Windsor Humanist Society

February 14, 2008

Judge Says ‘Maintain Life-Support” – Rules Doctors Must Take All Measures To Keep Man Alive Pending Trial

Filed under: Uncategorized — moderator @ 12:32 pm

Percy Golubchuk and sister Miriam Geller praised yesterday’s decision by a judge to keep their father alive.  Doctors wanting to pull life-support from the 84-year-old Winnipeg man have been blocked by a court ruling and told to do everything necessary to keep him alive.

Percy Golubchuk ~ Miriam GellerIn issuing an order to continue an injunction preventing doctors from taking Samuel Golubchuk off a ventilator and feeding tube, Justice Perry Schulman of Manitoba Court of Queen’s Bench said if Mr. Golubchuk was allowed to die before a full trial is held on the issue, “no relief at trial could adequately compensate him or his family for the loss.

“If the injunction is continued, the plaintiff may, during his lifetime, be afforded an opportunity to be heard fully on his legal, religious and charter positions,” Justice Schulman said on Wednesday.

“I think that most reasonably informed members of the public would support my finding on the questions of irreparable harm and balance of convenience.”

Justice Schulman said he wants to see the matter come to trial “as quickly as possible.”
Mr. Golubchuk’s son, Percy, and daughter, Miriam Geller, expressed relief after hearing the judge’s decision.

“God is with us,” Ms. Geller said. “This is for all the people in Canada and the world.”

Percy Golubchuk said “doctors are not always right.”

“God is the main doctor.”

When asked what their father would say about the decision, Percy Golubchuk said “he would be very proud of us — he would say ‘way to go.'”

Mr. Golubchuk has been treated in the intensive care unit of Grace Hospital since October after coming there suffering from pneumonia and pulmonary hypertension.

But after doctors decided further treatment would be futile — and Mr. Golubchuk’s family disagreed, saying pulling life-support is against their Orthodox Jewish religious beliefs — the case landed in court.

The medical dispute is being followed by people from around the world with even an online petition on the Internet garnering more than 2,800 signatures of support just days after being set up. And when you Google ‘Golubchuk’ and ‘petition,’ 421 websites pop up.

The family’s lawyer, Neil Kravetsky, used Justice Schulman’s decision to criticize The College of Physicians and Surgeons of Manitoba who just two weeks ago issued guidelines to physicians giving them the right to pull life-support.

“I think the college was irresponsible,” Neil Kravetsky said.

“They better smarten up before they issue directives that may border on criminal.

“This decision means any doctor who comes to that hospital has to maintain (Golubchuk’s) life.”

But Dr. Terry Babick, deputy registrar of The College of Physicians and Surgeons of Manitoba, said the college won’t be reviewing its end-of-life guidelines in light of the judge’s decision.

According to the college’s new guidelines on withdrawing life-support, released in January, the final decision to end support lies with the physician.

Terry Babick said the guidelines allow a four-day window giving families a chance to seek other counsel and in rare cases, a court injunction.

If patients or families are dissatisfied with a physician, Dr. Babick said they also have the option of filing a formal complaint to the college.

“At the end of the day, as happened here, the family appealed to the courts,” Dr. Babick said. “So where there is disagreement in rare circumstances, that’s why we have the courts.”

Pat Murphy, a medical ethicist based in St. Boniface General Hospital, said the court’s decision upholds the idea that physicians must seek mediation before ending treatment. She said it’s essential for patients and doctors to build consensus instead of pitting patients and their physicians “against one another.”

More importantly, Ms. Murphy said, the judge clarified that there is no law that gives doctors the right to have the final say on when to end a life.

“It’s not settled in law that doctors have the final say in these matters,” she said.

There are no Canada-wide guidelines on withdrawing life-support, and the practice differs between most hospitals and provinces.

Click here to download Justice Schulman’s decision.

New College of Physicians & Surgeons’ of Manitoba Guidelines for doctors wanting to withdraw life-support:

In the event a patient could achieve the “minimum” quality of life but the physician concludes the treatment should be withdrawn, as in Mr. Golubchuk’s case, the doctor must first get a second opinion from another physician.

If the second physician agrees treatment should be withdrawn and the family still disagrees, physicians must offer a time-limited trial of treatment or involve a patient advocate or mediator to help resolve the process.

If no consensus can be reached and the doctor concludes life-support should be withdrawn, the physician must provide the patient’s family with written or verbal notice 96 hours before life-support is stopped.

The guidelines apply to all Manitoba physicians and came into effect Feb. 1.

Backgrounder On Mr. Golubchuk’s Situation:
Four years ago Mr. Golubchuk fell down a flight of stairs and hit his head, sustaining injuries that resulted in his becoming both physically and mentally disabled. Confined to a wheel chair, he requires assistance for the most basic of needs. Communication with the outside world has been a challenge for him since he can no longer speak more than a word or two at a time, and even then usually only in response to others.

When living in a long-term care facility, he hadn’t been confined to his bed. His family visited with him, takes him on outings, and bringing him home for holidays and other family celebrations. It’s not always easy for outsiders to tell how he feels about these excursions, but his family says they always can. Every now and then he manages a smile. Recently, when his family brought him bowling, he even tried to push a ball down the lane. Some might say that he wasn’t very successful in his attempt, but not his children. For them, they say small acts like this bring the greatest joy.

Last October, Mr. Golubchuk got sick. Although not serious at first, it quickly developed into a life-threatening case of pneumonia and he was moved to Winnipeg’s Salvation Army Grace Hospital, where his life hung in the balance for some time. With treatment, he beat the pneumonia.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
…this post forwarded by Windsor Humanist, Alexander Neil, after a February 14, 2008 article by Kevin Rollason & Jen Skerritt in The Winnipeg Free Press

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