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Thursday, July 8, 1999 Published at 13:23 GMT 14:23 UK


BMA stands by end-of-life guidance

Decisions over withdrawing treatment are controversial

Doctors groups opposed to euthanasia have failed to get the British Medical Association to scrap guidelines which give doctors the go-ahead to withdraw artificial feeding and hydration from severely incapacitated patients.

An alliance of doctors' groups wanted to force an emergency debate on the guidelines at the BMA's annual conference in Belfast on Thursday.

But delegates voted against a debate and also threw out a motion calling for the conference to oppose the guidelines.

The rebels think the guidelines, which could apply to stroke and dementia patients, are the first step towards euthanasia.

Worcester GP Dr Anthony Cole said he was "disappointed" the issue was not debated.

"It is an important issue and we need to have a debate about these guidelines," he said.

He is a founding member of the Medical Alliance Opposing the Guidance on Withholding and Withdrawing Food and Fluids, which claims to represent 2,000 doctors.

It includes the Guild of Catholic Doctors, the Muslim Council of Britain's Medical and Health division and the World Federation of Doctors with Respect for Human Life.

The Alliance was set up after the BMA last month published the first guidelines for doctors on making "end-of-life" decisions.

The BMA claims the guidelines were drawn up in consultation with members and have the backing of the majority of doctors.

'Death ethic'

[ image: The BMA has published guidance on end-of-life care]
The BMA has published guidance on end-of-life care
But the Alliance claims that the power to withhold artificial feeding and hydration amounts to a "death ethic".

Dr Cole said: "The direct omission or withdrawal of nutrition and hydration with the aim, object and intention of ending life is inhumane and can never be justified.

"There is an obligation on all doctors to relieve suffering from hunger and thirst as long as those means are not excessively burdensome or dangerous."

He added: "We are concerned that while life should not be preserved at all costs, these guidelines are a danger to doctors, patients and society itself."

The guidelines advise doctors fully to assess the condition of the patient, obtain a second opinion and reach agreement with relatives before deciding whether to withdraw tube feeding and hydration.

A landmark High Court ruling in 1994 in the case of Hillsborough victim Tony Bland, who was in a Persistent Vegetative State, stated that artificial feeding was a medical treatment and could be withdrawn. The BMA still opposes the withdrawal of oral feeding which, it says, is part of basic care.

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