From Mr Charles Davis Sir, As clinical director of neurosciences in Lancashire and South Cumbria I am ultimately responsible for Leslie Burke’s provision of care, and I share his elation over the decision by Mr Justice Mumby that he should be able to obtain the treatment he requires (report and leading article, July 31).

The ruling is humane in the face of a prevailing climate of misguided medical authoritarianism. Decisions on treatment withdrawal, such as “do not resuscitate” orders, are being made too hastily within the NHS, particularly in hard-pressed intensive care units, without patient and relative agreement.

Patients and doctors should urge the General Medical Council not to appeal a wise judgment.

Yours faithfully,
CHARLES DAVIS,
Royal Preston Hospital,
Sharoe Green Lane North,
Fulwood, Preston PR2 9HT.
July 31.

From Dr Gerard Daly

Sir, The High Court judgment should be welcomed as an assertion by the State of its duty to defend basic human rights as they affect patients.

No professional body, including medical practitioners, should be above the law, or immune from prosecution by virtue of their specialised knowledge or function. The courts are also entitled to decide on whether codes of professional practice and conduct are lawful and fall within the Human Rights Act. This is all the more important for the medical profession, where life and death decisions are often made concerning the quality of life of patients and their “best interests” without even consulting with the patients or their family.

As these decisions are subjective, and often rely on the prejudices of the doctors concerned, the General Medical Council guidelines provide considerable latitude for doctors to starve and dehydrate patients to death, irrespective of the wishes of those patients. It was essential for the courts to intervene.

Yours faithfully,
GERARD DALY,
Flat 2, 61 Arlingford Road,
Tulse Hill, SW2 2ST.
gerardjd@hotmail.com
July 31.

From Mrs Helen Willan

Sir, My mother has suffered from increasingly severe dementia for a decade and she now cannot move, understand, speak, eat, drink, dress or toilet herself. She cannot recognise or communicate with her family and is cared for 24 hours a day in a nursing home. It is quite possible that at some stage in the near future she will no longer be able to open her mouth to receive nutrition.

From yesterday’s ruling it would appear that my mother might at that point have to endure being forced to take nourishment, perhaps three times a day, in order to provide her with life-sustaining treatment.

My mother did not provide a “living will” as to her wishes in the case of terminal illness, but nor will she be able to give her approval or consent to what could be termed an intolerable, painful and distressing physical assault on her person. She is a sick and frail lady who deserves a peaceful and dignified death, something which might apparently be denied her under the terms of this present ruling.

The law here would seem to be a very blunt instrument indeed.

Yours sincerely,
HELEN WILLAN,
15 Ullswater Road, Barnes, SW13 9PL.
July 31.

From Lord Donaldson of Lymington

Sir, What becomes of the age-old medical commandment: “Thou shalt not kill, but need not strive officiously to keep alive”? And what has happened to the well-known distinction between “board” and “treatment”, artificial nourishment and hydration surely being in the latter category? Are we now to see the courts ordering treatment, whereas hitherto their intervention has been confined to authorising or forbidding treatment which doctors wished to provide?

Yours faithfully,
JOHN F. DONALDSON,
House of Lords.
August 1.

From Mr Tony Kerpel

Sir, The High Court ruling in favour of Mr Burke’s wish to receive life-prolonging treatment is a welcome step in establishing patient autonomy for terminally ill people.

When may we expect equal recognition and equal rights for those terminally ill people who express a similarly clear wish to receive medical assistance to die?

Yours faithfully,
TONY KERPEL,
13b Downside Crescent,
Hampstead, NW3 2AN.
August 1.

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