46歲的蔣女士長年獨居於上海，未婚未育，父母早已過世，日常生活中幾乎沒有直系親屬可依靠。今年10月14日，她任職的公司突然收到她的請假申請，內容僅簡短表示自己頭暈、無法行動。由於蔣女士一向工作穩定，這樣的狀況引起同事警覺，於是主動前往她的住處查看情況，發現她身體狀況不佳，隨即將她送往醫院急救。

經醫院診斷，蔣女士出現腦出血症狀，情況危急，必須立即接受手術。然而，手術所需的家屬簽字卻成為第一道難題。在沒有直系親屬的情況下，蔣女士只能聯繫一名遠房親戚——表弟吳先生，請他代為處理相關醫療決定。吳先生表示，自己原本與蔣女士來往並不頻繁，但在得知她的處境後，仍選擇承擔起協助照料的責任。

經過將近兩個月的治療，蔣女士的病情一度出現好轉跡象，家屬與相關人員也因此稍感寬心。然而，上週一，她從上海新華醫院這家三級甲等醫院，轉至嘉定南翔一家民營康復醫院後，病情卻突然急轉直下，出現明顯惡化。郵電居民區黨總支書記王鎮君表示，原本計畫在上週日為蔣女士安排專家會診，吳先生也為此在上週六再度墊付1萬元人民幣作為醫療相關費用，但最終仍未能挽回她的生命。蔣女士於昨天上午10點45分不幸離世。

對於轉院的決定，吳先生心中始終存有疑問。他不理解，為何在病情尚未完全穩定的情況下，會從設備與醫療資源相對完善的三級甲等醫院，轉至一家知名度不高的康復醫院。對此，王鎮君解釋，轉院是基於新華醫院方面的專業建議，居委會並未指定具體醫療機構，僅在協調流程中扮演輔助角色。

隨著蔣女士的離世，另一個更為現實且棘手的問題浮上檯面——她的身後事該由誰決定、又該如何處理。吳先生坦言，自己曾向居委會提出，希望能動用蔣女士的遺產，為她購置墓地、妥善安排後事。他認為，既然這筆錢本來就屬於蔣女士，用於她自己的安葬與善後，理應合情合理。然而，相關人員卻回應，國家最多只能提供海葬等基本安置方式，購買墓地並非當然可行。這樣的答覆讓吳先生感到難以理解，他直言：「自己的後事，卻不能用自己的錢來處理，換成任何人，恐怕都很難想得通。」

上海申道律師事務所主任律師楊邹華指出，現行制度中確實存在模糊地帶。以追思會或喪葬規模為例，究竟什麼樣的支出屬於「合理範圍」，可以獲得遺產管理人或相關部門的認可，實際上並沒有一套明確、具體的標準，這也使得類似案件在實務操作上經常引發爭議。

對此，虹口區民政部門回應表示，依據《上海市殯葬管理條例》，一般情況下應由逝者的近親屬承辦喪事。像蔣女士這樣無直系親屬、孑然一身的情況，若吳先生願意承擔相關事宜，可以提出書面申請，但包括購置墓地在內的支出必須控制在合理範圍之內，且後續墓地的管理與維護費用，仍需由承辦人自行負擔。

最終，蔣女士的生命在病情突然惡化後畫下句點。依照法律規定，她名下的遺產將由民政部門依法接收與管理。然而，她的故事也引發社會更深層的討論：當一個人沒有親人、沒有明確的身後安排時，誰有權替她做決定？制度所能提供的「保障」，是否真能回應人們對尊嚴與善終的期待？這不僅是蔣女士個人的遺憾，也是一道仍待社會與法律共同回答的現實課題。

Ms. Jiang, a 46-year-old woman, had lived alone in Shanghai for many years. She was unmarried, had no children, and both of her parents had already passed away. With no close family members by her side, she led a largely solitary life. On October 14 this year, the company she worked for received a leave request from her stating that she was experiencing dizziness and was unable to move. Because Ms. Jiang had always been reliable at work, her sudden absence raised concern among her colleagues. They decided to visit her home to check on her condition and found that she was indeed unwell, prompting them to rush her to the hospital.

Doctors diagnosed Ms. Jiang with a cerebral hemorrhage, a life-threatening condition that required immediate surgery. However, a serious complication soon arose: the surgery required a family member’s signature, yet Ms. Jiang had no immediate relatives. Left with few options, she contacted a distant relative—her cousin, Mr. Wu—and asked him to help make medical decisions on her behalf. Mr. Wu later explained that although he and Ms. Jiang were not particularly close, he chose to step in after learning about her situation and took on the responsibility of assisting with her care.

After nearly two months of treatment, Ms. Jiang’s condition appeared to show signs of improvement, offering a glimmer of hope to those involved. However, the situation changed dramatically last Monday when she was transferred from Xinhua Hospital, a top-tier Grade A tertiary hospital in Shanghai, to a private rehabilitation hospital in Nanxiang, Jiading District. Shortly after the transfer, her condition deteriorated rapidly. Wang Zhenjun, secretary of the Party branch of the Youdian Residential Community, stated that an expert consultation had originally been scheduled for the previous Sunday. In preparation for that consultation, Mr. Wu had once again advanced 10,000 yuan in cash on Saturday to cover medical expenses. Despite these efforts, Ms. Jiang did not survive and passed away at 10:45 a.m. yesterday.

Mr. Wu later voiced strong doubts about the decision to transfer Ms. Jiang to another hospital. He could not understand why she had been moved from a well-equipped, highly reputable tertiary hospital to a relatively unknown rehabilitation facility, especially when her condition had not fully stabilized. In response, Wang Zhenjun explained that the transfer was made based on professional recommendations from Xinhua Hospital itself and that the neighborhood committee had not designated or chosen the receiving hospital, but merely assisted in coordinating the process.

Following Ms. Jiang’s death, a more complex and emotionally charged issue emerged: who had the authority to decide how her affairs should be handled after death. Mr. Wu revealed that he had proposed using Ms. Jiang’s own estate to arrange her funeral and purchase a burial plot. In his view, since the money belonged to Ms. Jiang, it was only reasonable for it to be used to handle her own final arrangements. However, he was told that the state could at most provide basic arrangements such as a sea burial, and that purchasing a grave plot was not necessarily permitted. This response left Mr. Wu deeply troubled. He remarked that if a person cannot even use their own money to settle their own affairs after death, it is something that anyone in a similar position would struggle to accept.

Yang Zouhua, chief lawyer at Shanghai Shendao Law Firm, pointed out that the current legal framework does indeed contain gray areas. For example, when it comes to expenses such as memorial services or funeral standards, there is no clearly defined benchmark for what constitutes a “reasonable” cost. As a result, whether such expenses can be approved by an estate administrator or relevant authorities often lacks consistency, leading to frequent disputes in real-life cases.

In response to public concern, the Hongkou District Civil Affairs Department stated that, under the Shanghai Funeral and Interment Management Regulations, funeral arrangements are generally handled by the deceased’s close relatives. In cases like Ms. Jiang’s, where the individual has no immediate family, a distant relative such as Mr. Wu may apply in writing to take responsibility for the arrangements. However, expenditures such as purchasing a burial plot must fall within a reasonable range, and any future maintenance costs would still need to be borne by the person handling the affairs.

Ultimately, Ms. Jiang’s life came to an abrupt end following the sudden worsening of her condition. According to the law, her estate will be taken over and managed by the civil affairs authorities. Yet her story has sparked broader reflection within society. When a person has no family and leaves no clear instructions for their final arrangements, who should have the right to make decisions on their behalf? And can existing systems truly provide not just legal order, but dignity and compassion at the end of life? These questions, raised by Ms. Jiang’s passing, remain unresolved challenges for both society and the law.