Doctors offer to treat dying Winnipeg man after colleagues refuse

Family's religious beliefs conflict with medical opinions

Last Updated: Wednesday, June 18, 2008 | 10:01 AM ET

CBC News

Samuel Golubchuk, 84, has been on life support with minimal brain function at the Grace Hospital since last fall. (Family photo)A doctor in Winnipeg has agreed to treat a dying 84-year-old man amid a legal and medical row between his family and physicians who say keeping him alive is unethical, a published report said Wednesday.

Three doctors at the city's Grace Hospital have refused to continue providing care to the elderly patient, Samuel Golubchuk, who they say has no brain function and should not be kept physically alive on a ventilator.

But other doctors have come forward and agreed to provide care, said Heidi Graham, spokeswoman for the Winnipeg Regional Health Authority.

"Our regional critical care program and hospital have developed a plan that involves having one attending physician of record for the patient in question," Graham told CBC News on Wednesday morning.

"This physician will be supported by two other physicians. These three physicians have already agreed to this, and this situation will allow the other physicians in the Grace intensive care unit to continue with their scheduled rotations if they so desire."

Graham also confirmed that discussions are underway that could result in the return of some of the doctors who refused to care for Golubchuk.

'God decides … not the doctors': daughter

Samuel's children, Miriam Geller and Percy Golubchuk, say taking him off life support would hasten his death, something they consider tantamount to murder under their Orthodox Jewish religious beliefs. (CBC)Golubchuk and his family are Orthodox Jews who believe it is immoral to hasten death.

"When a person is born, it's written down when they're going to die. So it's God that decides this, not the doctors," said Miriam Gellar, Golubchuk's daughter.

Gellar said her father still makes eye contact with her and is able to squeeze her hand. She believes he could still recover and that the doctors who refuse to treat her father are "misguided" and have "no compassion."

"We feel he knows we're there with him. We gave him his card on Father's Day and his eyes lit up," she said. "Give the person a chance to recover and, you know, to live out their life the way they're supposed to. We're speaking for him. This is his choice."

Last month, in a letter to the Winnipeg health authority, Golubchuk's original attending physician, Dr. Anand Kumar, said he would no longer work in Grace Hospital's critical care unit because it meant providing medical services to his former patient that were "grotesque."

Golubchuk had developed bedsores, Kumar wrote, and doctors were having to trim infected flesh from his body to prevent infections from spreading.

"To inflict this kind of assault on him without a reasonable hope of benefit is an abomination," Kumar's letter said. "I can't do it."

Do no harm: ethicist

Kumar advised the family to remove Golubchuk's ventilator and feeding tube, but they went to court instead and obtained a temporary order to continue treatment until the case can be heard fully in September.

Earlier this week, two doctors who had been maintaining Golubchuk's life support treatment also withdrew from the case.

"This week, I have come to the 'ethical line in the sand' that I had previously said I would never cross," Dr. David Easton said in a letter on June 17.

"Do potential legal consequences and threat of 'jail' take precedence over my duty to not inflict further harm to the patient? I have been, and am, extremely conflicted in all of this.

"I had perhaps naively thought that by having my own institution 'strongly suggesting' me to act against my will and provide said care, that I would somehow be absolved of these issues internally, but in fact has further compounded them and increased my degree of conflict to an indescribable degree."

Arthur Schafer, a medical ethicist at the University of Manitoba, said the physicians were correct to follow their conscience once they'd formed a professional opinion on Golubchuk's case.

"They did morally the right thing," Schafer said. "As every first year medical student learns, the basic principle of medical ethics is 'do no harm.'"

But Percy Golubchuk, the patient's son, said it's all about being able to trust that a medical team will provide the care that's needed to preserve life.

A person, he said, "should not be afraid when you go into a hospital that you might not come out because a doctor thinks your life is not worth living."

Golubchuk's father was put on life support late last year when he was being treated in hospital for injuries suffered in a fall.

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