Winnipeg Man’s Death Does Not End Debate Over When Doctors Can Refuse Treatment

By Steve Lambert, THE CANADIAN PRESS

WINNIPEG – An elderly Jewish man at the centre of a legal battle over the right to life support was remembered Wednesday as a fighter who never gave up.

Samuel Golubchuk was buried just one day after his death, as is customary for Orthodox Jews. But his passing has not stopped the debate over whether doctors have the right to refuse treatment to patients they feel are beyond hope of recovery.

“Sam fought during the Second World War for democracy,” his lawyer, Neil Kravetsky, told a small gathering of mourners at Golubchuk’s funeral Wednesday. “He fought for democracy ’til the end.”

“This is a case that all of us should be concerned about. It’s about sustaining what Sam fought for.”

Golubchuk was already living in long-term care last fall when, at the age of 84, he was taken to the intensive care unit at the Grace Hospital. He had pneumonia, so doctors attached feeding tubes and a ventilator.

Later, when they decided he had no chance of recovery, they wanted to take him off the life-sustaining equipment.

But Golubchuk’s family members argued that disconnecting him would violate his religious beliefs. They went to court and won a temporary injunction to keep him on life support until a trial that was scheduled for this fall to determine if the hospital could be forced to keep him alive.

The case attracted attention from many pro-life groups in the United States who denounced what they termed the hospital’s “dehydration” plan.

The controversy grew this spring when three doctors resigned their privileges at the hospital’s intensive care unit over the case.

One of them, Dr. Anand Kumar, wrote in his resignation letter that continuing to treat Golubchuk was akin to torture. Kumar wrote the ailing man had ulcers on his skin and that doctors had to “surgically hack away at (his) infected flesh.”

It was also suggested Golubchuk had minimal brain function, although his son Percy Golubchuk and daughter Miriam Giller argued their father was aware of what was going on but couldn’t express his wishes.

While the Golubchuk case may be over, the issue is bound to come up again until a court somewhere in Canada makes a ruling, said a medical ethics expert at the University of Manitoba.

“Will they send a doctor to jail for following physician ethics and conscientiously refusing (treatment)? It would be good to know the answer to that question,” said Prof. Arthur Schafer, director of the Centre for Professional and Applied Ethics.

“Can you compel health-care professionals to keep someone alive when they believe they are harming that patient? I think the answer to that is no.”

The Canadian Medical Association says doctors have no obligation to provide treatment where there is no benefit.

“To what extent can families demand care deemed by all the health-care providers involved to be inappropriate?” asked Jeff Blackmer, executive director of the association’s office of ethics.

“If we carry that further, then can families and patients demand any care?”

Golubchuk’s lawyer argued the elderly man was perfectly entitled the care to keep him alive.

“The right to self-determination is embedded in our way of life,” Kravetsky said.

He suggested that society has a double-standard in allowing doctors to make life-ending choices, while prosecuting people such as Robert Latimer, a Saskatchewan man who was sentenced to life in prison for killing his severely disabled 12-year-old daughter – something Latimer has always said he did out of compassion.

“How can a society be satisfied with putting people in jail for assisting people who want to kill themselves because they’re in mortal pain … and yet, here … the doctors are saying they want to put someone out of their misery against their consent. That’s not a crime?”

Kravetsky said Golubchuk’s death makes the trial later this year moot and the court will not proceed.

The lawyer has yet to talk to the family about whether they want to sue the hospital.