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From: Dr Michael Howitt Wilson

15th February 2002

The Trust: The Age of Consent. Channel 4. Thursday 14th February 2002 at 9pm

This programme, whatever its intention, effectively demonstrated the absurdity and immorality of adhering to guidelines on withholding and withdrawing treatment, food and fluids and on cardiopulmonary resuscitation.

Critical decisions discussed were: whether the patient should live or die, whether the patient should be kept alive, whether or not to feed the patient and whether or not to continue fluids without which the patient would die.

It is not within the doctor's or anyone else's power to decide whether a patient should live or die. Should the patient be kept alive? It is surely incumbent upon everyone, especially doctors to take all ordinary measures to keep a person alive. To feed the hungry is a duty for all. How much more if they are directly dependent on you. Whether to continue fluids without which the patient would die, begs the question. To deliberately cause the death of the innocent is against all codes of ethics and in particular a doctor's ethics, although the Department of Health seems unsure about this. It is a fearsome health service, which encourages death and ignores human rights.

Cardiopulmonary resuscitation is an emergency action when the cause of sudden cessation of respiration and/or heartbeat is thought to be remediable. It should never be a routine treatment and can never be planned in advance. It is a very undignified and intrusive procedure to perform on a dying patient when there is little or no chance of success. Guidelines have been written back to front. They should indicate when to resuscitate, not when to decide in advance that it should not be attempted. It is a procedure, which is carried out far too often, but as with any form of treatment, to write on the notes that it is out of the question suggests to the patient and the staff that you have given up on him/her and he/she can be neglected.

No wonder patients and relatives expressed surprise that CPR decisions were being discussed and asked, "Are you expecting a cardiac arrest?" No wonder the nurse seemed unhappy to be watching Joseph dying of lack of fluids for ten days, yet still alive. Could she not at least have cleaned and moistened his mouth for him?

It is frequently asked, "What is wrong with our Health Service?" Well, would you trust this Trust?