In 2006, the Terry Schiavo case attracted national attention in the United States, with a conflict between a woman’s parents (who wanted to care for their daughter and keep her alive) and the woman’s ex-husband (who wanted her feeding tubes removes so that she would die of dehydration, and who said that he was acting according to her wishes). Right now in Canada, a similar case is playing out, with one crucial difference: all of the man’s family wants him to live, while his doctors want him terminated.
Samuel Golubchuk is an 84-year-old Orthodox Jew in Winnipeg, Manitoba. Hospitalized since October 26, he is believed by his doctors to be terminally ill, and to have suffered brain injuries which leave him unconscious. The doctors want him removed from his respirator and feedng tube. His family strongly objects on religious grounds, argues that where there’s life there’s hope, and says that he holds their hands during visits. It appears that Mr. Golubchuk has not been examined by a neurologist, or had tests performed which might confirm the Winnipeg doctors’ belief about his brain function status.
Toronto professor Peter Singer, and of the rightfulness of killing humans with low degrees of self-consciousness, writes that forcing the doctors to continue to provide care for Mr. Golubchuk violates the doctors’ rights. He argues that the family should be given time to find another hospital willing to care for Mr. Golubchuk, and if they cannot, then the family should accept his death.
Over the forceful objections of the Canadian Medical Association, a Winnipeg judge has issued a temporary injunction forbidding Grace Hospital from euthanizing Mr. Golubchuck. The doctors point to their own ethical standards against providing what they believe to be “futile” treatment, and claim that end-of-life decisions should be made by physicians, who have the patient’s best interests at heart. Supporters of the family reply that doctors should not have the authority to over-ride a family’s religious beliefs, liken the proposed euthanasia to Nazi tactics, and point to a recent case in Calgary, where a man believed by physicians to be irreversibly brain-damaged made an unexpected recovery.
The debate in Canada, which has been reported in international newspapers, does not yet appear to have dealt with the fact that the “physician rights vs. family rights” conflict is exacerbated by Canada’s rigidly socialized system of health care. Unlike, for example, in the U.K. or Ireland, it is extremely difficult (although, thanks to a 2005 Supreme Court ruling, technically legal) for physicians to operate outside the government-run health care system. In a non-coercive system of health care, families could use their own money, or private insurance to pay for health care. Privately-funded hospitals could operate under the standards of their sponsors, such as religious organizations. A Catholic hospital could accept for Mr. Golubchuk as a patient (and provide him with medical care pro bono, if the hospital so chose), and keep him alive pursuant to Catholic beliefs about the sanctity of human life. Conversely, physicians who wanted to practice euthanasia could operate at hospitals which allowed the practice, and patients and families who accepted such practices could choose such hospitals.
There are many pro/con arguments about fully socialized vs. partially-socialized vs. non-coercive systems of health care. It does seem that one advantage of systems with less coercion is not forcing doctors or families to violate their ethical beliefs, or forcing health-care decisions into courts. In any case, it is fortunate for Mr. Golubchuk’s family that Canada still has an independent judiciary.