Dr Ken Taylor is appearing before the General Medical Council on charges of failing to properly assess 85-year-old woman and not listening to nursing staff's concerns about his decision to withdraw food and not allow her to sit out of bed.

If found guilty, he could be banned from practising.

The woman, referred to only as Mrs X, took 58 days to die after her only source of nutrition, a food supplement called Fresubin, was withdrawn.

An inquest found that she died of broncho-pneumonia caused by malnutrition.

She weighed just three stone 12 pounds when she died.

Home Office pathologist Dr Edmund Tapp told the inquest he had never seen anyone who had lost so much weight.

"She was skin and bones," he said.

Nursing staff's views

Rosalind Foster, a barrister for the GMC, said Dr Taylor had failed to conduct an adequate examination of Mrs X before he ordered her food to be withheld, had failed to take nursing staff's views into account and had not made proper efforts to get a second opinion.

She said June Bleasdale, deputy matron at Oxford House nursing home in Preston where Mrs X was living, had questioned Dr Taylor's orders and asked him to record them in the patient's nursing care plan.

She said the nurse told him she would "have no part in carrying out" his orders.

Mrs X was admitted to the home in 1991 after suffering a series of strokes.

Ms Foster said her family had begun to hope that their mother would "slip away" without any further suffering as early as 1994 and had fully backed Dr Taylor's decision.

"I do not seek to portray Dr Taylor as a callous man," she said, adding that she would not be using "emotive" terms like euthanasia during the case.

He had simply "lost sight of his objectives", she said.

For example, despite the fact that Mrs X had little awareness of what was going on after September 1994, Ms Foster said there was no evidence that her condition was worsening.

She added that there was no indication that the doctor, who works at Ashton Health Centre in Preston, had reconsidered his opinion between June 1995 and August when Mrs X died.

Denials

Dr Taylor admits ordering nurses to withdraw Fresubin from Mrs X and suggesting that she should not be moved from her bed.

He also admits being asked to record his decision in her care plan.

But he says he was not aware that the nursing staff objected to his decision and he denies knowing that Mrs X would die without Fresubin.

He denies that he failed to reassess her condition after his initial diagnosis and that he should have sought a second opinion.