Chinese Nobel Peace Prize-winning dissident Liu Xiaobo is in critical condition and his breathing is failing, the hospital treating him says.
Liu, a prominent participant in the Tiananmen pro-democracy protests of 1989, was jailed for 11 years in 2009 for "inciting subversion of state power" after helping to write a petition known as "Charter 08" calling for sweeping political reforms.
He was recently moved from jail to a hospital to be treated for late-stage liver cancer.
Liu's kidney and liver functions are failing, and he suffers from blood clots, among other ailments, the hospital in the city of Shenyang said on its website on Wednesday.
However, Liu's family has declined the use of intubation machinery to help him breathe with the aid of a plastic tube in his windpipe, the hospital said.
The announcement suggested a significant deterioration in Liu's health since early on Wednesday, when the hospital said he was being treated for worsening liver function, septic shock and organ dysfunction.
Rights groups and Western government have urged China to allow Liu and his wife, Liu Xia, to leave the country to be treated abroad, as Liu has said he wants to.
But the government has warned against interference in its internal affairs and said Liu is getting the best care possible and is being treated by renowned Chinese cancer experts.
The state-backed Global Times tabloid said the "confrontational tone" of those in the West voicing their opinions on Liu failed to focus on his illness.
The government allowed two foreign doctors, from the United States and Germany, to visit Liu on Saturday and they later said they considered it was safe for him to be moved overseas, but any move should be done as quickly as possible.
After the doctors' Sunday statement, China released short videos of their visit, apparently taken without their knowledge, in which the German doctor appeared to praise the care Liu had received.
Liu's friends voiced suspicion about the hospital's earlier statement, which suggested a worsening of his health soon after two foreign doctors said he was well enough to travel abroad.
No one answered the telephone at the hospital's publicity department on Wednesday.
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