From Mail Online.

By Steve Doughty
7th March 2009 

Doctors have been warned they will be struck off if they ignore the wishes of patients who have made 'living wills' which say treatment should be stopped.

The ethical rules of the medical profession will in future demand that doctors obey the living wills, in which patients can ask to be killed if they become too ill to speak, eat or drink.

The new guidelines for medical staff appear to reverse the ancient principles of saving life which underpin the work of doctors. These are expressed in the Hippocratic Oath which states 'a physician shall always bear in mind the obligation of preserving human life'.

The new draft guidelines are to be circulated by the General Medical Council, the regulator for doctors, for consultation over the spring and summer. They are likely to come into force later in the year.

They update the rules which govern the behaviour of doctors to take into account Labour's Mental Capacity Act, the law which gave legal force to living wills. Doctors can already be prosecuted for assault and jailed if they try to save a patient who has given an advance directive for treatment to stop.

Under the law, living wills do not have to be written and doctors must act on what they believe to have been the patient's wishes. The new guidelines yesterday drew a blizzard of criticism from MPs, medical ethicists and campaigners against abuse of elderly and vulnerable patients.

Dr Peter Saunders, of Care Not Killing, said: 'We have always opposed legally binding rules. A doctor who treats their patient can now be actively breaking the law.'

Tory MP Julian Brazier said: 'Medical staff will frequently have crises of conscience when the law requires them to do something they know is wrong. The GMC guidelines reflect a pernicious law.

'There is always a terrible risk with living wills that somebody has changed their mind and the doctors do not know. There is also a high risk that people have relatives with a vested interest in their death.'

The GMC said that the rules were to ensure that doctors remain within the law. But critics said that the council had been guided by law which in practice makes euthanasia a legal requirement.

The new guidelines said: 'A valid advance decision or directive refusing treatment is one that was made when the patient had the capacity

to decide, on the basis of adequate information about the implications of his or her choice.

'A valid advance refusal must be respected, where it is clearly applicable to the patient's present circumstances and there is no reason to believe that they have changed their mind.' They added that 'acting against the patient's wishes should be deemed to be causing harm'.

Doctors are warned: 'Serious or persistent failure to follow this guidance will put your registration at risk.' The guidelines spread concern-in the medical profession that doctors will be firmly bound by both the criminal law and their own professional rules to kill patients who are not dying.

Tory MP Nadine Dorries said: 'It's a thin line between someone wishing not to continue with treatment - and the state or others making that decision on someone's behalf. All over the UK patients are being cared for safe in the knowledge that their life is protected in law. This ruling will make many vulnerable and elderly people very nervous indeed.'

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