Melanie McDonagh: We are not talking here about killing the poor infant

The case of baby Charlotte, the mite whose parents lost their attempt to ensure that her hospital carers should keep her alive for as long as possible, was initially redeemed by the reflection that everyone in this distressing case acted for the best. Mr Justice Hedley, the judge who ruled against the parents, is a decent Christian; Portsmouth hospitals NHS trust was motivated by the baby's best interest, and the parents, Debbie and Darren Wyatt, wanted life, against all the odds, for their child, while paying tribute to the care given her by the hospital.

Alas, that consensus about the essential decency of all concerned took a battering yesterday with the revelation that Mr Wyatt had, during his previous marriage, behaved so badly that his first wife, Amanda, barred him from access to their three children, though he says that he is now a different man after returning to his Christian faith. Fair enough. People do change. It may be that Mr Wyatt's consciousness of his conduct towards his other children is one of the things that makes him now so anxious to do the right thing by this baby.

Plainly, the case is as distressing as can be, but I can't, myself, find that the judge's decision is as contentious as many distinguished and kindly commentators have found it to be. Of course, we should attempt to prolong life wherever possible. But we are not talking here about killing the poor infant, who was born three months prematurely. We are talking about not going to extraordinary means to keep her artificially alive. There is a difference.

So far as I understand it, in order for the baby to have the maximum chance of survival, the parents want her to be given artificial ventilation - treatment which the judge describes as "aggressive" - over and above the extra oxygen she already receives in the plastic box that covers her head. Both the judge and the parents want the hospital to consider giving Charlotte a tracheostomy, as part of her palliative care - the insertion of a breathing tube through the throat.

But after this ruling, if the baby's condition deteriorates further, she will be, as the judge put it, "allowed to slip away peacefully" rather than artificially ventilated. Or, as her parents have insisted, she will die in their arms. I can't help thinking that this outcome is as decent, and human, as most of us would wish.

It's also a far cry from the treatment given to other unfortunates in the NHS who, like this baby, are in no position to decide their own fate. Being allowed to die, like Charlotte, is one thing; being killed is quite another. And according to British Medical Association guidelines, it is legitimate for doctors not only to withhold aggressive ventilation from a patient, but also to withdraw hydration and nutrition. Or - let's cut to the chase, shall we?- doctors want to be able to starve their terminally ill patients to death if they think it's in their best interests. And to cause them to die of thirst - about the most agonising death I can think of.

To any sane way of thinking, food and water, whether administered through a tube or at the end of a spoon, isn't medical treatment in the way that artificial ventilation is. It's fundamental care.

Yet since the grim precedent of the Tony Bland case, the young man who was left in a vegetative state after the Hillsborough disaster in 1989 and whose parents decided that his feeding tubes should be withdrawn, feeding and watering a patient now counts as medical treatment and can be withdrawn at the say-so of a patient's doctors or parents.

It would be useful, then, if the same heartwarming publicity that has been accorded baby Charlotte could be extended to Mr Leslie Burke, who is, admittedly, both male and grown up, but who is also terminally ill and who has gone to the High Court to secure a ruling that he will never be starved by his medical attendants.

The judge, Mr Justice Munby, decided that it would be hard to see how the suffering of being denied food and water could be squared with the European Convention on Human Rights. The BMA - presumably exorcising the Hippocratic oath its members used to take from its memory - is appealing against his decision.

By comparison with the death which some patients will undergo if the BMA has its way, I fancy that baby Charlotte's passing will be a model of dignity and peace.