Staying Alive

Controversies over end-of-life care are sometimes as inevitable as death itself.

While Philip Nitschke and Jack Kevorkian have injected euthanasia into the public consciousness, a recent Canadian case has stirred the pot in the opposite direction—leading to the refusal of three doctors to continue to treat a dying man.

Samuel Golubchuk, an 84-year old Winnipeg man, died last month after being kept on life support for eight months at Grace Hospital. His family had lobbied doctors to keep him on life support since November, citing Orthodox Jewish law. A court ordered doctors to keep Golubchuk alive, and a trial would have commenced in September.

Golubchuk entered the hospital in October with pneumonia and pulmonary hypertension. Doctors wanted to take Golubchuk off life support because his condition deteriorated to the point that treatment—which included the cutting of infected flesh from his body—amounted to “torture,” according to one doctor. The case forced the closure of two intensive care beds and the transfer of nursing staff to help keep Golubchuk alive.

As one doctor asked, “how heroic should we be?” Is it right to divert resources from the treatment of others to keep alive a dying man? And is it ethical to inflict pain, with no hope of improvement, to fulfill a family’s wishes? The doctors treating Golubchuk didn’t think so, drawing an “ethical line in the sand” before withdrawing from the case.

In a perfect world, individual choice and medical opinion would always align for the best possible outcome. But as the Golubchuk case shows, the two can sometimes lead to ugly legal battles. And since the case never made it to the Canadian courts, the question at issue remains in the balance: Who has the right to determine when life support should be removed?

Golubchuk died without being removed from life support, and his family claimed victory following his death. But did anyone actually win?