Sir, I should like to clarify why the Department of Health is appealing the judgment in the case of Leslie Burke (report, May 19).

We agree that people should be able to request artificial nutrition and hydration. This is what happens now and this is not the aspect of the judgment which has motivated us to appeal. Nobody is denied artificial nutrition and hydration on grounds of cost.

Our concern is that the judgment is not clearly limited to artificial nutrition and hydration. It can be read as giving patients the right to demand any life-prolonging treatment they wish — no matter how inappropriate. It gives a patient the right to force doctors to provide supposedly life-prolonging treatment even when the clinical judgment is that the treatment would be of no benefit or even damaging to that individual.

There is even a risk that the implication could be drawn that the judgment would force doctors to provide life-ending treatment.

As a result of the judgment, it is not clear to practitioners what is legal. It is crucial that they have clear principles to follow if people are to be given the best healthcare, and that is why we feel obliged to join the General Medical Council in appealing the judgment.

Yours faithfully,
PATRICIA HEWITT,
Department of Health,
79 Whitehall, SW1A 2NS.
May 22.

From the Reverend Roy C. Allison

Sir, If food and fluids are to be regarded as “treatment” in hospital, it follows that they are being recognised as part of nursing care. This being so, they become part of the NHS-funded element of nursing care (as distinct from personal care) for those in nursing homes. Does the Government realise the funding implication of this?

Yours,
ROY C. ALLISON,
(Member, Executive Committee, Christian Council on Ageing),
Coombe Cross Bungalow, Dittisham,
Dartmouth, Devon TQ6 0HZ.
May 23.

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