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?"