"Right to die": ...but context of limited resources can be encountered in developed countries too

doi:10.1136/bmj.330.7504.1389-a

BMJ 2005;330:1389 (11 June), doi:10.1136/bmj.330.7504.1389-a

Letter

"Right to die"

...but context of limited resources can be encountered in developed countries too

The first 150 words of the full text of this article appear below.

EDITOR—Grayling writes that it is perhaps characteristicof humankind that it regards reasoned choices about when andhow to die as morally problematic, whereas ignoring the questionand hoping for the best is seen as acceptable or even right.¹Vijayashankara (previous letter) reminds us of the need to considersuch decisions in the context of limited resources.

This is particularly salient for those who care for the smallminority of babies who are receiving mechanical ventilationfor inevitably lethal conditions in neonatal intensive careunits. A prospective study in 54 such units in the United Kingdomshowed that occupancy was linearly related to the odds of riskadjusted mortality.² In other words, the more babies alreadyreceiving intensive care in a neonatal intensive care unit,the more likely it was that a newly admitted baby would die.This is likely to reflect the effects of increased staff workload.

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William O Tarnow-Mordi, professor of neonatal medicine

Children's Hospital at Westmead, Westmead, NSW 2145, Australia williamt@westgate.wh.usyd.edu.au