The doctor cleared of misconduct in hastening the deaths of two terminally ill babies called yesterday for more debate on end-of-life decisions.

Michael Munro emerged with his reputation untarnished after a ruling by the General Medical Council that he had not acted inappropriately and that his fitness to practise was unimpaired. The consultant neonatologist had been accused of “actions tantamount to euthanasia”. After the hearing he said that he was very relieved to have been cleared.

He said he hoped that the outcome would promote further consideration of the treatment of premature babies and clearer professional guidance for doctors.

Dr Munro, 41, had admitted injecting two premature babies with a large amount of muscle relaxant to ease their suffering as they entered the final phase of the dying process. He did so with the support of the babies’ parents, who had already taken the decision to withdraw breathing tubes from their infants.

The GMC acknowledged that clear guidance was lacking in this area and said that it had assurances that Dr Munro would not act in the same way again. It found that at all times he “sought to act in the best interests of each baby” and concluded it was “neither necessary nor proportionate” to issue a warning to him. Earlier, allegations that Dr Munro had acted inappropriately were also dismissed.

Dr Munro said after the hearing in Manchester: “I very much regret any distress caused to the parents of both babies by these proceedings.

“I hope that today’s decision will promote further consideration of the treatment of neonates and the end-of-life decision-making and that this, in turn, will lead to clearer professional guidance for doctors, better patient care and greater support for parents.

“Obviously, I am very relieved by the outcome of the fitness-to-practise panel hearing and I would like to thank everyone who has supported me over the last few months.”

The actions by the doctor took place in 2005 at Aberdeen Maternity Hospital. Dr Munro, a graduate of Aberdeen University, has been a consultant at the hospital for seven years. He specialises in treating premature babies.

The GMC said in its ruling to Dr Munro: “Having regard to the lack of clear, specific, professional guidance and that it is undisputed that your intention was to relieve suffering rather than to hasten death, the panel is satisfied that at all times you sought to act in the best interests of each baby.

“Doctors should exercise extreme caution when giving treatment outside accepted professional practice. However, in these particular circumstances, the panel found that your actions were not inappropriate or below the standard to be expected. In the judgment of the panel, the concerns raised by the facts are not so serious as to raise the question whether you should continue to practice. Accordingly, the panel has determined that your fitness to practise is not impaired.”

The GMC said that Dr Munro administered the drug pancuronium, a muscle relaxant, which was outside accepted professional practice. He did so when the babies suffered violent body spasms accompanied by irregular, gasping breaths shortly before death — a phenomenon known as agonal gasping.

Last night official bodies reasserted the existing guidelines on end-of-life issues for premature babies. Roelf Dijkhuizen, medical director of NHS Grampian, said it agreed with the GMC’s view that the doctor’s actions were taken in the best interests of the babies and their families.

He said: “The treatment given to both babies was not part of accepted practice and therefore the decision was taken to refer Dr Munro to the GMC. Since the incidents, a protocol for all end-of-life decisions has been put in place. It complies with the guidelines of the GMC and Royal College of Paediatrics and Child Health.”

The Royal College of Paediatrics’ document Withholding or Withdrawing Life-Sustaining Treatment: A Framework for Practice states that it would be unlawful to use a paralysing agent “simply to avoid terminal gasping . . . which should be managed with more appropriate and specific treatment to relieve distress.”

The British Medical Association said: “Our view on assisted dying is that we are opposed to it and it is illegal.”

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