|
Feb. 8, 2008
Golubchuk improves
Legal battle surrounding his condition continues.
RHONDA SPIVAK
The family of an 84-year-old Orthodox Jew who is on life support at a Winnipeg hospital says his condition continues to improve 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 said that her father, Sam Golubchuk – who is unwittingly at the centre 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.
Golubchuk is still alive only because his family 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 his life support, a move that would have violated the family's wishes and religious beliefs.
At a hearing on Dec. 11, 2007, the hospital and doctors maintained that Golubchuk had minimal brain function. Following that hearing, the family's lawyer, Neil Kravetsky, sought to file affidavits disputing Grace Hospital's position, written by Dr. Daniel Rosenblatt, a critical care physician in New Jersey, and Dr. Leon Zacharowicz, a neurologist from New York.
In his affidavit, Zacharowicz said that even according to entries in Golubchuk's medical chart made before Dec. 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, preadmission clinical condition, is incomprehensible to me."
Schulman is 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 a final ruling in the case.
On Jan. 30, Manitoba's College of Physicians and Surgeon's released new guidelines, effective Feb. 1, stating 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 in which they can be aware of themselves, their environment and their existence.
In the event that a physician and a family do not agree as to whether the minimum goal has been met, the guidelines provide that the decision ultimately rests with the physician, who 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, the doctor must provide the patient's family written or verbal notice 96 hours before life support is stopped.
Dr. Bill Pope, the registrar of the college, said the guidelines are not a response to the Golubchuk court case and added that 100 stakeholders have been working to draft the new guidelines for the past three years. He would not comment on the case, but said the college would review its statement should Schulman rule in favor of a patient's family.
Kravetsky called the new guidelines "terrible." He said, "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."
Medical ethicist Pat Murphy, from Winnipeg's St. Boniface General Hospital, said the college has put patients and their families at a clear disadvantage. She said, "You and I didn't elect the college. Discussions around withholding or withdrawing life-sustaining treatment aren't solely medical decisions. In Ontario, for example, where a physician and a family disagree, there is consent legislation providing a remedy to a third party that will hear both sides to the conflict."
Murphy also indicated that she considered the 96-hour notice provision in the guidelines unreasonable, in that it isn't sufficient time to allow a patient's family to get legal advice and make an application to a court to issue an emergency injunction. In response, Pope said there were those consulted who felt "that the notice provision ought to have been less than 96 hours."
Rhonda Spivak is a Winnipeg freelance writer.
^TOP
|
