Futile Care Power Play in Canada: But What About Conscience Clauses?

CBC News has learned that two other doctors—Bojan Paunovic and David Easton—have also said they will no longer care for Golubchuk.
“What I can tell you is that there are three critical care doctors who have recently resigned from the [intensive care unit] shift schedule at the Grace Hospital,” said Heidi Graham, spokeswoman for the Winnipeg Regional Health Authority. The WRHA is working with other physicians to ensure the hospital can continue to provide critical care despite the loss of the three doctors, Graham said.

A few thoughts: First, this seems a power play to me—even though I have no doubt that the physicians sincerely believe that maintaining Mr. Golubchuk is the wrong way to go. Second, in their determination, they are, in effect, abandoning other patients in their care. Third, the court is precisely where this case belongs. If wanted life-sustaining treatment is really so egregious that it is torture—rather than merely a matter of a profound disagreement over values—doctors and hospital bioethics committees should have to prove it in an open court with full rights of due process and appeal for the patient/family. Moreover, I think the hospital should pay the legal expenses of the patient/family otherwise it becomes David versus Goliath.

And now, let’s ponder this paradox. The Bioethics and Medical Establishments generally insist on the right to withhold wanted life sustaining treatment based on their views about the quality of the patient’s life and/or the proper use of the resources involved. In contrast, they also insist that doctors and other medical professionals appalled by birth control, Plan B, RU 486, abortion, or (eventually) assisted suicide should not be able to opt out based on their moral principles because patients have a right to these services. Yet, the futile care cases involve life and death while the others usually are elective in the sense that there are not lethal consequences for the denial of services.

In reality, it isn’t a paradox because the medical issues are actually the fronts for the real contest, which is about determining the first principle moral values that will govern general society—as, when I think about it, are many if not most of the issues that we discuss here at SHS.