Family fights to keep 84-year-old on life support

In what could be a precedent-setting decision, a Winnipeg court will rule on whether an 84-year-old brain-injured man who cannot walk, speak, eat or breathe on his own, can be removed from the machines that are keeping him alive.

Samuel Golubchuk has been in intensive care for four weeks with no sign of improvement, and doctors want to remove him from life-support systems, saying it's only a matter of time before he dies.

His family, however, maintains that doing so would constitute a sin under Golubchuk's Orthodox Jewish beliefs and is equal to assault because it would hasten his death.

"The family knows that there is a very poor prognosis for Mr. Golubchuk, but he's alive now and according to their beliefs, they believe that he should be kept alive as long as his heart is beating and he's functioning and has got brain activity, he's alive," Neil Kravetsky, the lawyer representing the family told Canada AM on Monday.

Golubchuk's family was granted a temporary injunction on Dec. 11 to keep him alive while a judge in Manitoba's Court of Queen's Bench considers the decision.

Golubchuk is being treated at Winnipeg's Grace Hospital.

The court's decision could have a far-reaching impact on Canadians trying to make decisions about their relatives at the end of their lives, said Arthur Shafer, director of the University of Manitoba Ethics Centre.

"Mr. Golubchuk was plugged into life support when they weren't sure whether he would benefit or not -- and once they discovered that he wouldn't benefit, what this family is saying is that if they disconnect him, they're committing murder," Shafer said.

"That means we have thousands of murders every year in Canada done by doctors, which I think is a completely untenable position."

In the majority of cases, Shafer said, decisions are made through dialogue and discussion between family members and physicians. In some cases, hospitals will keep a patient on life support long after it is justified medically to do so, simply to accommodate the family, he said.

But there comes a point, Shafer said, when families must realize that with a shortage of hospital beds, "one person's provision is another person's deprivation."

"So we can say to Canadians, yes, all of you can be kept alive forever, but the person you are can't be kept alive, your body can be kept alive. I don't think that's a sensible use of resources and I don't think that the hospitals can accommodate such wishes," Shafer said.

Kravetsky, however, said doctors aren't in a position to determine a person's quality of life and where there is life, there is still the possibility of a recovery.

Golubchuk has been in hospital since Oct. 26. He had a pre-existing brain injury from a fall in 2003, that resulted in the removal of part of his brain.

He was admitted with pneumonia and a heart that was struggling to beat regularly.

Because he had MRSA, an infection that resists antibiotics, he wasn't a good candidate for a pacemaker. He also had poor kidney function.

The hospital says the decision to remove Golubchuk from the ventilator had nothing to do with freeing up resources, but was made strictly on medical grounds.

There is no word on when the court will hand down its decision.

Comments are now closed for this story

Linda
said
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I read this article and understood all to well the difficulty the family is encountering. When I was a teenager we too had to make the same decision regarding my mother's life. We choose to remove her from life support (on doctors recommendation) as we knew she would not want to live in this manner but also because all that remained was a shell that housed what we had loved so much for so long. Do I struggle with the decision? Yes every single day of my life I wonder if we did the right thing, maybe we could have had a miracle. That is my heart speaking, but reality was she did not take one breath when life support was removed so it was her time to go home. If religion entered into the question; for me it would have come in the fashion that if she was meant to live she would have done it under her own volition not with the aid of a machine that could have kept her alive artificially for many years.

Rhody77
said
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For all those who say that "he would not live if the machines were removed, so let him go", I have this question: if we were discussing an infant, unable to breathe on his own, would the arguments be the same? Would you still say to let him live or die on his own, 'cos we need the bed for a teenager? What about someone on dialysis: without it, they would die. Same answer? I don't believe there is an easy answer here for this elderly man and his family, but should the decision revolve around money? The cost of his care? Is that all that matters anymore? I don't know what that man would do if he could speak and make a choice, but neither does anyone else. His family has a fundamental belief that cannot be ignored. If they choose to fight for him, so be it: the Jehovah Witnesses often go to court to restrict medical treatment. Give these folks the same rights to maintain treatment.

Linda J.
said
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I have to agree with others that this decision on whether to keep him on or off life support should be up to the family with no government interference. Having said that, I also believe that the hospital and courts do need to make a decision in cases like this. But the decision should be on WHO is to foot the bill, since it should not be the taxpayer footing the bill in such cases. If the family wants to keep the machines running, the courts should be deciding if it is the taxpayer or the family that is to pay the bill.

Marky
said
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This is really not a complicated issue.

The man has already had part of his brain removed, his kidneys have failed, AND he can't respond to antibiotics.

Oh, I almost forgot - he is 84.

Let him go in peace.

Matt
said
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Sammy,
You asked the right question.
"Are the family willing to foot the bill for the extra costs and space this dying man is taking."

In Canada the answer is no. We can't pay for our own health care, and we get the kind of health care the government wants.

In this case the sickening part is the government isn't just saying they won't continue to provide life support, they are saying the family isn't allowed to provide it either.

This makes me want private health care so I could at least have the option to keep my loved ones alive.

Hanoch Bernath
said
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Great. Go ahead.Be cold. Be logical. Be G-d,just remember - the person in that bed is not a nameless somebody. He/she is your mother, your father, your brother, your sister, ...your child. Someone YOU love and can't let go ,for emotional, or even religious reasons. Now... what are you going to do?
This is not a multiple choice exam,you have 3 hours to write a coherent answer. Please make sure you phrase your answer as a logical self sustaining argumnent with proofs and references as necessary.

Jeff R.
said
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As for Loomis Poons comment, listen to this... If you have diabetes and require insulin to survive, then take it! You might get another 50 years of life. If you are on life support, you might get hours, days, months or longer. To remove someone from life support is wrong. It is aiding in suicide, no matter how you try to get around it. I remember a story of a man in a similar situation. They were about to remove life support, but stopped the procedue once they seen tears dripping from his eyes. He had no other way to communicate. Remember... they are still alive.

John T
said
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At this time we have the luxury to debate such decisions. With the preponderance of the population shifting into retirement homes and the minority of workers supporting extended care of senior Boomers, this will become, and please don't be offended, 'a no-brainer'.

Society will be unable to sustain such costs or provide the resources currently available within the decade. Given the convexity of cost curves, it is necessary to begin doing what must be done in the present period.

The family has done their best. So has society, so has the gentleman...there is no practical or logical argument for failing to set them all free from this prolonged inevitability.

Joanne Tremblay
said
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Perhaps the family should consider keeping him hooked up for humane reasons, but bringing him home for the duration of his life. If they do not want to be blamed for his "murder" then they should be willing to not only provide him with his life support but all of his required care as well.

Jason
said
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The ethics around death and dying have been part of Jewish law for thousands of years. Yes, the Talmud does deal with cases of removing life support when death is imminent.

The Jewish perspective is that a living soul has value. This value is not effected by the 'quality of life' standard now used to determine who is allowed to live.

The general principal is one is not allowed to be proactive in hastening death. There are situations where a DNR would be permitted.

Through a living will a person can decide who will make their medical decisions for them. If there is no living will the decision falls to the family. The doctors should work with the decision maker to determine what is best for the patient. The final decision should rest with the people who cared about the patient during life. Should life and death decisions ever be made by someone who sees their patient as a waste of hospital resources?

Lina
said
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It is still better to be alive and a vegetable than to be dead, and I fully support this family's decision to keep him alive.

And for everyone saying that the family should be allowed to keep him like this if they would be willing to pay the costs, why not make that argument for anyone in a hospital? Why is someone who is younger more deserving of medical resources and funds? It sure would be a lot cheaper for the taxpayers if no one had free care, especially those who need it the most, like this man.

Sherry - Ottawa
said
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If the machines that seem to be the only reason for this person to be alive at all were turned off and the person continued living -then fine - keep him going. However if the person cannot in anyway sustain himself then it is playing God by forcing the body to stay alive. Then it is better for the machines to be turned off so that another person who will live with treatment be given the chance to live. If someone dies because the bed and treatment is not available and the present patient dies as well - that's two people lost. THAT is not fair. They're not choosing who lives or dies - they are just giving them a chance to live or die. Let's not go overboard by saying things like "who will they choose next?" The Doctors are just trying to do the right thing. It's understandable the family wants to keep the person alive but isn't it really because of their wants and not a reasonable choice? Unfortunately the person who should choose cannot speak for himself. "God's will be done"

zippn
said
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The lesson to all of us reading this will hopefully be to make sure our wishes are very clear to our loved ones while we are still healthy and able. My husband and I as a young couple known exactly what each others wishes are, and as difficult as that discussion was to have, will hopefully ease some pain some if and when that time comes.

Joel-Sebastien Newman
said
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'we must let people die with dignity' ... while I agree, in this case it seems dignity has come and gone. The patient has a completely broken and dependant body and no clear signs of sentient capabilities. He apparently already had ailing health, tehrefore the family should have already had more than adequate time to prepare for this moment. Regardless of religious beliefs, as humans we must accept death as inevitable. To blame health care workers (the only ones keeping the man alive) for this 'pending murder' is ridiculous and clearly relies on emotionally based responses to a completely common problem that most deal with in a realistic and accepting way.

KJ
said
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This has happened far too many times - why are we avoiding having discussions with our loved ones regarding their wishes, should they become incapacitated? The discussion may not be pleasant but is necessary, the choice should be clearly communicated as it makes these types of decisions up to the patient and can avoid heartache for the family and wasted money on health care that can be put to better use for other patients. My parents are healthy baby boomers, but I still have had this difficult discussion with them and I already know what their wishes are. Being an adult and making the effort to have these discussions with loved ones ultimately will benefit everyone involved.

rm
said
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Certainly the hospital can recommend to the family where to purchase the required equipment.
This way both sides get what they need.

susan
said
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I don't think the issue should be bed availabilty or cost of care. It sounds like this man is dying. Wouldn't it be nice just to palliate him, and keep him comfortable until mother nature or God decides it's time to go.

Colin
said
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Wouldn't preventing this man's death by the use of life support in fact be playing God? All those who say not to remove life support because it would end his life and that would be playing God...isn't this the same thing? He would have died naturally by this point already, and now that the talk of letting him pass over is upon us, people don't like that. If people believe in afterlife like the claim to, they would no doubt have let him go by now. Keeping him alive when he's not actually living is playing God, but some have no issues with this? Hypocritical!!

Chris from Kitchener
said
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I can understand some of you saying "Why can't they just let him go?" I can only imagine how tough that decision would be. It's hard to let go of anything that you love, especially when it's a family member. It's easy to sit back and say something like that, however we have to understand the emotions of the family, and that is something we can't pass judgement on.

JD
said
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This would be a gut wrenching situation for any family to be in. My heart goes out to this family, and every other family who has to make a decision like this.

The family, has to, how ever hard it is.Be objective, step back and really think of their relative, and ask themselves if this is how their relative would want to spend their remaining days.
And is this how they want to remember their loved one.
I think it is a selfish decision by the relatives to do this, and for their lawyer to say that the physicians cannot,"determine a person's quality of life" isn't that what they went to Medical school for? No doubt the doctors are not God, but I do believe they have the knowledge and expertise to know that with everything that is medically wrong with this gentleman, his quality of life is not that great right now. And will not improve.

I believe that if the family wants to continue to have their relative on life support for his remaining days, they should have to pay the costs.

I have been in the same position as this family's, and it was a very hard decision to make. But I knew that allowing my loved one come to rest is what they would want.

This is why when a person is admitted into a hospital for any procedure, they should really consider a living will.

Patrick from Waterloo
said
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We all need to have a long hard look at what we can reasonably afford as Canadians. As a 25M with boomer parents I know I will one day grapple with this and, unfortunately, I understand Canada is socialist. In all cases I need to accept what is good for society rather than what is preferred by the individual.

In cases like this we must decide what to do as a society. If doctors say there is no hope, the family should be required to assume responsibility for all costs.

Space and costs aside, I'm more concerned about MRSA. Does this mean the man was treated with high power antibiotics when he had little to no hope for recovery? If this is the case forget the lost bed -- we should stop breeding super bugs in mechanically supported bodies.

J.R.
said
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It's interesting how Canadians will fight to keep a murderer on death row alive, but push to end the life of the innocent even when the family wants him kept alive.

Great sense of justice.

Donald E. Austin
said
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I understand their concerns, however, if not for the equipment he likely would be deceased already.
If they are truly concerned of God's will, if God wants him to survive, he doesn't the equipment mankind poduced
Cruel, but factual
DEA (RN)

Gloria
said
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I agree with Loomis and John. If the family wants to foot the bill and move the father to a facility, then great, that is their decision. But, to expect the public to pay for a clinically dead person to 'live' when we have so many sick children and teenagers who are just starting out in life. Well, the answer is quite obvious to me. Let him go and let him rest in peace.

SLC
said
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This is a decision I had to make this past October. My Mom had COPD, congestive heart failure and was on oxygen constantly. I was given the choice to do certain procedures which would have prolonged her life for a little while, maybe a week. I wanted my Mom back but I knew deep down and with her doctor's support that she wouldn't ever come back and be the person she would want to be. Even though she was semi-comatose, she was still pushing away all efforts (eg: putting a nebuliser mask on or trying to get another IV in) to try to help her. That told me what I had to do! I chose to keep the oxygen on Mom and nothing else. Mom was allowed to pass away peacefully and surrounded by the love of her family. If I would have put her through more needles, masks, IVs, breathing tube, etc, I would have been doing it for myself, not for my Mom. It was inevitable she was dying. Don't prolong the inevitable --it is hard enough for the family to watch a loved one die, let this man die peacefully and please stop playing God.

Cathy
said
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My mother was diagnosed with Cancer. The onocologist was agressive and put her on life support with full knowledge from the family that that was not what she wanted. He would not listen. Two weeks later the onocologist asked that we the family have her removed from the life support system as she would no longer have what they determined as quality of life. To this day we struggle with the fact that the onocologist making a decision and then when he determined that her life no longer had quality in medical opinion she was to be removed but in order to do so needed the families consent. He was asked the question that he had not required our consent to put her on life support but that he now needed our consent to remove her. So to this day I struggle with the decision that I made as the family advocate to remove her from the life support. I know it was the right decision as I knew that she was suffering and that it was not what she wanted for herself or her family. End of life decisions are difficult ones. I feel for this family and understand their religous conviction. End of life descions are difficult ones. Most families see that when their family member is suffering in silence and that by keeping them on life support they are only prolonging the inevitable gather together to say their final goodbyes make the decision to discontinue with life support. This family is still holding on to the hope that their family member will come back to them in some shape or form. But what they need to also understand religious conviction or not is that if it is in God's hands then in God's hands it should be. Life support is not putting it in Gods hands. It is not allowing GOd and nature to determine whether this man lives or dies. Maybe the struggle is not only their religious belief but also the inside struggkle that no one wants to take responsibility and say itr is time we have to let what is meant to be happen.

Chan
said
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"One person's provision is another person's deprivation" True this philosophy is scary, but if the parents were to pay for the hospital fees, would they re-consider staying plugged? My personal thought, if I was to be a vegetable I rather dead then even plugging on the machine. There is always Pros and Cons, depending where it stands, but overall how long would he be plugged for? a years 2 years?

Mike
said
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I don't think it's just age that's playing a factor here...although clearly, some of you are reading it that way. The fact is that this man will not recover, and therefore it is a waste of resources to have him on this machine, when it could be someone else who has a chance. If it was a 20 year old with no chance of recovery...I imagine the decision would be the same. Take him off life support and let him pass in peace.

Layton
said
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I think that we have played God with medicine long enough. Let the poor man go to the light. Instead of arguing pros and cons over turning off the machines. Perhaps the onus should be on the attending physician to justify how the machine WILL save the life, before the patient is hooked up.

Jack
said
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If the family wants to give him a chance... they should be prepared to pay for it. They would be able to choose how long he lives and when he dies. It's unreasonable to support beating hearts forever. If the medical system is forced to support this man... many lives may later be lost because doctors won't choose life support in the first place.

Zak
said
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IN response to Gregory... dying with dignity?? YOU THINK LIFE SUPPORT is dignifying?? You think having someone change your diaper every few hours, having lines hooked up to every orifice of your body is dignifying?? This man's body has already wanted to die, it has shut down, His body CANNOT support his life anymore, without external intervention. SO, the question becomes whether we have the right to prolong a body that isn't capable of life on its' own. And that, to me, is where the family is in error. This man's body can't support life, so removing extraneous life support isn't murder, it is allowing the body to continue its' own course. Go and see exactly what happens to a person on life support, and see if YOU WANT that kind of last days??

George V.
said
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All medical intervention IS playing god.

Denise
said
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This is exactly why it's so important to have instructions for your family regarding your wishes. There have been so many of these cases in recent years, and there will only be more as Canada's population is aging.

Chris
said
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There should be a decision made based on quality of life, before a person is put on life support. If there is no hope for a quality of life, why do we need to extend someone's life for the sake of it.
People used to die, and it was chalked up to natural causes. In some areas we have come way too far with medical science and forgotten that we cannot cure all.

hilary
said
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I do not understand the families decision here. This individual is 84 years old, and obviously not in good health. Where is the quality of life? Why not just let him go and rest in peace, not to mention the cost to the health care system.

AJ Benny
said
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I feel like each situation should be privately discussed with each family and a doctor/board/committee. There could never be 1 hard fast rule-too many variables. I was on life support for 6 weeks while I was in a coma 10 years ago. I would have died, but now am a thriving Wife/Mom of 3.

Bruce King
said
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I just lost my own father one week ago. We were very lucky that he was able to communicate with us right up to the last moment. He chose a Home Death as his way to go. He did not want any form of medical intervention, other than to keep him as pain free as possible.

During all the debate, please keep one thing in mind. The last wishes of the patient should take precedence over everything else, including religious beliefs. What would he request if he had the ability to communicate?

Mark
said
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Are we not already playing "God" by intervening medically at all? Some religions allow very few medical interventions, still others allow virtually none. In this case obvious steps were taken to allow a higher quality of life when the man had the brain surgery. One could argue that was when we started playing "God", then putting him on life support 4 weeks ago is another point where the "God" issue comes up. Did "God want this man to linger on until his family is ready to let him go? Also, this is Manitoba we're talking about, the bed space is very much needed by someone who can actually make a recovery. So are we "Playing God"? If you are religious, yes absolutley! Don't confuse religion with a grieving family that doesn't have to pay his medical bills and is too selfish to let him go in peace.

John
said
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Nobody wants to talk about it, but it's really about the cost. If the family wants to pay themselves to keep him on life support, it's their choice. Nobody can't stop them. The real issue is this: should the rest of Canada be forced to pay for their decision to go to extraordinary lengths to keep this 84 year old somewhat alive?

Sylvie Anne
said
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Totally agree with Loomis... taking him off life support would only let him live as long as his heart would let him. Why prolong the inevitable? We are more human for your pets...

Teresa
said
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What this unfortunate man's family needs is some compassionate counselling with a trusted person, be it their Rabbi and /or social worker, or another family who has struggled with the same decision before. As a nurse, I have seen this type of thing happen only a couple of times, thankfully.

Nancy Chuipka
said
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In a sense,are we not playing God, by allowing this man to continue living on life support?
If it were up to "God", he would have already died.

Marty
said
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The decision should be up to the family. Under our system people are not allowed to get insurance for treatment covered under the province's health plan. A bed shortage is not an excuse to end treatment. Until the patient or guardian say end treatment they must continue. Any other decision is just an execution.

Johnny
said
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What if a 22 year old dies because this guy's family is taking up a bed? Its not that far of a stretch, people die everyday because our healthcare system lacks resources. How many people are dying because we expend so much effort to accomodate the selfish wishes of a family who can't bear to let this man die in peace.

island girl
said
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"One person's provision is another person's deprivation". That is a very scary philosophy on death to this aging baby boomer.
All my life I've had to jostle for positions for university, jobs, etc. and now I'm told to "Move over, sweetie, and make room for someone younger. You cost too much and take up too much room!"

Chris from Kitchener
said
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This is tough. While I think that it should be up to the family to decide, I don't know what I would want done if I were in that position. THis could be a very slipper slope we go down. The judge has to be extremely careful.

jbc
said
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If he could speak, I know what his answer would be. Without the machine, the answer would be there. The relatives should let go.

Donna O
said
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Having been in a similar situation with my grandfather I can understand the family's position. However, as was the case with my grandfather we decided that since he could not survive without the machines he should be allowed to pass without the artificial assistance.

Jack Godard
said
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Perhaps a solution for the family is to take care of their loved one in their home with all the equipment rented and hire a full time nurse etc. If it is important that a human being be kept alive in such unfortunate condition as this, then make it the families' responsibility to do so.

BK
said
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I don't understand how anyone can use a religious argument to keep this man alive. Religion was born long before life support machines so where in these beliefs does it say he should be kept alive by machines. Take him off and if he dies naturally then that is the way it was intended according to any of the religions. People have to accept what is and move on...

Rhody77
said
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One of the scariest comments I have heard in many years: "...with a shortage of hospital beds, "one person's provision is another person's deprivation." " Save us from doctors who want to play - or be - God. Does this mean that young people get beds before old people? What's next: Christians before Jews? White before black? Rich before poor? A slippery - and coldhearted - slope indeed.

Richard
said
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If the family wants to keep him alive then do so. I thought that this was the way it already was?

I'm not sure why this is being blown way out of proportion like this. Maybe that is the real problem.

PBW
said
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A difficult decision for all concerned.

We have the ability, these days, to do a lot, medically. However, the decsion must be made initially: Just because we can, should we in this case?

All religious arguments aside, I would not like to be doctors or judge in this decision, as any action - or inaction - leaves them in an untenable situation, subject to criticism from all and sundry.

Marty
said
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I do not wish to tread on anyone's religious beliefs or hurt any feelings, but I feel there is a point when family member's emotions seriously cloud their judgment AND their beliefs. I know how hard it is to part with a beloved family member- I have had my share. But this man living on a machine (with no chance of surviving more than a couple minutes after he is disconnected) is NOT God's will. It is time to let him go to be with God. Keeping him here is for his family, not for him. Let him go home and be at peace- as hard as it may be. Human bodies can be kept alive indefinitely in some cases, when machines are employed. How long should he be hooked up to this and called life? 2 years? 5? Maybe 10? Let him go home.

John
said
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I wonder if the family would want to keep him alive if they had to pay for all the associated costs or if one of their other family members needed the bed. Get real people, why do we waste beds for people who have no hope of recovery.

Sammy
said
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Are the family willing to foot the bill for the extra costs and space this dying man is taking. Would it be more humane to give the bed to someone that has a chance.

Kato Katlin
said
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Whether the medical community gets to decide what to do or not; it should be quick and as pain free as possible. Cutting the life support systems isn't enough.

Gregory Boudreau
said
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This is where our country is going, deciding who lives or who dies. We are playing God, and that is what scares me.
In our country, we respect people'e rights, including religious convictions, so why not in this case? I bet they (hospital) are wanting the bed for someone else. We must let people die with dignity, not like this.
It is looking more like if you are old and get sick, people are deciding when you die.

Loomis Poon
said
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I really don't understand the logic of the family's argument that removing the patient from life support would hasten his death. If it weren't for the equipment, he would have been dead already. All the equipment has done is to delay the inevitable.