LESLIE Burke, a 45-year cerebellar ataxia sufferer, won a landmark ruling last year to stop doctors withdrawing food and drink when he cannot speak. He feared reaching a point where, unable to communicate, he would be denied food and water and would take weeks to die of starvation and thirst.

The decision, at the High Court in London, was controversial, but one which suited the current emphasis on individual rights. It was seen as a shift in the balance of power away from the doctor to the patient, and from the medical profession to the courts.

But can patient autonomy work in such sensitive areas? The General Medical Council, quietly appalled by a ruling which puts doctors in an even more impossible position than they are already in when dealing with terminally ill patients, yesterday went to the Court of Appeal to try to overturn Mr Burke's so-called right-to-life victory.

They want clarification of a situation which, as it now stands, removes doctors' broad powers to withdraw treatment based on their perception of a patient's quality of life. It means that doctors are obliged to provide treatment notwithstanding their clear professional view that the treatment will either provide no benefit, be futile, or will even cause greater suffering.

Mr Burke, a wheelchair-user and disability campaigner from Lancaster, appears to be a brave and dogged man. That does not make him right.

Nor does it entitle him to alter the delicate moral balance in the doctor/patient relationship in a way which will adversely effect everyone else who seeks as dignified a death as possible.

What is at stake here - what the GMC is fighting for on behalf of all of us - is the right of the terminally ill to have treatment withheld when it serves them no further benefit. One of the issues the council seeks to clarify is whether antibiotics and respiratory intervention are, like artificial nutrition, classified as treatment.

Otherwise the Burke ruling demands the use of all kinds of potentially inappropriate medical intervention.

If one believes in the right to a peaceful exit, as patently the vast majority do, then this ruling amounts to an insensitive diktat that decrees that for as long as breath remains in a body doctors must invade it with tubes, drugs, artificial nutrition and expensive, futile, "life-prolonging" procedures.

For every individual unfortunate enough to suffer a dreadful condition like Mr Burke, and to dread the withdrawal of treatment, there will be 20 individuals in extreme old age, or in the throes of terminal cancer, who could under the ruling as it stands be kept alive when they desperately desire to slip away. This is not justice.

Let us not prevaricate about the underlying implications of the Burke decision. By granting rights to the few, it removes them from the many.

The GMC seeks to overturn a ruling which, fundamentally, removes the professional discretion of doctors in managing death. In the absence of instructions to the contrary, from relatives or in the form of a living will, only when things become "intolerable" can they withdraw life-prolonging treatment and accept the inevitable.

Few of us, I suspect, particularly want to wait until our condition is "intolerable". Mr Burke's no doubt genuine intention to increase compassion has in fact lessened it for the rest of us.

This in itself would be bad enough.

But the bigger danger of this case is that loud clatter you hear in the background, which is the sound of people with issues jumping on to Mr Burke's bandwagon. This appeal is becoming an international cause celebre for those who think death can be postponed indefinitely.

The Disability Rights Commission and Patient Concern are backing the Burke ruling. The Catholic Bishops Conference of England and Wales is making representation in the case.

And, chillingly, an American lawyer who advised the family of Terri Schiavo, the brain-damaged Florida woman, is also involved on Mr Burke's side. Wesley Smith claims this appeal could be the most important right-tolive case ever, setting a precedent around the world. Hijack, anyone?

The Christian Medical Fellowship, for its part, says the original Burke ruling signalled a dramatic shift from bedside decision-making to the courtroom, away from the everyday pressures of bed management and finances, and said that Christian doctors should welcome it. "It provides a means of resisting the pressures of expediency and truly considering what is best for vulnerable patients, " said a statement.

Which is pretty offensive to doctors, implying as it does that their decisions are based not on compassion but on resources. But such a corrosive atittude goes to the heart of this case: the lack of trust, the cynicism, the Shipman effect, which is destroying patients' relationship with doctors and drives the fearful to law.

Along with this goes the fashionable climate of managerialism. This case exposes how scared we have become to make decisions on an individual basis, case by case. This is too risky for today's regulated world.

Even the incredibly delicate matter of a doctor deciding when a dying person should be allowed to fade away, it seems, must be laid down by law - when common sense says it cannot possibly be.

Given proper safeguards, there is a silent majority in favour of letting doctors ease us out of life by withdrawing treatment. I suspect most people would also support the withholding of treatment from people who have had a catastrophic stroke or suffer advanced dementia.

Many go further and believe in doctor-assisted suicide - witness the cheers that erupted in Newcastle Crown Court some years ago when a GP, Dr David Moore, was cleared of the murder of a terminally ill cancer patient who begged for pain release.

But in general this is a deeply twilight area in which the majority stay quiet and the minority make most noise.

The art of dying well is not something we can practise. Sadly. We only get to go once and how we do it is, for the most part, outwith our control.

We may hope, for our own sakes and the sake of our relatives, that death is swift and clean: everyone fancies the idea of dropping dead at a great age, fit and well, without knowing a thing about it, thereby avoiding physical suffering and the dread with which most people anticipate the end.

But few of us are that lucky. Most of us are fated to end up ailing, wretched and dependent on the compassion of doctors. Having managed two such deaths in recent months, I can assert that people in those circumstances are desperate to die. It is an absolute truth: there is a point at which treatment of any kind ceases to be of benefit to the patient. And the law must recognise it, for the sake of mercy.