Doctors wanting to pull life support from an 84-year-old Winnipeg man have not only been ordered not to, but to do everything necessary to keep him alive.
In 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 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,” 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.”
Schulman said he wants to see the matter come to trial “as quickly as possible.”
Golubchuk’s son, Percy, and daughter, Miriam Geller, expressed relief after hearing the judge’s decision.
“God is with us,” 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 said “he would be very proud of us - he would say ‘way to go’.”
Golubchuk has been treated in the Intensive Care Unit of Grace Hospital since October after coming there suffering pneumonia and pulmonary hypertension.
But after doctors decided further treatment would be futile - and 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 on-line 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 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 supports.
“I think the College was irresponsible,” 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. Contrary to the medical people there is no precedent for this.
“This is not just an old man who happens to be Jewish - he’s like all of us.”
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 pull the plug lies with the physician.
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, 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,” 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 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, Murphy said, the judge clarified that there is no law that gives doctors the right to have the final say on when to pull the plug.
“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.
Lawyer Vivian Rachlis, an in house legal counsel for the Winnipeg Regional Health Authority who is acting for the Grace Hospital, said the judge’s decision will be reviewed.
Rachlis said the decision to “withhold or withdraw life-sustaining treatments are never easy and are not made lightly by medical experts.
“Both the Grace Hospital and the WRHA recognize that the past several months have been very difficult for the Golubchuk family as well as the staff who have been caring for Mr. Golubchuk.
“Having said that, the families, the health care professionals involved in the care of Mr. Golubchuk, the Grace Hospital and the Winnipeg Health Region have all been acting in what each of them believe to be in the best interests of the patient.”
Rachlis said she hopes the court case will show people, including ordinary Winnipeggers, medical professionals and other organizations, see how difficult and complex it is to resolve cases like this.
Meanwhile, Schulman, to ensure there is no question by doctors and nurses what his order means, also ordered that his decision be added to Golubchuk’s medical chart.
And after lawyers for the doctors asked the judge whether they also have to treat Golubchuk for other medical issues which might arise, Schulman ordered them not to put a do not resuscitate order on the patient and to continue to give him all necessary treatment.
kevin.rollason@freepress.mb.ca
- with files from Jen Skerritt
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