Leading Article: Officiously to keep alive

SENTENCE will be passed today on Nigel Cox, the consultant found guilty at Winchester Crown Court of attempting to murder an elderly patient dying in prolonged agony of rheumatoid arthritis. Subsequently he will have to face his employer, the Wessex Regional Health Authority, which runs the Royal Hampshire County Hospital from which he is suspended on full pay, and also the General Medical Council (GMC), which has the power to revoke his licence to practise.

The indications are that Mr Justice Ognall is unlikely to send Dr Cox to prison. This is as it should be. Dr Cox is a dedicated and highly regarded specialist. He had treated Lillian Boyes for many years and had developed a close relationship with her. It is clear she was suffering appallingly during a slow, terminal decline when he administered a lethal dose of potassium chloride. She had begged medical staff to help her die. Her family apparently accepted her decision. A symbolic sentence from the court would be appropriate. Similarly, it would be wrong for the GMC to deny Dr Cox the right to continue to earn his living by caring for the elderly. As for his employers, they should think hard before dismissing him or leaving him in administrative uncertainty for any length of time. For every potential patient who has qualms about being treated by Dr Cox in the future, there are likely to be half a dozen who would regard him as a good and kindly man and who would seek him out.

It is precisely because this heart-rending case is so unambiguous that it is likely to prove a watershed. The horror of Mrs Boyes's condition, the sincerity of her wish to die, the acquiescence of her family and the competence and integrity of the doctor are all beyond dispute, as is the fact that the fatal injection speeded her death by a few hours at most. The distress of the jury was obvious.

As a result there will be renewed interest in a change in the law. The Voluntary Euthanasia Society wants doctors to be allowed to respond favourably to patients suffering from incurable conditions who request, under controlled conditions, actively to be helped to die. 'Actively' is the key word here. It takes the debate beyond the question of how far doctors should treat those whose suffering is intense and/or whose prospects of recovery are non-existent. High technology now enables hospitals 'to strive officiously to keep alive' an increasing number of patients lingering in agony or in limbo. The law should offer complete protection to doctors who - at the request of patients - decline to give such treatment.

Parliament should, however, think hard before legalising active euthanasia. The relationship between a gravely ill patient - frightened, perhaps disorientated by heavy medication, often in severe pain - and his or her consultant is an unequal one. A request to put an end to suffering could easily be induced or assumed. Dr Cox merits the most sympathetic treatment, but the case against euthanasia remains powerful.