I have reported on the Canadian futile care lawsuit involving Samuel Golubchuck here at SHS previously. For those who may not recall, Golubchuck is a terminally ill elderly patient being treated in a Winnipeg hospital’s ICU. Doctors want to refuse life-sustaining treatment. The family—citing religious reasons (they are Orthodox Jews) and believing that Mr. Golubchuck would want treatment to continue—sued and won a temporary injunction requiring his life to be maintained.
Now, the doctor who wanted to impose his values on the patient and family by forcing Golubchuck off of a respirator and feeding tube has resigned rather than continue treatment. I have no trouble with that so long as there is continuity of care. But the following comment by the head of an ICU should alarm everyone. From the story:
But the man seems so sick! I have been involved either publicly or privately in too many of these kind of cases to accept what the hospital spokespeople say about Mr. Golubchuck’s condition at face value. If they are accurate, I would probably make a different decision than this family has. But those are my values. When it comes to extending life, I don’t think the patient’s values should be trumped by those of strangers—no matter how well motivated they might be.
If the doctors/bioethicists prevail in this case, if they can force a man off of life support in pursuit of the institution’s values, it is the end of patient autonomy. Better stated, it would transform patient autonomy into a one-way-street: If you want to die by refusing treatment (or perhaps requesting euthanasia), patient autonomy rules! Otherwise, we reserve the right to refuse service.
Now, the doctor who wanted to impose his values on the patient and family by forcing Golubchuck off of a respirator and feeding tube has resigned rather than continue treatment. I have no trouble with that so long as there is continuity of care. But the following comment by the head of an ICU should alarm everyone. From the story:
Dr. Dan Roberts, director of the medical intensive-care unit at Winnipeg’s Health Science Centre, said he is sympathetic with Kumar’s decision. “I think it’s very difficult under the circumstances to continue to have to provide care with the only intent to extend the life of a dying patient,” he said.Gee, extending the lives of dying patients used to be a primary purpose of medicine—at least when that is what the patient/family wanted. And let’s not fail to connect the dots here to the Oregon woman refused chemotherapy by Oregon’s rationed Medicaid plan but told the state would cover the costs of her assisted suicide. What we see developing before our very eyes is the creation of a disposable caste of people.
But the man seems so sick! I have been involved either publicly or privately in too many of these kind of cases to accept what the hospital spokespeople say about Mr. Golubchuck’s condition at face value. If they are accurate, I would probably make a different decision than this family has. But those are my values. When it comes to extending life, I don’t think the patient’s values should be trumped by those of strangers—no matter how well motivated they might be.
If the doctors/bioethicists prevail in this case, if they can force a man off of life support in pursuit of the institution’s values, it is the end of patient autonomy. Better stated, it would transform patient autonomy into a one-way-street: If you want to die by refusing treatment (or perhaps requesting euthanasia), patient autonomy rules! Otherwise, we reserve the right to refuse service.
