Plot twist, they knew all along she was doing well, they were just bullying her all along. Double plot twist, Okita was the last one to find out she was lying.
Otose is like my mom, everytime someone is sick she wants to "stop our suffering by letting us go" way too soon 😂. Also I think is cute that Soyo too saw through all that, since she is not surprised when Kagura comes back to life, She knows her bestie.
Gintama is one of the few shows where the anime is just so much better due to voice acting and music. I believe sorachi deliberately wrote a lot of the scenes with voice acting in mind.