I refer to Dr J Veight's amusing comments in his letter , Anwar does not require a medical decision.

In order to justify his strongly held opinion, that Anwar Ibrahim be allowed to go to Germany for micro-endoscopic spinal surgery, he insults me - and all Malaysian doctors - as being paternalistic. He just goes on and on.

In discussion with doctors who have examined Anwar, I have come to my own opinion as to what is required. I have shared this opinion with the readers of this forum, and my belief is that it is in Anwar's best interests to have his surgery urgently, and this would mean here in Malaysia, and this would mean open surgery.

If in a context where Anwar was a free man, not sentenced to jail by a lawful (not necessarily moral) justice system, and that he has the option of choosing either open or endoscopic surgery, then he should be offered the pros and cons of both options and be allowed to make his own decision.

In the present context of his incarceration, Malaysian orthopaedic surgeons who have examined him repeatedly - both clinically and radiologically - have given him their opinions as to the best options for him.

And after discussing the pros and cons, have left him to make up his own mind (you don't see Anwar being dragged howling and kicking to the operating theatre do you?)

The problem seems to be that their opinions, and those of a majority of doctors acquainted with the facts, do not coincide with those of Veight and others who 'know' that Anwar needs endoscopic spinal surgery in Germany or nothing.

Yes, there are paternalistic doctors in every country (I have worked on three different continents). Thankfully, they are now becoming a minority. My patients are told the options, given my advice, and left to make their decisions.

Of course, bad decisions are actively discouraged, if for example, a patient would prefer an urut to treat a cancer. Yes, I do see these patients occasionally, and yes, they do sometimes end up going for kampung treatment even after being strongly advocated not to.

And yes, they do eventually succumb to their diseases ... often when a cure was possible earlier.