Serious doubts about assisted suicide ONCE again, the subject of euthanasia/assisted suicide appears in the papers. I would like to raise a few points. First, assisted suicide in the context of terminal illness should not be conflated with suicide as an expression of psychotic depression or with episodes of self-harm. These are completely different entities.

Serious doubts about assisted suicide
ONCE again, the subject of euthanasia/assisted suicide appears in the papers. I would like to raise a few points. First, assisted suicide in the context of terminal illness should not be conflated with suicide as an expression of psychotic depression or with episodes of self-harm. These are completely different entities.

Secondly, I would like to dispel the myth that effective palliative care leads to a shortened life. On the contrary, relief of symptoms and increased wellbeing are more likely to increase life expectancy. The most frequently used drug group in terminal illness is opiates (which includes morphine and heroin). Used legally and in correct doses, these are extremely "clean" drugs whose only major side-effect is constipation. The psychosocial damage associated with illegal opiate use has led to misapprehension about safety and effect.

Thirdly, it seems probable that the wish of some terminally-ill people to end their lives is an expression of desire for independence and control rather than anxiety about symptom relief. This is a legitimate attitude but probably that of only a minority. But terminal illness does not in itself justify abrogation of all social responsibility.

This brings me to the fourth point. Just who will take responsibility for assisted suicide or euthanasia? Who will do the (no doubt, quite extensive) legal work and who will administer the lethal dose? It is quite unrealistic and unfair to assume that either hospital or community medical professionals should take this on. It would be an ethical and emotional stress too far for most. Change in the law is unlikely to produce a killing spree; much more probable is that it would be extremely difficult to find professionals who would take this on. At the very least, it would require a dedicated clinic. Even then, staffing might be problematic and would need endless checks and safeguards. Unless it was completely funded by the NHS (unlikely), this would have very little advantage over travelling to Switzerland, apart from saving air miles, and would not be compatible with the wish to die at or near home.

Palliative care may be "patchy" but it has steadily developed over the past decade and is likely to go on doing so. Most people show amazing bravery when confronting their own death and in their last months of life may both console and inspire those they leave behind. For families and friends, sudden death is more disturbing - there is no opportunity to say goodbye. Those who would have their lives ended may believe their reasons are altruistic, but they may well have got it wrong.

Dr Anne Rosemary Wright, Ardlea, Ardmory Road, Rothesay

No excuse for not preventing blindness
Thank you for reporting the case of Marina Borrows (February 12) who has lost her sight following the refusal of Greater Glasgow Health Board to provide facilities for the treatment of her eye condition. We have previously, through The Herald, highlighted instances of people with the condition known as "wet AMD" who are at risk of sight loss because Macugen treatment is not being provided by health boards six months after the drug was approved for NHS use by the Scottish Medicines Consortium.

It is a terrible indictment of the present system that even when a health board, in this case Forth Valley, is willing to pay for a patient's treatment, the intransigence of another health board can result in that person losing their sight. If a clinician believes that Macugen treatment can prevent someone's sight from deteriorating, then there is no excuse for not delivering that treatment.

The statement by Greater Glasgow Glasgow Health Board that "the prescribing of Macugen is of uppermost importance and priority to us" is meaningless so long as it fails to implement it. It is time for health boards to give priority to the prevention of avoidable sight loss and provide the resources to deliver available treatments. Otherwise Marina Borrows may not be the last person to lose her sight needlessly.

John Legg, Director, RNIB Scotland

Regarding your article on February 12, I have been pursuing NHS Greater Glasgow and Clyde to provide a Macugen service for patients with wet age-related macular degeneration for several months now. The health board wrote to me in January informing me that it was intending to put in place a business plan which would eventually lead to the provision of Macugen. Last week in the Scottish Parliament I asked Lewis MacDonald, the Deputy Health Minister, to explain why NHS Greater Glasgow and Clyde is only now, six months after the Scottish Medicine Consortium has approved Macugen, just formulating its business plan. Mr MacDonald responded: "Treatment centres in Glasgow have the capacity to deliver the treatment . . . It is a clear directive that health boards should respond to the SMC's judgment."

NHS Greater Glasgow and Clyde must tell us when it will provide Macugen to the estimated 300 people in the NHS Greater Glasgow and Clyde area who will benefit from it as the alternative is blindness.

Stewart Maxwell, MSP, The Scottish Parliament

MPs' Trident trip
RORY Bremner must have taken over the Ministry of Defence. Who else could have made this one up?

In order to counter the major demonstrations against Trident renewal in Glasgow and London on February 24, Des Browne, the Defence Secretary, has invited all Labour MPs to come to Faslane and have a sail on a Trident submarine, complete with weapons of mass destruction, on February 24. This is obviously intended to be Des's little counter-demonstration.

Apart from Eric Joyce and Tom Harris, who can we expect to turn up? Surely Gordon Brown will want to look at the controls that could at the touch of a button incinerate millions of innocent civilians and create a desolate environment. After all, he has expressed his enthusiasm for the project and will be using vast amounts of our taxes to pay for an upgrade. Surely the Secretary of State for Scotland, Douglas Alexander, would be failing in his duty if he did not turn up to show his support. And has Jack McConnell not had a courtesy invitation, given his new-found enthusiasm for weapons whose use would make Hitler seem almost like an amateur in the killing stakes?

Jack could then ask Des and the Trident commander in whose direction the missiles are targeted when out at sea since, when last asked, he did not know the answer to that question.

There should be a three-line whip for every other MP planning to vote with the government on Trident renewal so that we can see them all sail away. What a contribution to the future of Scotland, England and the rest of the planet it would be if they just didn't sail back.

Isobel Lindsay, 9 Knocklea Place, Biggar

Export market for Scottish water
Graeme Smith's Warning of threat to North Sea oil industry (February 13) highlights the problems that the decline of exploration activity in the North Sea will bring. The reality is that oil and gas reserves throughout the world are being depleted at an ever-increasing rate.

Scotland should be looking to the future and deciding how it is going to develop perhaps one of its greatest renewable resources: water.

People can, if forced to, live without oil or gas but they cannot survive for any length of time without water. In England, the introduction of water meters heralds the rationing of water on a price basis and the introduction of hosepipe bans is evidence that water shortages are now a fact of life particularly in south-east England.

Parts of Scotland suffer from flooding which is water running to waste and bringing misery to the people flooded out of their homes and businesses.

Water is a devolved matter and, therefore, the Scottish Parliament should be looking at methods of collecting, storing and treating this renewable natural resource with a view to exporting that which is surplus to Scotland's needs.

Research would be required into developing markets and into methods of transportation. If, as predicted, the global climate is becoming warmer, many countries, including England, are going to have to find new sources of water; therefore, the market for high-quality Scottish water should be limitless.

If, in the forthcoming elections, for the Scottish Parliament MSPs with vision are elected, then it is possible that some time in the not too distant future Scotland may have a water port.

Thomas L Inglis, 7 Menzies Avenue, Fintry

Energy shortfall
STUART Allan (February 13) is quite adamant that I should be careful "what I wish for" in relation to nuclear power stations. What I did say was that, at present, there would appear to be no alternative to cater for our future electricity needs.

The existing nuclear power plants in Britain produce about 26% of our electricity. It is intended to close down half of these by 2010 (three years hence), their life expectancy having been exceeded. Thus we shall lose 13% of output.

The government has introduced legislation to ensure that 3% of our electricity will come from wind power by 2010. Thus in three years we will be 10% short of output, and it is anybody's guess how long it would take to make up that shortfall with wind power. As further gas, oil and coal generating plants are in disfavour due to their considerable greenhouse gas contribution, I would ask Mr Allan what viable alternative he would suggest. Perhaps he should consider purchasing shares in a candle factory.

Frederick Jenkins, The Lodge, Burnton, Kippen

MSPs' expenses
IT IS disappointing that Nicol Stephen, the Enterprise Minister, so soon went back on his word to cut back on unnecessary flying (February 13). And why did he have to pay £170 for a hotel room? I recently went to central London (by train) for a meet-ing and found satisfactory accommodation for £55. The electorate would have a higher regard for MSPs if they took as little rather than as much as possible from the public purse.

Bob Holman, Glasgow

Intriguing concept
BILL Wardle introduces an intriguing concept - "rebuilding the nature of learning" (February 10). I didn't know that the nature of learning could be rebuilt. Can The Herald investigate this and tell us how it is accomplished? It sounds fascinating.

David Boyce, 26 Bute Street, Gourock