By Michael Horsnell

An ethical backlash by doctors opposed to euthanasia is emerging in the wake of the British Medical association's new guidelines on refusining food and water to patients.
More than 6000 doctors are expected to support the launch of the Medical Ethics Alliance an umbrella group that aims to fight the proposals and galvanise what it calls "the silent majority" of doctors.
The guidelines published in June, effectively dispense with the need for court orders before nutrition and hydration by tube are withdrawn from patients in a persistent vegetative state (PVS)
More controversially, the BMA wants doctors to be allowed, without fear of prosecution, to authorise withdrawal in cases involving stroke victims and the confused elderly, even when the patient is not terminally ill. In cases where relatives object, they would have to go to court to prevent withdrawal of fluids.
An interdenominational movement of doctors from the Christian, Jewish and Muslim faiths is combining with other non-secterian groups who still abide by the Hippocratic oath to combat the proposals.
Many doctors who affirm under the oath that they will "first do no harm" to their patients are dismayed that a debate and vote on the issue were denied them at the BMA`s annual representative meeting in Belfast last month.
The Medical Ethics Alliance is drawing up a constitution and hopes to set up its own website to test opinion.
The Alliance believes that if the guidelines are accepted by the law and by health trusts, some patients will be subject to a lottery of treatment, dependent on the views of doctors caring for them.
The acting chairman of the group is Anthony Cole, a consultant pediatrician and former Mater of the Guild of Catholic Doctors.
Dr Cole, 60 who is also a magistrate said " The silent majority of doctors still subscribe to the Hippocratic tradition. Medical excellence is dependent on sound medical ethics. All people are of inestimable worth whatever illness or disability they suffer. The right to life is fundamental and many hold that life is sacrad."
He added" We are not vitalists. Death must be accepted and burdensome and futile treatment must be withdrawn. But to withdraw food and fluid from the sentient is to inflict suffering. Fortunately a lot of doctors and carers are not in tune with this death ethic."
The Alliance plans to draw up its own guidance on the the withholding or withdrawing of life-prolonging medical treatment.
The Alliance which is backed by three Hippocratic groups-Hope, The World federation of Doctors and First Do No Harm- has received messages of support from Jonathan Sacks, the Chieh Rabbi and Dr Jafer Qureshi, a consultant Psychiatrist after a meeting of the medical and health committee of the Muslim Council of Britain.
There is anecdotal evidence that patients have overheard and recalled discussions about withdrawing their fluids and nutrition. There is also published evidence that as many as four out of ten patients said to be in PVS were found to have been incorrectly diagnosed.
Inquiries by The Times show that more than 60 cases of alleged "back-door euthanasia" are under investigation by police and health chiefs, amid fears that the BMA guidelines could legitimise the practise of withholding hydration.

THE TIMES 12th August 1999