Prof David Hatch
GMC Working Party
Standards Committee

Dear Prof Hatch

We have ben following recent parliamentary debates and have taken note ot a number of ministerial statements which appear to us to be of great importance. "When a patient is in hospital there is no doubt that the doctor owes a duty of care. That certainly includes a requirement not to kill the patient intentionally by any means act or ommission"

This is a very clear statement that we welcome. We are also encouraged by the debate in the Scottish Parliament on the subject of medical decisions made on behalf of incompetent adult patients. In the debate on the Incapacitated Adults (Scotland)Bill Mr Iain Gray SMP and a member of the Scottish Executive had this to say during the debate of the first of March; "Concerns have been raised regarding comments in the BMA guidelines on non pvs patients such as those who have suffered stroke. The Law Hospital case only applies to pvs. To withdraw hydration from non pvs petients with the purpose of hastening death would leave a medical practitioner open to criminal charges"

In the susequent debate he took issue with the BMA`s view that it was no longer necessary to seek a court declaration on withdrawal of fluids in pvs patients in Scotland. In the debate of 1/3/00 he said; "...to take that action witjout the authority of the Court of Sessions would leave the doctor open to prosecution".

We are not alone in the profession when we hold that food and fluid should be given with medical assistance if necessary , to those who need them and would suffer from the lack of them'

Many including ourselves would accept the conclusion of the report of the House of Lords Committee on Medical Ethics (1994 s 285)where there is an exeption made made when the adminisrtation is evidently burdensome in itself' Although this report was accepted by Parliament in 1994 ,no mention of it appears in the BMA document.

Signed Chairman of the Alliance.
18/7/00