As an intensive care physician, it is with great sadness that I have observed the legal circus surrounding the case of the late Sam Golubchuk unfold in the media (“Winnipeg man in life support controversy dies,” CJN, July 3).
End-of-life decision-making in the intensive care unit occurs each and every day. The issue of when the suffering and burden of a particular treatment becomes too great for a patient to bear is a difficult one for doctors and patient’s families alike. To effectively address these issues requires a collaborative approach that includes the recognition of a patient’s values, wishes and beliefs by the medical team, as well as trust in the skill and expertise of the medical team by the patient and their family. It is only in cases when a lack of respect and trust develops that conflicts such as those resulting in the Golubchuk case arise. Unfortunately, conflict in such cases only leads to the further polarization and entrenchment of views.
As an intensive care physician, I have had the privilege of caring for many religious Orthodox Jews and their families, as well as patients of other religions who share similar beliefs pertaining to medical care. When faced with end-of-life decisions in such cases, suggesting that the family seek guidance from their rabbi or even inviting the patient’s rabbi to sit in on family meetings – with the family’s permission – has encouraged dialogue as well as encouraging people to keep an open mind. I will tell families that a rabbi, just like a physician, cannot provide an expert opinion without first being made aware of all the facts and circumstances.
As a physician and as a Jew, I believe that all life is precious and of infinite value. I also believe that alleviating suffering and providing comfort to a dying patient is a core purpose to any of the healing arts. As the great rabbi and physician Maimonides describes in his oath for doctors, “May I never see in the patient anything but a fellow creature in pain.”
These are not opposing beliefs – rather they are one in the same.
Golubchuk’s final battle
With regard to the story “Winnipeg man in life support controversy dies” (CJN, July 3) about the death of a disabled man, Samuel Golubchuk, please note that I was misquoted more than once.
What I had said in my eulogy was, “Many worship the god of utilitarian philosophy, which espouses ‘futile care’ theory as a rationale to end the lives of disabled individuals, and other false gods. Chaim Shmuel, Samuel Golubchuk, worshipped only one God.”
In addition, I noted that, “In Europe, on the battlefield, he faced evil and did not flinch. And in his final battle, he also did not flinch.”
The suggestion that his final battle was with the hospital was not made by me. Indeed, his final battle was with the Angel of Death, a final battle nearly all of us will eventually have to face (a few of us will die suddenly, or in our sleep). In that battle, we hopefully will have physicians who obey their Hippocratic oath and seek to cure, or to care, but never to kill.
Leon Zacharowicz, MD
CJC lobbied for ITF membership
Prime Minister Stephen Harper and Secretary of State Jason Kenney do indeed deserve warm commendation for the government’s principled decision to apply for membership on the Task Force (ITF) for International Co-operation on Holocaust Education, Remembrance and Research (“Canada to become member of Holocaust Task Force,” CJN, July 3). This move did not occur in a vacuum, however, and The CJN was remiss in not acknowledging the longstanding efforts of the Jewish community advocacy organizations, which finally came to fruition under the current government.
Canadian Jewish Congress (CJC) has been in the forefront of lobbying for Canada to join the ITF since the task force’s inception. We have worked closely with Kenney and officials at Canadian Heritage and contributed to the baseline study on domestic Holocaust initiatives that Canada submitted as part of the application process. CJC representatives have participated in the NGO component of Canadian delegations to recent ITF gatherings, and I have been given the honour of representing CJC on the task force’s education working group. In particular, CJC has worked for more than a decade on securing a government commitment to memorialize the S.S. St. Louis with a historical monument in Halifax Harbour.
We look forward to this ongoing partnership with the Canadian government to help Canada gain full membership on the ITF and to the establishment of the St. Louis historical marker.
CJC Ontario Region