ambulance started, the deceased's husband requested to be taken to a tertiary hospital, but was strongly refused by the driver on the grounds that "the car from Jian'an Hospital can only go to Jian'an Hospital". When the family members sealed the medical records afterwards, they saw the dispatch form and found out that it was the designated tertiary hospital. The question is, why does the 120 dispatch instruction have rigid binding force in accordance with the law, but it is "as soft as a ball of cotton" on the execution end, and non-compliance seems to be commonplace? Just one day before Ms. Zhang's incident, Jian An Hospital also had a "cut-off" behavior.

The low cost of violating the law is one reason. A fine of 76000 yuan and a six-month suspension of pre hospital emergency qualifications - according to relevant regulations, this punishment is already "severe" or even close to the top level. But from a rational perspective, in the face of the loss of life, the price paid by lawbreakers is as light as a feather.

Indeed, the family has filed a civil lawsuit and the court has commissioned a professional organization to conduct medical damage assessment. In the future, the hospital may face other punishments, but overall, the benefits of "cut-off" are still greater than the costs. If it weren't for the extreme event of patient death, the violation would likely go undetected and would only result in a fine of a few tens of thousands of yuan if discovered. Compared to the low probability and light volatility on the cost side, the returns are certain and tempting. Taking a step back, even in the event of serious consequences, medical identification is lengthy and complex, and proving the causal relationship between violations and death is not an easy task. Ultimately, doing bad things seems to be cost-effective, who wouldn't want to take some risks?

Moreover, regulatory loopholes make the risk very low. The supervision of 120 after issuing scheduling instructions is almost blank. As early as 2009, Shenzhen invested over 24 million yuan to upgrade and renovate the 120 command and dispatch system, introducing GPS global positioning devices, which theoretically could achieve real-time monitoring of ambulances throughout the entire process. 16 years later, technological means should be more advanced, why is real-time monitoring just a formality? Deviation from the destination route triggers an alarm - this is not difficult to achieve technically.

In addition, if the 120 dispatch center sends a text message to users after completing the assignment, displaying the destination hospital and other dispatch information, it can give users the confidence to question illegal claims. Empowering users with more information rights and making dispatching transparent is also a way to curb illegal activities. Many times, good governance is reflected in the details.

In the Shenzhen incident, some people still wonder: Jian'an Hospital is a first-class private hospital, is it qualified to become an emergency network hospital?

According to the Regulations on Medical Emergency Care in Shenzhen Special Economic Zone, non-public medical institutions that meet the corresponding establishment standards can become emergency network medical institutions by signing a network access agreement. Among the existing list of 122 emergency network medical institutions announced in Shenzhen, Jian'an Hospital is not the only first level private hospital.

In fact, being included in the list itself is not a problem. Medical institutions of different levels and attributes can play different roles in the emergency network. Third tier hospitals have more experience in handling critically ill patients, but for some diseases or injuries, lower tier hospitals can fully cope. The key issue is how to ensure that any medical institution in the network can fulfill its emergency responsibilities and prevent its improper profit-making behavior after "inclusion"? This is an undeniable regulatory responsibility.

Post event accountability is certainly important, as it not only demonstrates justice but also provides comfort to the deceased and their families. But life should not pass away so despairingly and absurdly, and preventing tragedies from happening is equally important - if not more important. The rigid constraints of 120 scheduling must not become 'soft cotton'.

When the ambulance drove Ms. Zhang and her husband to Jian An Hospital, the only thing in her husband's heart was patience. He believed in 120 and believed that he could receive professional treatment at the hospital. When life is hanging by a thread, this natural trust should not be let down - for society, it is the cornerstone of the lowest level of security.