Dear Sir Nicholas

I was surprised by the editorial in the Marie Curie News of February which reported the Dutch Euthanasia Bill in at best, neutral terms.It has been clear for some time that euthanasic deaths have been improperly ascribed to natural causes and that involuntary euthanasia has been practised , as can be seen by the Remmelink Report of the Dutch Attorney General.

Last year a study in the New England Journal of Medicine showed that Physician Assisted Suicide in the Netherlands was leading to distressing symptoms or failing to result in death. Again the new Bill passed last year ,has the inherent fault of of leaving the resposnsibility for reporting euthanasic deaths to the doctor concerned. This cannot be right or an adequate legal safeguard.

The reason that the Alliance is writing is to correct the impression that the BMA`s document on the Withdrawal or Withholding of Medical Treatment is satisfactory with regard to food and fluids adminisstered with medical assistance.We published an alternative document because the BMA had not made clear that patients who are not dying and would suffer if not given food and fluids, should receive them. The two patient groups that the BMA mentioned specificaly were stroke and Alzheimer patients in connection with the withholding and wthdrawing of food and fluids.

It is often the case that the dying do not require more than fluids offered by mouth for comfort, but this is not always the case. The position that we took is that the risk of suffering should be determinative and that thirst in particular, can be relieved in a variety of ways with minimal or no invasiveness. I hope that the tone of this editorial does not signal a change in the philosophy and ethos of your admirable organisation.

Yours sincerely,
A P Cole,
Chairman Medical Ethics Alliance