BEIJING (NYTIMES) - As the life ebbs from Mr Liu Xiaobo, China's most famous dissident and only Nobel Peace Prize laureate, a battle is shaping up over his life, his legacy, his words and maybe even his remains.

It is a battle that other countries are largely sitting out, even though Mr Liu could become the first Nobel laureate to die in state custody since Mr Carl von Ossietzky, the German pacifist and foe of Nazism who died under guard in 1938.

The tepid international response to Mr Liu's case is a reflection of China's rising power, and its ability to deflect pressure over its human rights record.

The Chinese government has sequestered Mr Liu in a hospital room in northeast China and refused his request to go abroad for treatment, saying it wants to ensure that he receives the best care for his terminal liver cancer.

The hospital is surrounded by guards, and Mr Liu has been filmed lying still and frail in his bed. The footage, which shows him surrounded by doctors praising his medical care, was released without his permission for propaganda purposes.

Mr Liu's supporters have expressed outrage, saying the government wants to control his last days in defiance of his lifelong cause: the right of the individual to live, speak and remember, free of authoritarian control and censorship.

"The key is control of his talk - they don't want him to be able to speak freely," said professor of Chinese Perry Link at the University of California, Riverside, who edited an English-language selection of Mr Liu's essays and poems.

"If he's let out for treatment, he could talk, and that's what the regime is afraid of," said Prof Link.

Mr Liu has written about "angry ghosts" who denounce official misdeeds from the grave, and Beijing seems fearful that he will become one of them, inspiring opposition even in his afterlife.

On Tuesday (July 11), the hospital treating Mr Liu said he had septic shock and organ dysfunction, suggesting his condition was grim.

The panoply of state censorship and propaganda around Mr Liu is testament to his tenacious influence, almost seven years after he was awarded the Nobel Peace Prize, nearly a decade after he was last detained and sentenced to 11 years in prison for inciting subversion, and 28 years after the Communist Party denounced him as a seditious "black hand" for backing the student protests that swept China in 1989.

Mr Liu has not been allowed to speak freely since he was arrested in late 2008, and his wife, Madam Liu Xia, has been under heavy police surveillance since 2010, when he was awarded the Nobel medal. But lately, the Chinese authorities have released images and videos abroad to make the case that the couple are contented and cooperative.

"They want everything to be controllable, and if he went abroad, he would lie beyond their control," retired professor of Chinese literature Cui Weiping, who is also a friend of Mr Liu's, said from Los Angeles, where she now lives.

"This has always been the purge approach for dealing with dissidents - minimise their influence so they don't become a focus."

Yet, while the government wants Mr Liu to stay silent and to ensure that his legacy fades as quickly as possible, his supporters have mobilised, despite intense restrictions and police warnings. They want to win him the right to speak out, go abroad for palliative treatment and decide how he is memorialised.

Some sympathisers of Mr Liu have tried to visit him in his hospital, where the police blocked their way; some organised a petition calling for him to be given freedom at the end of his life.

Longtime friends of Mr Liu have been warned not to speak out.

"To make Liu Xiaobo spend his final time like this doesn't bring honour to the government, but they'll stick to their ways," said Mr Wen Kejian, a friend of Mr Liu who unsuccessfully tried to visit him in the hospital. "I think the chances that we'll get what he wants are slim - that would require a dramatic change in the system - but we must try our best."

Mr Liu, 61, was moved from prison to the First Hospital of China Medical University in Shenyang, 390 miles northeast of Beijing, last month (June), and officials revealed that his cancer had already reached a terminal stage.

Mr Liu has said that he wants to travel to Germany or the United States for treatment. The Chinese government has not flatly rejected that request, but it has left little hope it will say yes.

The tensions over Mr Liu have also spilled abroad.

China's president, Mr Xi Jinping, exudes disdain for human rights lobbying, and Western governments have weighed how far to press his case even as rights groups call for action.

A spokesman for China's Ministry of Foreign Affairs, Mr Geng Shuang, on Monday (July 10) denounced calls for Mr Liu to be freed to go abroad as "meddling" by foreigners, even though two doctors, a German and an American, who were invited by the government to examine Mr Liu said that he could travel and that their hospitals would treat him.

"Politically, it's 100 per cent sure that the Communist Party doesn't want Mr Liu to be freed or leave China," said Mr Zhao Hui, a writer and friend of Mr Liu who goes by a pen name, Mo Zhixu.

He said: "Whatever chance we have of making that happen depends on external pressure."

But so far, most Western leaders, including President Donald Trump, have said nothing publicly about Mr Liu, leaving any comment to lower-ranking officials.

There is no guarantee Mr Xi would bow to stronger foreign pressure to free Mr Liu. In past decades, Chinese leaders were willing to release political prisoners to Western countries after granting medical parole. They included Mr Wei Jingsheng, the most prominent dissident of his generation, who reached the US in late 1997 after then president Bill Clinton pressed his case with China's president at the time, Mr Jiang Zemin.

But as the Chinese government has grown more confident and impatient with Western criticism, it has stopped that practice. Mr Xi appears particularly set against making concessions that could weaken his strongman reputation.

"The Chinese government is legitimate in its refusal of calls for Liu to be taken overseas for treatment," the English-language edition of Global Times, a party-run newspaper with a nationalist tinge, said in an editorial on Monday.

In any case, it added that "Western mainstream society is much less enthusiastic than before in interfering with China's sovereign affairs".

Even after Mr Liu dies, his funeral arrangements could become a focus of contention. Chinese rules say that prisons control the funerals of prisoners and can cremate them even if the family objects.

But the "whole area of the rights of individuals serving sentences on medical parole is a murky one indeed, including funereal rights", said Mr John Kamm, the founder of the Dui Hua Foundation, an organisation in San Francisco that has worked to free Chinese prisoners.

The Chinese government will almost certainly try to prevent any grave site for Mr Liu from becoming a place of pilgrimage for dissenters.

The grave of Ms Lin Zhao, an outspoken writer executed during the Cultural Revolution, has become one such site, and Mr Liu's pull would be more powerful.