Letter: Doctor of death

Sir: Dr Kevorkian is back in the headlines again, now flaunting his dealing in death on American television (" `Mercy killer' puts man to death on TV", 24 November). But we must exercise the greatest caution. If it were to be ruled legal that a person's life could be defined as not worth living, then the question would inevitably follow: Who is best qualified to make such an assessment?

Perhaps not the ill patient, who may be depressed or confused. Perhaps not their family members - they might be too upset to approach the issue objectively. Will the onus then fall on the medical profession to pass the sentence as well as carry out the deed, to act as judge as well as executioner?

This is not far-fetched. More than 10,000 people in Holland now carry anti-euthanasia "passports" out of fear of being killed by doctors if they fall seriously ill. And their fears are well founded, for a survey of Dutch doctors has revealed that 23 per cent have ended patients' lives without their explicit request.

Now, as the whole concept of "managed care" takes hold in the NHS, the spectre looms of guidelines and protocols setting out whose life it may be cost-effective to preserve. Put bluntly, the most economic management decision for the elderly sick requiring long-term care is to bring life to a speedy end - "managed death". And the idea of the state which looks after you "from cradle to grave" takes on a whole new meaning.


Consultant Surgeon