WITH regard to the euthanasia debate, what is the morality in allowing an elderly, frail and terminally ill patient to be starved to death by withholding fluids and nourishment? Those who commit similar acts to animals would be prosecuted for neglect. The anomaly is that if we actively helped a person to end their life, we would be prosecuted for euthanasia.

During my career as a veterinary surgeon, I have humanely "put to sleep" hundreds of animals in order to end their suffering. I know how I would prefer my life to end.

David C Jessiman, BVMS, MRCVS, Airntully, Kirkcudbright. DR David Shaw's last statement (February 15) that "Doctors should acknowledge that there is no important moral distinction between killing patients and letting them die", is one of those scary lines of thought that could only come from someone thinking with a calculator, or with a view of the human person as machine.

There is a world of a difference between deciding to kill someone and allowing them to die. Clearly there is no point in continuing with pointless medication and treatment if it is not going to achieve its end, or if someone is unwilling, but to say that deliberately killing or terminating a life is no different beggars belief. It is clear that medical staff have to make life and death decisions even now but what Dr Shaw is suggesting turns the whole role of doctors or nurse on its head, from healers and carers to killers.

There seems to be increasingly a mindset in our healthcare ethos that if you cannot cure someone you get rid of them. The right to die shifts to the duty to die.

To imply that to allow someone to slip away is undignified and painful is a glib view of the work of those involved in caring for the dying and ignoring the development of palliative treatment. There does come a point when our present hospital and healthcare system cannot offer further help, which throws up the gap in our healthcare system in looking after the dying. The fact that most hospices are run by private charities seems to indicate the powers that be don't see this part of life as something needing properly funded support.

Fr Michael Savage, 30 Huntly Street, Inverness. I FEEL compelled to respond to the points raised by Dr Anne Rosemary Wright (February 14). My own experience is that I was widowed almost three years ago having watched my husband die from cancer. We were never aware of any myth that palliative care shortens life, but I can say with absolute certainty that while some patients may temporarily experience an increased feeling of wellbeing due to palliative care, not all of them do. I can also assure Dr Wright that when you are watching the progression of a terminal illness in someone you love, concern about the "psychosocial damage associated with illegal drug use" is not the first concern that springs to mind when that person is given legally administered opiates in a hospital bed.

Dr Wright's next point is condescending in the extreme. If the wish of some terminally ill people to end their lives is "probably" a desire for independence and control rather than an anxiety about symptom relief then so be it. Who are we to argue? The physical deterioration of the body does not equate to the deterioration of the mind, spirit and character of the terminally ill patient. Their illness does not remove their desire to protect themselves and their family, nor does it negate their feelings of responsibility to the people they love and have lived their life with. And if "probably only a minority" of terminally ill people wish the option of assisted suicide, then why shouldn't they have that choice?

I agree that most people show astonishing bravery when confronting their own death, but is Dr Wright really saying that because terminally ill patients show bravery they should not be given any other options? Her claim that a dedicated clinic would be required contradicts her assertion, oft quoted by medics, that patients "prefer to die in their own homes". I have yet to see the evidence to support this view but acknowledge that it is a convenient one for an overstretched NHS in a country which has a woeful shortage of inpatient hospice beds.

This issue is not going to go away, and the sooner the medical profession acknowledge that working in partnership with patients means listening to and acknowledging all patient needs then the sooner a constructive debate can begin.

Carol Vanzetta, 90 Dunedin Drive, Hairmyres, East Kilbride.