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At funeral of Sam Golubchuk
photo by Rhonda spivak


Neil Kravetasky, counsel for the Golubchuk family


Miriam Geller and Percy Golubchuk, Sam Golubchuk's children.
photo by Rhonda Spivak

 
THE DEBATE CONTINUES-THE CASE THAT MADE HEADLINES AROUND THE WORLD: SAM GOLUBCHUCK AND THE RIGHT TO LIFE SUPPORT

Neil Kravestky and Arthur Schafer will debate how to draw the line between prolonging life and death at Etz Chaim on March 8-Read articles from Ha'aretz about the case

By Rhonda Spivak, February 16, 2011

The case of Sam Golubchuck and the issues surrounding the right to continue or withdraw life support made international headlines in 2008.

I reported on this for a the Israeli daily Ha’aretz [English edition], as well as other  Canadian Jewish publications[the articles in Ha’aretz are reprinted below].

A debate about the issues involved in this complex case will take place as part of Etz Chaim Synagogue’s Adult Education Program between lawyer Neil Kravetsky, who acted for the Golubchuck family and Arthur Schafer, director of the  Centre of Professional and Applied Ethics.

The debate will be moderated by Jack London, senior partner at Pitblado LLP and former dean of the Faculty of law at the University of Manitoba. It will examine not only where the line should be drawn between prolonging life and death, but also who should decide, and what role, if any, should religion play.Admission is $10.00

It is interesting to note that in the case of former Prime Minister Ariel Sharon ,the State of Israel put Sharon on life support and has not withdrawn it such that he has been alive in a coma for just over five years.

Below are the two articles published in Ha’aretz, that exposed the Golubchuk case to the wider Jewish world

ORTHODOX FAMILY TAKES HOSPITAL TO COURT OVER FATHER’S LIFE SUPPORT

By Rhonda Spivak, published in H’aretz, 11.01.08

http://www.haaretz.com/print-edition/news/orthodox-family-takes-hospital-to-court-over-father-s-life-support-1.237042

WINNIPEG, Canada - The family of an 84-year-old Orthodox Jew who is on life support says he is alert and improving after hospital doctors unsuccessfully tried to pull the plug on him over a month ago, against the family's wishes. The family of Sam Golubchuk went to court to require his hospital to continue giving him life support, including a ventilator and feeding tube, in accordance with the family's religious beliefs. The hospital has wanted to take him off life support because it says there is no hope for recovery and he has minimal brain function. Golubchuk has been on life support since November 7.

Golubchuk's children, Percy Golubchuk and Miriam Geller, retained legal counsel to prevent Grace Hospital from violating their father's religious beliefs and hastening his death.

"This appears to be the first case in Canada where a hospital has actually fought with a patient to take him off life support," said Neil Kravetsky, the family's lawyer. "Other cases haven't gone this far because the family has given in and the patient has died."

On November 30, Kravetsky was successful in getting an ex parte injunction (without notice to the hospital) on an emergency basis from Justice Perry Schulman that prevented the doctors from removing Golubchuk's life support.

"There is no evidence that Mr. Golubchuk is brain dead, and his heart is functioning independently," said Kravetsky.

After a Dec. 11 hearing, Dr. Bojan Paunovic, the director of the hospital's intensive care unit, submitted an affidavit in response to a question posed by Schulman regarding the method for withdrawing life support.

Kravetsky says that at this hearing, Golubchuk's "entire chart was not presented by the hospital, only some parts of it." He asked for and received the whole chart from the hospital after the hearing.

Kravetsky sent the chart to Dr. Daniel Rosenblatt, a critical care physician in New Jersey, and Dr. Leon Zacharowicz, a pediatric neurologist from New York. Both doctors filed affidavits this week in response to Dr. Paunovic's affidavit. These two affidavits will not be made public until Schulman rules whether they are admissible as evidence, since they were filed after the closing of the hearing of Dec. 11.

Kravetsky says they "ought to be admissible since I didn't have the hospital chart earlier." "There will be a hearing at two o'clock [today] before Schulman, who will decide on the admissibility of the two affidavits."

 

Schulman's final decision in this precedent-setting case will determine whether it is the patient and his or her family or the doctor who has the final determination over whether to withdraw treatment.

"From a halachic standpoint, what is at issue is at what point a person is considered to be a goses [a person in the final stage of dying]," said Rabbi Avraham Altein, the city's senior Chabad-Lubavitch rabbi who knows the Golubchuk family well. "When a person is a goses, you are not allowed to hasten the process of dying, but you don't have to prolong it.... According to Rabbi Bleich, from Yeshiva University in New York, a person is considered a goses if they cannot possibly live for 72 hours, even by using whatever machines modern medicine has available.

"This means that if Golubchuk were a goses and he wasn't on life support, we would not be required to put him on it. However, even when a person is a goses, if he is already on life support, then it cannot be withdrawn. There is no doctor that has said that if Mr. Golubchuk stays on life support, he won't last 72 hours, so it can't be said he is a goses."

Arthur Shafer, director of University of Manitoba's Centre for Professional and Applied Ethics is of the view that, if the case goes against the hospital, it could have a potentially harmful effect on the practice of medicine.

"If Mr. Golubchuk is in an irreversible vegetative state, then treatment is futile," said Shafer. "He could potentially be in this irreversible state for a very long time. If so, would the Orthodox Jewish community want to see tens or hundreds of thousands of people in Canadian hospitals kept alive for decades by ventilators and other machines? Is that how they want us to spend our scarce medical resources?...

"Ariel Sharon, who appears to be in an irreversible vegetative state, may be getting this kind of treatment, but if every Israeli got this kind of treatment, the whole state budget would be used up. Should every Jew really be kept alive like Ariel Sharon?"
 
 
ORTHODOX MAN IMPROVES AS DOCTORS BATTLE FAMILY OVER LIFE SUPPORT
 
By Rhonda Spivak, published in Ha’aretz, Feb. 2, 2008
 

WINNIPEG, Canada - The family of an 84-year-old Orthodox Jew who is on life support says his condition has improved substantially after hospital doctors unsuccessfully tried to pull the plug on him over two months ago on the basis that there was no hope for recovery.

Miriam Geller says that her father, Sam Golubchuck - who is unwittingly at the center of a precedent-setting court case - is now "being weaned off life-support," and "is awake and holding our hands."

"The nurses have him up in a cardiac chair every day, a couple of times a day for two to three hours" and "a physiotherapist comes in regularly to do arm and leg exercises," she added.

Golubchuck is alive today only because his family was successful in getting an emergency ex parte injunction (without notifying the hospital) from Justice Perry Schulman that prevented the doctors from removing him from life support, a move that would have violated the family's wishes and religious beliefs. At a hearing on December 11, 2007, the hospital and doctors maintained that Golubchuck had minimal brain function.

Following that hearing, the family's lawyer, Neil Kravetsky, sought to file affidavits by Dr. Daniel Rosenblatt, a critical care physician in New Jersey, and Dr. Leon Zacharowicz, a neurologist from New York, that dispute the hospital's position.

"This appears to be the first case in Canada where a hospital has actually fought with a patient to take him off life support," Kravetsky told Haaretz last month. "Other cases haven't gone this far because the family has given in and the patient has died."

After a hearing on January 11, 2008, Justice Schulman allowed Kravetsky to refile edited versions of these affidavits so they could be admissible as evidence.

In his affidavit, Dr. Zacharowicz said that even according to entries in Golubchuck's medical chart made before December 11, "There is no evidence whatsoever that he is brain dead, close to brain dead, or dying, from a neurological point of view."

Zacharowicz concluded, "The decision of any medical professional to disconnect this clearly alive patient - whom medical records indicate is returning neurologically to his baseline, pre-admission clinical condition - is incomprehensible to me."

Justice Schulman will be allowing lawyers for the hospital to cross-examine Rosenblatt and Zacharowicz on their affidavits and to file additional affidavits in response. He has not made any final ruling in the case.

Lawyers for the hospital maintain that it is the sole right of the team of physicians to decide when to withdraw life support, and that this decision ought not to be in the hands of the courts.

On January 30, Manitoba's College of Physicians and Surgeons released new guidelines that became effective February 1. They state that the final decision to pull the plug on a patient lies with the physician.

The guidelines say that the minimum goal of life sustaining treatment is for patients to recover to a level at which they are aware of themselves, their environment and their existence.

In the event a physician and a family do not agree as to whether the minimum goal has been met, the guidelines provide that the treating physician must consult with one other physician and then communicate the decision to the family.

In the event that a patient could achieve the "minimum goal" but the physician concludes treatment should be withdrawn anyway, the physician must provide the patient's family written or verbal notice 96 hours before life support is stopped.

Kravetsky called the new guidelines "terrible."

"It's extremely suspicious that after taking three years to prepare these guidelines, the college would release them now and direct doctors to follow them immediately when the court is ruling on this very issue," he said.

 
 
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Rhonda Spivak, Editor

Publisher: Spivak's Jewish Review Ltd.


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