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Right to Decide When to End Treatment is Doctor's, not Family's: Physician's Guidelines

By Hilary White

WINNIPEG, Manitoba, January 31, 2008 (LifeSiteNews.com) - At the same time that a Canadian hospital is still engaged in a court battle over whether or not doctors can starve and dehydrate to death an 84-year-old Orthodox Jewish man who was brain injured, the Manitoba College of Physicians and Surgeons has issued guidelines for doctors that says that doctors have the right - not patients or their families - to decide when life-sustaining treatment can be withdrawn. 

The ultimate decision, says Dr. Bill Pope, registrar of the College, lies with the physician, and there is no need to heed the wishes of patients or families. Doctors must "communicate" the decision with patients or their legal proxy "to make that situation more transparent," Pope said. "Nonetheless, doctors are permitted to make that decision."

Alex Schadenberg, the executive director of the Canadian Euthanasia Prevention Coalition, said the guidelines are a reflection of the current trends in bioethics that designate some patients as persons and others as disposable, according to purely utilitarian criteria.

Schadenberg said, "If you have a child with a significant cognitive disability or a parent with dementia you cannot bring them to the hospital in Manitoba because it would be a death sentence."

Samuel Golubchuk suffered a brain injury after a fall in 2003, but was still responsive and could communicate. He was sent to Grace Hospital in Winnipeg in October after contracting pneumonia, where doctors attempted to hasten his death by starvation and dehydration. His family has gone to court to defend his life, using arguments based on their strongly held religious belief in the sanctity of life.

In early January, Golubchuk regained consciousness and appears to be improving. Although a hospital doctor treating Golubchuk wrote "Awoke" on his chart, the hospital did not disclose this to the court. The Manitoba Court of Queen's Bench has reserved its decision.

Neil Kravetsky, the family's lawyer, said in December: "To pull you physically off these machines takes [away] the patient's consent...I don't see the difference if [a doctor] came in and put a pillow over his face."

Grace General Hospital in Winnipeg is being supported by the Canadian Medical Association in its court battle to introduce euthanasia into the Canadian medical system.

A Grace General Hospital lawyer told the court that doctors "have the sole right to make decisions about treatment - even if it goes against a patient's religious beliefs."

Kravetsky said the patient or the family makes decisions to withdraw treatment, not the doctor. But the new guidelines from the Manitoba College of Physicians and Surgeons claim otherwise, in support of Grace Hospital's argument.

The guidelines say the "minimum goal" of life-sustaining treatment, including food and water, is for patients to recover to a level in which they can be aware of themselves, their environment and their existence. This is language, Schadenberg says, that comes straight out of the Peter Singer playbook.

Peter Singer, the Ira W. DeCamp Professor of Bioethics at Princeton University, is the world's leading proponent of euthanasia, including infanticide for healthy unwanted children after birth. Under the Manitoba College's guidelines, in accordance with the Singer school of bioethics, newborns and those suffering dementia would thus not be considered persons and have no rights to care or treatment.

Schadenberg points to the fact that the case is still before the courts in Manitoba. "Clearly," he said, "this is an attempt to pressure the court to decide in their interests."

The recently released guidelines apply to all Manitoba physicians and come into effect February 1. Pope said if the judge rules in favour of a patient's family, the College will review their end-of-life regulations.

Read related LifeSiteNews.com coverage:

Canadian Hospital Wants to Withdraw Patient's Feeding Tube but Jewish Family Says No in Court
http://www.lifesitenews.com/ldn/2007/dec/07121212.html

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