It was the longest period that an American jazz musician had performed there and he

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It was the longest period that an American jazz musician had performed there and he built up a considerable reputation, which helped him survive financially in the late 1970s and 1980s.If the consistent quality of his musical output diminished in the 1960s, the myth surround ing Baker grew. The report recommends that a limit be placed on the number of opinions that patients and health authorities are allowed to seek (the Patients Charter currently permits two) and that children should be given a greater say in how decisions are made.Was it all worth it for Jaymee? The central issue in the case was the ancient medical conundrum of how to ensure that more good is done than harm. As the report says, it reflects the individualistic values to which medicine has always subscribed. They usually have a very large private practice and whatever rules we decide are appropriate in the NHS, they won't apply to private practice."Each side clung to its own view and its right to disagree.

As one paediatrician put it: "Some specialists would feel that somebody is trying to tell them how they should or shouldn't practise medicine It's very classical behaviour of famous specialists. The paediatricians accused the adult specialists of "clinical arrogance" and the adult specialists responded with charges of "empire building" by the paediatricians.It was also a clash between state and private medicine. "I won't go on doing treatments that I think are wrong for children or unkind to children."The adult leukaemia specialists whom David Bowen consulted at Hammersmith Hospital and the private Portland Clinic took the view that extending Jaymee's life was worthwhile even if she could not be cured. They cited Mr Bowen's strong wish to do everything possible and Jaymee's courageous attitude to her illness.

Professor John Goldman of the Hammersmith said: "If you say that just prolonging people's lives for six months is futile, then for practical purposes I'm out of business We don't cure that many people with proper cancer. We do prolong their life."Dr Peter Gravett, the consultant haematologist who treated Jaymee privately, said: "Paediatricians feel that if there is no protocol then there should be no treatment."This clash of philosophy generated fierce animosity. It would allow her to enjoy what remained of her life, avoiding further suffering - and there was no guarantee, anyway, that more aggressive treatment would gain her extra time. Dr Valerie Broadbent of Addenbrooke's said that all her clinical experience confirmed that further intensive treatment in Jaymee's case would not be in the patient's best interests. Two months later, she died a harrowing death.In this unique and sensitive study, the authors, Professor Chris Ham and Susan Pickard of the Health Services Management Centre at the University of Birmingham, were granted interviews by all the protagonists in the case, most importantly with the senior consultants, who have never spoken about it before. She was concerned with what she called "good death and bad death." Dr Simon Meller of the Royal Marsden was unequivocal.