Imprisoned Chinese Nobel Peace Prize laureate Liu Xiaobo's condition is life threatening with multiple organ failure and his family has opted against inserting a breathing tube needed to keep him alive, the hospital treating him said.

Liu, who has advanced liver cancer, is suffering from respiratory and renal failure as well as septic shock, the First Hospital of China Medical University said on its website Wednesday.

The hospital said doctors informed Liu's family of the need for a tracheostomy to keep him alive, but they declined. Liu and his family, who are being closely guarded in the hospital, could not immediately be reached for comment.

Liu, China's most prominent political prisoner, was diagnosed in May after his cancer had entered the final stages and was transferred to the hospital in the northeastern city of Shenyang. He is accompanied by a small group of family members, including his wife, the poet and artist Liu Xia, but is kept out of the sight of supporters and the media.

Exiled Chinese dissident Yu Jie, a close friend of the couple, said he was "very sad and angry" at the deterioration in Liu's condition.

"In front of the world, Liu Xiaobo is being murdered by (Chinese President) Xi Jinping. Yet not a single Western political figure is condemning Xi Jinping," Yu said.

"This is a sign of the complete failure of Western human rights diplomacy," he said.

Liu's declining health has become the subject of international attention, with supporters and several foreign governments calling for him to be freed on humanitarian grounds.

German Chancellor Angela Merkel's spokesman, Steffen Seiberton, told reporters Wednesday that China should allow Liu to leave the country for medical treatment. President Tsai Ing-wen of Taiwan tweeted a similar appeal on Wednesday, joining a chorus of pleas already made by the U.S., Britain, France and several other governments.

Two foreign doctors, one German and one American, reported Sunday after visiting Liu that he expressed a desire to leave for the West and said it would be possible to evacuate him safely — but that it needed to happen soon.

Beijing has rebuffed those calls, saying Liu is too sick to travel and is already receiving the best care possible. China has accused other countries of politicizing the writer's case and interfering in China's internal affairs.

"We hope relevant countries can respect China's judicial sovereignty and not use such individual case to interfere in China's domestic affairs," foreign ministry spokesman Geng Shuang told reporters at a briefing Wednesday.

Liu, a former professor who helped negotiate with the military for the safe passage of students during the 1989 Tiananmen Square protest, was convicted in 2009 of inciting subversion for his role in the "Charter 08" movement calling for political reform and was sentenced to 11 years in prison. He was awarded the Nobel Peace Prize a year later while serving his sentence.

After Wednesday's hospital announcement signaling that Liu was near death, his supporters grappled with the news that his family had declined to put him on respiratory support.

Some said the family wished to spare him the suffering of throat surgery and the need to stay on a ventilator for the rest of his life, however brief. Others said the family may still be holding out hope that he could be moved overseas. Yet others said Liu may simply be beyond rescue.

"Why the family made the decision is beyond the point, which is that this was a political murder," said Wu'er Kaixi, a Taiwan-based activist and one of Liu's former students in 1989.

Although the Chinese government has repeatedly said it has given Liu first-rate care since his diagnosis, his supporters and international human rights groups have questioned whether he received adequate care during his imprisonment. Chinese prisons are notorious for their harsh conditions, and it's common for released prisoners to return to society in a perilously weakened state.

China has in the past released high-profile dissidents on medical grounds and immediately exiled them to the U.S., notably veteran democracy campaigner Wei Jingsheng in 1997 and a leader of the 1989 student pro-democracy protests, Wang Dan, in 1998.

But Xi's government has adopted a considerably tougher line in such matters, forbidding many of its critics to travel abroad while it pursues a sweeping campaign against dissent.

Bao Tong, a former aide to top Communist Party officials who was ousted for showing sympathy for the Tiananmen protesters in 1989, said the government — not its critics — was effectively politicizing Liu's case.

"Corrupt officials can freely walk around for years even after they're convicted, but patriots must be persecuted?" Bao, who has been kept under various degrees of house arrest for decades, said by telephone.

"A sick person, in his dying moments, can't have some peace on free soil — that's a political decision in itself," he said.


Shih reported from Beijing.