From my experience, spousal visas are becoming a big joke. Last year, without any medical check requests, i could get a one year L in Guangdong, where my wife's hukou was. This year, however, when i applied for the same one year spousal L as last year, just like the OP here, i also was offered a 6 months Spousal L only. According to the local PSB in the location, the regulations changed and one year spousal RP with a health check necessary was available instead. With the health check necessary, i have felt the same way as the OP here. I have a 3 year old son, born on mainland China, and my wife, a local, has her mother seriously ill. Hypothetically, and as the OP has also suggested in his case, if i failed the health check, i would probably have to abandon my little son, wife and her ill mother. Really, this isn't just about the human rights but about some seriously sick logic of a few foreigner haters with roled up sleeves, and pants above their knees somewhere in a smoky room.
Cheers and beers to some hopeful improvements in spousal visa issues

If there are still one year L visas

No 'if', but they can only be issued on the mainland at the discretion of the PSB office serving the huko area of the Chinese relative, and then usually only to foreigners with Chinese relatives. One would have expected their issuance to be automatic to all foreigners on the mainland with Chinese spouses there too. Clearly that's not the case. The OP is quite right in being annoyed imo. The playing field is not level here in this respect. And the PSB aren't obliged to explain their actions to visa applicants. Another thing that's bad here is you cough up your visa fee before beng informed if you'll get what you asked for.

I gets to the PSB office this morning with my passport and pick-up slip, dated for pick-up today, to get my new L visa, my current L is due to expire. As it happens, I've a Chinese wife and 'we like touring'..sic. Because she is my wife, that's no reason at all for me to stay in her huko hometown, human rights, get it? So, when I completed my visa application form last week, I ticked two boxes, one for 'visiting Chinese relatives', and the other for 'touring'. Fair enough, I think.

Now, let's just go back to the Foreigner Accommodation Form. I have to get that stamped by the local police station first, and then take it to the Head of the Provincial Police Station, for another stamp. Then I have to submit that form to the PSB along with my visa application form.

Now get this, at my local police station the police boss forges the signature of the policeman in charge of the district where I live in an apartment bought by myself, where I've been staying for the past couple of weeks after having returned from a teaching gig in another province. Said policeman was not present, hence the forging.

Once I get my 180 day L, I'm all set for doing another teaching gig outwith my wife's province. I'd prefer a one-year L, but the Provincial PSB here are stingy. In most other provinces, 360 dayers are par for the course for laouwei with Chinese spouses - I'd been told I'd have to take a medical to get a one-year L visa, but why in hell's name should I? Anyway, would they drive me out of China if I failed a medical regardless of my wife being Chinese, to let me die alone in my homeland? Have they ever heard of human rights? Guess not!

But the joke's on them, I've taken their shit one step farther in my own hands - I TEACH WITHOUT TAKING MEDICALS....LOL, AND THRIVE ON IT, BEEN AT IT FOR 12 YEARS SO FAR!USE THEIR LONG VISA TO TEACH ELSEWHERE!

Now, they wouldn't give me a new visa today coz they said the photo on my visa application form was too old,they didn't pick that up last week, maybe 2 years or so old, far too picky they are, [edited] them. I've to return next week to get my new visa, no worries, as I asked them if it'd be ok for my wife to collect it on my behalf. They agreed, which means in essence they're not after my blood. I'll qualify that - maybe they are, but they have no hard evidence.

BTW, the policeman in charge of my district here was castigated when he was just a rookie for not checking my visa had expired when I got in the mire with the PSB some years back after turning myself in for overstaying my RP. There's no love lost between him and the PSB!

Oh, I almost forgot to mention what happened when I submitted my wife's huko plus its photocopy. Two hukos were returned to me, my wife's and another Chinese woman's. Luckily I was still there when the woman protested - I dug hers out of my briefcase! The PSB here are a bunch of [edited] with shitty English and entitlement mentalities! Anyway, I pressed the button for excellent service, everything is relative after all!