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U.S. Doctors at Odds With Call to Remove Winnipeg Man From Life Support

Posted on: Friday, 11 January 2008, 21:00 CST

By Tamara King, THE CANADIAN PRESS

WINNIPEG - A family's fight to keep their 84-year-old father on life support because of their faith has turned into a messy court case that is pitting physicians' opinions against one another.

Several doctors at Winnipeg's Grace Hospital say Samuel Golubchuk has minimal brain function and because chances of recovery are slim, they want to disconnect his ventilator and pull his feeding tube.

Golubchuk's adult children believes that would be a sin under the Orthodox Jewish faith because it would "hasten his death."

On Thursday, exactly a month after the first court hearing, Court of Queen's Bench Justice Perry Schulman called lawyers back to debate whether to allow sworn statements from a pair of American doctors, who are suggesting Golubchuk's condition has improved.

Neil Kravetsky, the family's lawyer, argued since it's a life-and-death situation, the new evidence is important enough to reopen the case.

"I don't believe Mr. Golubchuk (is) shown to be dying," Kravetsky read from Dr. Leon Zacharowicz's affidavit.

Kravetsky said that there's no evidence that Golubchuk is brain dead, or "close to brain dead," according to what Zacharowicz, a neurologist, wrote after reviewing the patient's medical charts.

The document was not released publicly because the judge has yet to rule on whether it would be admitted as evidence.

But lawyers for the Winnipeg doctors involved with the case suggest the real question is whether physicians have the right and the ethical responsibility to make end-of-life decisions.

"All the court is deciding is the appropriate person to make the judgment," said Bill Olson, the lawyer for Dr. Bojan Paunovic and the Winnipeg Regional Health Authority, which oversees the Grace Hospital.

"What is not before the court ... is whether doctor A, doctor B, doctor C or doctor D's decision was to be preferred."

Even if the judges' ruling agrees with Winnipeg doctors and the hospital, medical staff would make an up-to-date assessment on Golubchuk's condition, Olson said.

Schulman gave no indication Friday whether he would admit the two doctors' evidence. He told court he hopes to have some sort of decision next week.

Most physicians want to see a decision that is based on legal precedence, rather than an interpretation of the clinical facts, said Dr. Jeff Blackmer, executive director for the Canadian Medical Association's board of ethics.

"We don't want to see the courts substituting their judgment for the clinical judgment of physicians," Blackmer said in a recent telephone interview.

According to Orthodox Jewish law, a man in Golubchuk's condition is "fully alive," says a senior rabbi within the faith.

"Certainly, any attempt to terminate his life would be considered euthanasia, and therefore is strictly forbidden in Jewish law," Rabbi Basil Herring, the executive vice-president of the Rabbinical Council of America, said in a recent interview with The Canadian Press from New York.

While physicians should be respected, Herring said: "Doctors are not God. Doctors can describe clinical phenomenon, but the decision to whether someone should live or die is not a medical one."

Blackmer argues that ultimately, death is not caused by shutting off of the ventilator, but by the underlying disease state.

"It's not euthanasia, no one calls that euthanasia anymore. That's an outdated concept, and really, a grossly inappropriate use of the term," said Blackmer.

There are no countrywide guidelines on end-of-life decisions. The practice differs from province to province, from health-care region to health-care region, and sometimes, even from hospital to hospital.

Source: Canadian Press

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