A "tired and stressed" doctor administered a dangerously high dose of diamorphine to a terminally-ill patient so he could "die in peace", a medical disciplinary panel was told.
Dr William Lloyd Bassett allegedly injected around 10 times the accepted amount of the drug into a 65-year-old man who was suffering from terminal lung cancer.
The General Medical Council disciplinary panel was told today that Dr Bassett, who works as a general medical practitioner in Brown Clee Medical Practice in Shropshire, carried out his final treatment on "Patient A" on May 29 2009.
Peter Atherton, counsel for the GMC, said: "The GMC alleges that Dr Bassett administered a dangerously high dose of diamorphine with the intent of hastening the patient's death."
Mr Atherton said that at the time of the incident, Dr Bassett was "highly regarded" by his colleagues and patients and had a particular interest in palliative care.
At around 1pm on May 29, Dr Bassett made his fourth visit to Patient A in 24 hours.
The patient was very "unsettled and frightened" by his illness, the hearing was told.
Mr Atherton said the doctor administered 100mg of diamorphine to the patient.
The hearing heard that in his notes Dr Bassett said it was "large dose but he is dying and I would like him to die in peace".
Later in his notes, the doctor described telling the family about what he had done.
He said they discussed the high dose of morphine and were "told honestly what morphine did, ie) hasten death".
The notes also said: "Family accepts this."
The nurses who were caring for the patient reported the incident, as they believed it was a "serious departure" from the end of life care standards.
The matter was reported to West Mercia Police and on June 12, 2009, Dr Bassett gave police a prepared statement in which he said he had injected the full dose of 100mg of diamorphine to the patient "accidentally" due to the fact he was "struggling".
He said he had not intended to inject the full contents of the syringe and he accepted he did not give any thought to trying to reverse the effects of the overdose but that he believed what had happened was "in the best interests" of the patient.
Mr Atherton added: "He said in hindsight he was wrong and he should have taken some action to reverse the effects.
"He said it was not his intent to cause the patient's death and that it was caused by stress and tiredness and that he had allowed his own emotions to affect his decision making."
The GMC called in an expert to review the evidence who found that the 100mg administered was between six and 10 times greater than he would have expected to see.
The expert also said Dr Bassett carried out the injection "at a time when his judgment was affected by a distressed patient and his family, stress from overwork and tiredness due to an interrupted night's sleep on the previous night".
"His actions fall significantly below the standard accepted of a reasonably competent general practitioner," the expert said.
The hearing was told that Patient A's family have no grievance with Dr Bassett and do not wish to take part in the GMC proceedings.
The doctor accepts he administered 100mg of diamorphine, that he took no action to reverse it, and that his actions put the patient at risk of respiratory failure.
But he denies he did it to hasten the patient's death.
The GMC alleges his fitness to practise is impaired because of his misconduct.
The hearing is scheduled to last three days.