June Bleasdale, deputy matron of the Oxford House Nursing Home in Preston, told the General Medical Council she refused point blank to carry out Dr Ken Taylor's order to withdraw the patient's only food source, a supplement called Fresubin.

She added that nursing staff had felt so strongly about the case that they had kept feeding the patient until they ran out of the supplement.

They hid their actions by setting up a false register for Dr Taylor and the family of the patient, known only as Mrs X.

She weighed just three stone 12 pounds when she died in August 1995, 58 days after the order was given to withdraw Fresubin.

Dr Taylor, whose decision was backed by Mrs X's family, denies a charge of serious professional misconduct in relation to her treatment.

He is accused of failing to take nursing staff's opinions on her treatment into account, failing to reassess the patient after he gave the order to withdraw food and knowing that his order would lead to her death.

If found guilty, he could be banned from practising.

Distressed

Ms Bleasdale told the disciplinary hearing that Dr Taylor, aged 51, was staring out the window when he gave the order and claimed he said: "It is not as if she is going to do much".

She alleged he said he had been approached by two members of Mrs X's family.

"He said they were both distressed and depressed at their mother's situation," she said.

"He said that they were very distressed that her position was showing no signs of getting any worse.

"He said they had discussed it and said that he wanted the Fresubin stopped and the fluid regime reduced."

"He said it was about quantity of life versus quality."

Ms Bleasdale, a Macmillan nurse, stated that she was "horrified" at Dr Taylor's order and had refused to carry it out.

"I said I would not be party to it," she said. "I was very frightened that she was going to be harmed. I was desperately worried about her."

She said she asked him if he was talking about euthanasia and said that would be wrong.

She also told him that any reduction in fluids during a very hot summer would cause severe dehydration.

Mrs X had suffered a series of strokes since being admitted to the nursing home in 1991.

But Ms Bleasdale, who broke down during cross examination, said she was fully aware of what was going on around her.

She left the nursing home four days after Dr Taylor gave the order.