Jump to content


Getting an "Insecure Connection" warning for Exisle? No worry

Details in this thread

When should life support be cut off?

Medical Ethics End of life 2008

  • Please log in to reply
51 replies to this topic

#1 Raina

Raina

    Cpt. Raina 'Starlee'

  • Validation Team
  • 6,009 posts

Posted 22 June 2008 - 02:22 AM

I've been following this story, which is related to another current discussion about religion and medicine, and whether someone's religious beliefs should be allowed to trump medical practice.

From CTV

Quote

Two more doctors have stopped working shifts at a Winnipeg hospital's critical care unit to avoid treating an 84-year-old man on life support. A third doctor said surgery needed to keep the patient alive was like "torture."
...
Golubchuck's doctors have recommended that he be removed from life support, but his family has fought that in court. They are Orthodox Jews, and their beliefs strictly forbid the hastening of a death.
...
On Monday, doctors Bojan Paunovic and David Easton became the second and third doctors to stop accepting shifts at Grace Hospital's critical care unit.

Dr. Anand Kumar had told Golubchuck's family it would be best to take him off life support because he has minimal brain function and his chances of recovery are slim.
...
In his resignation letter, Kumar detailed how doctors had to "surgically hack away at Golubchuck's infected flesh" because of ulcers on his skin. He likened the treatment to torture.
...
"It would be against their religious convictions not to fight for life and there is life and they are fighting," Kravetsky told CTV Winnipeg.

I also read in the newspaper (I can't find the same article online) that that hospital had to close down two ICU beds in order to come up with the resources to keep the man alive, and that the average ICU patient costs $2000/day to keep alive.



Do you think the doctors had a right to refuse treatment? Do you think their medical oaths and/or personal ethics should trump the family's religious beliefs?

Do you think that the healthcare system has the right to cut off treatment and indirectly kill him? Do you think that the family has the right to put more strain on an already strained healthcare system and use up resources that could be used to help someone else who does have a chance at recovery, when he's likely dead in all but body?

What should happen when a person's religious beliefs (the family's belief that cutting off life support would be murder) cross the line into impeding on the rights and beliefs of others (the doctors' belief that keeping him alive is torture, and the rights of other people to use the resources that he's taking up)?

"First thing they tell you is to assume you're already dead... dead men don't get scared or freeze up under fire. Me, I'm just worried that hell's gonna be a lonely place. And I'm gonna fill it up with every toaster son of a bitch I find." -Racetrack

"I believe what goes around comes around and if I am the instrument of 'coming round' then I'll do it happily. " -Shal


Viper Squadron CAG
Roman Warrior
Browncoat

#2 Lord of the Sword

Lord of the Sword
  • Islander
  • 15,681 posts

Posted 22 June 2008 - 02:32 AM

This is why it is SO important to make YOUR wishes know to all. Because IMO the only person whose wishes should count are the patients.

Make your wishes known, before surgery or whatever, this way you don't have this problem.

As for whose right...MO is that the doctors are. If there is no chance of recovery, they should just let him go. This smells like another Shiavo case to me.
"Sometimes you get the point of the sword, sometimes the edge, sometimes the flat of the blade (even if you're the Lord of the Sword) and sometimes you're the guy wielding it. But any day without the Sword or its Lord is one that could've been better  " ~Orpheus.

The Left is inclusive, and tolerant, unless you happen to think and believe different than they do~ Lord of the Sword

Looks like the Liberal Elite of Exisle have finally managed to silence the last remaining Conservative voice on the board.

“The tree of liberty must be refreshed from time to time with the blood of patriots & tyrants. It is it’s natural manure.” ~Thomas Jefferson

#3 Raina

Raina

    Cpt. Raina 'Starlee'

  • Validation Team
  • 6,009 posts

Posted 22 June 2008 - 03:02 AM

View PostLord of the Sword, on Jun 22 2008, 12:32 AM, said:

This is why it is SO important to make YOUR wishes know to all. Because IMO the only person whose wishes should count are the patients.
But even then, if he had wanted to be kept alive at all costs, then the issues would be the same. Granted, if he had specified that he didn't want to be kept alive at all costs, his children wouldn't have a leg to stand on.

"First thing they tell you is to assume you're already dead... dead men don't get scared or freeze up under fire. Me, I'm just worried that hell's gonna be a lonely place. And I'm gonna fill it up with every toaster son of a bitch I find." -Racetrack

"I believe what goes around comes around and if I am the instrument of 'coming round' then I'll do it happily. " -Shal


Viper Squadron CAG
Roman Warrior
Browncoat

#4 Broph

Broph
  • Islander
  • 6,671 posts

Posted 22 June 2008 - 06:41 AM

View PostRaina, on Jun 22 2008, 07:22 AM, said:

Do you think the doctors had a right to refuse treatment? Do you think their medical oaths and/or personal ethics should trump the family's religious beliefs?

Why was the family told of the options in the first place? Doctors have that phrase "there's nothing more we can do" that can be used.

Quote

Do you think that the family has the right to put more strain on an already strained healthcare system and use up resources that could be used to help someone else who does have a chance at recovery, when he's likely dead in all but body?

Is it the family or the doctors and nurses who are putting the strain on the healthcare system by not showing up for shifts? If those doctors showed up, those 2 other beds might be available.

#5 D'Monix

D'Monix
  • Islander
  • 4,060 posts

Posted 22 June 2008 - 07:52 AM

I think the man's family would realize that instead of hastening death, they are preventing what must occur naturally under God's heaven (at least from a religious standpoint) and thus actually doing a  disservice unto Him.

just my .02

D'

#6 Annibal

Annibal
  • Islander
  • 3,036 posts

Posted 22 June 2008 - 08:02 AM

View PostBroph, on Jun 22 2008, 11:41 AM, said:

View PostRaina, on Jun 22 2008, 07:22 AM, said:

Do you think the doctors had a right to refuse treatment? Do you think their medical oaths and/or personal ethics should trump the family's religious beliefs?

Why was the family told of the options in the first place? Doctors have that phrase "there's nothing more we can do" that can be used.

Because he's on life support. He is, in a sense, alive, so I can't see anyone going to the family and saying "there's nothing more we can do" while discreetly taking him off it and letting him die. So as soon as the family knew he was "alive," they would start fighting.

Quote

Quote

Do you think that the family has the right to put more strain on an already strained healthcare system and use up resources that could be used to help someone else who does have a chance at recovery, when he's likely dead in all but body?

Is it the family or the doctors and nurses who are putting the strain on the healthcare system by not showing up for shifts? If those doctors showed up, those 2 other beds might be available.

Both are at fault. The family for demanding their torture of their loved one be continued and the doctors who fled their job, duty and oaths. What I would do is sue the family for emotional trauma, and tell them to set up a home care room at their house. If they want to keep him fighting they can pay for it and do the work. I dunno how badly he's in need of a hospital, but in many coma cases they can be taken care of at home. That may just be if they can breath for themselves though.
"A song for a heart so big, god wouldn't let it live. May angels lead you in. Hear you me my friends.
On sleepless roads the sleepless go.
May angels lead you in."

Blue skies, Alex.


My Deviantart page!
My Films and Animations!

#7 Broph

Broph
  • Islander
  • 6,671 posts

Posted 22 June 2008 - 08:32 AM

View PostAnnibal, on Jun 22 2008, 01:02 PM, said:

Because he's on life support. He is, in a sense, alive, so I can't see anyone going to the family and saying "there's nothing more we can do" while discreetly taking him off it and letting him die. So as soon as the family knew he was "alive," they would start fighting.

I didn't say anything about taking him off life support without telling the family, but they're doing procedures on him.

Quote

What I would do is sue the family for emotional trauma

Hospitals can't have it both ways.

Quote

and tell them to set up a home care room at their house. If they want to keep him fighting they can pay for it and do the work. I dunno how badly he's in need of a hospital, but in many coma cases they can be taken care of at home. That may just be if they can breath for themselves though.

That's not likely to work.  I doubt he'd survive transfer out of the hospital. And if he's to "survive", he needs the care of an ICU and an available operating room. That couldn't happen at a home.

#8 Rhea

Rhea

  • Islander
  • 16,433 posts

Posted 22 June 2008 - 09:21 AM

http://www.wesleyjsm.....ck Case..html

Doctors are beginning to quit rather than to continue to prolong Golubchuck's life:

Quote

Two more doctors have stopped working shifts at a Winnipeg hospital's critical care unit to avoid treating an 84-year-old man on life support. A third doctor said surgery needed to keep the patient alive was like "torture."

The Winnipeg Regional Health Authority said Tuesday it's in negotiations with doctors at Grace Hospital to have one physician treat Samuel Golubchuck, who has been on life support since last fall.

Golubchuck's doctors have recommended that he be removed from life support, but his family has fought that in court. They are Orthodox Jews, and their beliefs strictly forbid the hastening of a death.

Heidi Graham of the WRHA said that Golubchuck's doctor would be assisted by two other physicians.

"This will allow the other doctors at the Grace ICU to continue their rotations as scheduled," Graham told CTV Winnipeg.

However, the hospital's doctors have yet to agree to this plan.

On Monday, doctors Bojan Paunovic and David Easton became the second and third doctors to stop accepting shifts at Grace Hospital's critical care unit.

Dr. Anand Kumar had told Golubchuck's family it would be best to take him off life support because he has minimal brain function and his chances of recovery are slim.

Earlier this month, Kumar resigned from his rotations at the hospital, saying he could no longer, in good conscience, continue to keep Golubchuck alive.

In his resignation letter, Kumar detailed how doctors had to "surgically hack away at Golubchuck's infected flesh" because of ulcers on his skin. He likened the treatment to torture.

However, Golubchuck's family went to court and got an injunction to keep him on life support. The case is due in court again this September.

Golubchuck had already sustained brain damage before he was admitted to the hospital.

And isn't it interesting how easily one can use words to twist the facts:

http://lazerbrody.ty...pora/index.html

Quote

Beware of Manitoba Doctors
Samuel Golubchuck wants to live. Manitoba's doctors, adopting a social Darwinist outlook, say that he doesn't deserve to. The case is now in a Winnipeg court.

Rebbe Nachman warned us repeatedly about such messengers of the Angel of Death:  On January 30, Manitoba's College of Physicians and Surgeons released new guidelines that became effective February 1. They state that the final decision to pull the plug on a patient lies with the physician. We condemn this arrogant attitude, where Manitoba's physicians hold themselves higher than G-d, Heaven forbid.

Winnipeggers, we suggest that you keep your loved ones out of hospitals. If there's no choice, make sure someone from the family is with the patient around the clock. Where there's no fear of Hashem, there's no morality. Where there's no morality, there's murder. Pulling the plug of life support is murder, period.

Samuel Golubchuck is brain-damaged - he doesn't know whether he wants to live or not. He doesn't know anything, because he has minimal brain function. Amazing how the Rabbi claims to know what Samuel would want, isn't it?

Edited by Rhea, 22 June 2008 - 09:29 AM.

The future is better than the past. Despite the crepehangers, romanticists, and anti-intellectuals, the world steadily grows better because the human mind, applying itself to environment, makes it better. With hands...with tools...with horse sense and science and engineering.
- Robert A. Heinlein

When I don’t understand, I have an unbearable itch to know why. - RAH


Everything is theoretically impossible, until it is done. One could write a history of science in reverse by assembling the solemn pronouncements of highest authority about what could not be done and could never happen.  - RAH

#9 Lin731

Lin731
  • Islander
  • 4,126 posts

Posted 22 June 2008 - 10:42 AM

Quote

Is it the family or the doctors and nurses who are putting the strain on the healthcare system by not showing up for shifts? If those doctors showed up, those 2 other beds might be available.

Hmmm...aren't doctors like barowners or burger flippers? Shouldn't they have the right to refuse "service" they don't agree with? Afterall there are other doctors and hospitals right?
Posted Image
Posted Image

#10 Godeskian

Godeskian

    You'll be seein' rainbooms

  • Islander
  • 26,839 posts

Posted 22 June 2008 - 11:30 AM

View PostLin731, on Jun 22 2008, 04:42 PM, said:

Quote

Is it the family or the doctors and nurses who are putting the strain on the healthcare system by not showing up for shifts? If those doctors showed up, those 2 other beds might be available.

Hmmm...aren't doctors like barowners or burger flippers? Shouldn't they have the right to refuse "service" they don't agree with? Afterall there are other doctors and hospitals right?

Hey if pharmacists can refuse to do their jobs because of their deeply held convictions, why not doctors too.

Defy Gravity!


The Doctor: The universe is big. It's vast and complicated and ridiculous and sometimes, very rarely, impossible things just happen and we call them miracles... and that's a theory. Nine hundred years and I've never seen one yet, but this will do me.


#11 G1223

G1223

    The Blunt Object.

  • Dead account
  • 16,164 posts

Posted 22 June 2008 - 11:43 AM

I think it should be cut off when the person is only being kept alive by the deivces. They will never recover the abilty to breath or eat on their own. I had to make this choice with my father. His living will stated that it did not want extra ordinary measures taken and the feeding tube they wanted to give him would never be taken out for the rest of his life. That was by me seen as something he would not want done.  So it was not.

But keeping someone alive just to be alive leaves me a bit ill. I think the counter argument to the jewish faith issue is that the life support is not allowing the man die as he would normally. The turning off of the devices will not hasten death.
If you encounter any Trolls. You really must not forget them.
And if you want to save these shores. For Pity sake Don't Trust them.
paraphrased from H. "Breaker" Morant

TANSTAAFL
If you voted for Obama then all the mistakes he makes are your fault and I will point this out to you every time he does mess up.

When the fall is all that remains. It matters a great deal.

All hail the clich's all emcompassing shadow.

My playing well with other's skill has been vastly overrated

Member of the Order of the Knigths of the Woeful Countance.

#12 Annibal

Annibal
  • Islander
  • 3,036 posts

Posted 22 June 2008 - 11:46 AM

View PostGodeskian, on Jun 22 2008, 04:30 PM, said:

View PostLin731, on Jun 22 2008, 04:42 PM, said:

Quote

Is it the family or the doctors and nurses who are putting the strain on the healthcare system by not showing up for shifts? If those doctors showed up, those 2 other beds might be available.

Hmmm...aren't doctors like barowners or burger flippers? Shouldn't they have the right to refuse "service" they don't agree with? Afterall there are other doctors and hospitals right?

Hey if pharmacists can refuse to do their jobs because of their deeply held convictions, why not doctors too.

Yeah. I mean, hospitals are a business. It's not like patients should force their beliefs onto the doctors, the doctors should be able to help who they think deserves help.

Edit to add: well said, G. I fully agree. If it were me, I would not want to be kept "alive" as some sort of veggie. It's not living, it's just keeping you from whatever "afterlife" you believe in.

Edited by Annibal, 22 June 2008 - 11:49 AM.

"A song for a heart so big, god wouldn't let it live. May angels lead you in. Hear you me my friends.
On sleepless roads the sleepless go.
May angels lead you in."

Blue skies, Alex.


My Deviantart page!
My Films and Animations!

#13 Lin731

Lin731
  • Islander
  • 4,126 posts

Posted 22 June 2008 - 11:53 AM

Quote

Hey if pharmacists can refuse to do their jobs because of their deeply held convictions, why not doctors too.

Exactly...So we should get our bobsleds ready for that slipperly slope on the horizon because that's where we're headed.

If I were a nurse (under those standards) would I have the right to not take care of drug addicts because the bible says it's a sin? If I were an anethesiologist and an emergency abortion or some other procedure that might violate my religious beleifs came in, should I be able to refuse to put the patient under? How about a police officer? Should I have the right to not take an abusive spouse into custody, counsel the wife to "pray for him"?
Posted Image
Posted Image

#14 Godeskian

Godeskian

    You'll be seein' rainbooms

  • Islander
  • 26,839 posts

Posted 22 June 2008 - 11:55 AM

View PostLin731, on Jun 22 2008, 05:53 PM, said:

Exactly...So we should get our bobsleds ready for that slipperly slope on the horizon because that's where we're headed.

If I were a nurse (under those standards) would I have the right to not take care of drug addicts because the bible says it's a sin? If I were an anethesiologist and an emergency abortion or some other procedure that might violate my religious beleifs came in, should I be able to refuse to put the patient under? How about a police officer? Should I have the right to not take an abusive spouse into custody, counsel the wife to "pray for him"?

Apparently you can refuse to do your job, as these doctors and the pharmacists from the other thread are proving.

Defy Gravity!


The Doctor: The universe is big. It's vast and complicated and ridiculous and sometimes, very rarely, impossible things just happen and we call them miracles... and that's a theory. Nine hundred years and I've never seen one yet, but this will do me.


#15 G1223

G1223

    The Blunt Object.

  • Dead account
  • 16,164 posts

Posted 22 June 2008 - 12:13 PM

They are refusing to keep a dead body on life support just so someone can feel better about it.
If you encounter any Trolls. You really must not forget them.
And if you want to save these shores. For Pity sake Don't Trust them.
paraphrased from H. "Breaker" Morant

TANSTAAFL
If you voted for Obama then all the mistakes he makes are your fault and I will point this out to you every time he does mess up.

When the fall is all that remains. It matters a great deal.

All hail the clich's all emcompassing shadow.

My playing well with other's skill has been vastly overrated

Member of the Order of the Knigths of the Woeful Countance.

#16 iMel

iMel

    New and improved!

  • Islander
  • 2,338 posts

Posted 22 June 2008 - 12:53 PM

The Hippocratic oath states "to keep the good of the patient as the highest priority." If the patient has no chance of recovery and is undergoing unnecessary painful surgical procedures, I think the doctors should be able to refuse to treat him based on the oath. I also don't think a patient is really "alive" who requires life support to exist and isn't going to wake up. The patient is existing, not living.
I use these words pretty loosely. There's so much more to life than words.
--Over the Rhine, "Latter Days"


Formerly known as Neozephryus :)

#17 Lord of the Sword

Lord of the Sword
  • Islander
  • 15,681 posts

Posted 22 June 2008 - 06:16 PM

View PostRaina, on Jun 22 2008, 04:02 AM, said:

But even then, if he had wanted to be kept alive at all costs, then the issues would be the same. Granted, if he had specified that he didn't want to be kept alive at all costs, his children wouldn't have a leg to stand on.

True. And it IS the doctor's job to deliver health care...And I don't really like the idea of doctor's just saying "No, I won't treat that." that is a very slippery slope.

But, then again, doctors have been known to be wrong in the past.
"Sometimes you get the point of the sword, sometimes the edge, sometimes the flat of the blade (even if you're the Lord of the Sword) and sometimes you're the guy wielding it. But any day without the Sword or its Lord is one that could've been better  " ~Orpheus.

The Left is inclusive, and tolerant, unless you happen to think and believe different than they do~ Lord of the Sword

Looks like the Liberal Elite of Exisle have finally managed to silence the last remaining Conservative voice on the board.

“The tree of liberty must be refreshed from time to time with the blood of patriots & tyrants. It is it’s natural manure.” ~Thomas Jefferson

#18 Broph

Broph
  • Islander
  • 6,671 posts

Posted 22 June 2008 - 07:19 PM

View PostLord of the Sword, on Jun 22 2008, 11:16 PM, said:

And I don't really like the idea of doctor's just saying "No, I won't treat that." that is a very slippery slope.

Why not, though? If the doctor thinks that the treatment is prolonging pain, rather than working with a treatable illness/condition, why shouldn't they be able to say that they won't treat that?

#19 Lord of the Sword

Lord of the Sword
  • Islander
  • 15,681 posts

Posted 22 June 2008 - 11:40 PM

View PostBroph, on Jun 22 2008, 08:19 PM, said:

Why not, though? If the doctor thinks that the treatment is prolonging pain, rather than working with a treatable illness/condition, why shouldn't they be able to say that they won't treat that?

because there have been too many times the doctors have been proven wrong. How many times have doctors swore that a patient wouldn't walk again...only to have that patient eventually walk?

I'm all for letting the doctor give his honest opinion...but to then just up and say "No, not treating you any more." just seems like a very slippery slope. You could easily have patients denied care for racial, gender, or religious reasons...only covered up with the doctor's comment of "It would cause undo pain, "ect.
"Sometimes you get the point of the sword, sometimes the edge, sometimes the flat of the blade (even if you're the Lord of the Sword) and sometimes you're the guy wielding it. But any day without the Sword or its Lord is one that could've been better  " ~Orpheus.

The Left is inclusive, and tolerant, unless you happen to think and believe different than they do~ Lord of the Sword

Looks like the Liberal Elite of Exisle have finally managed to silence the last remaining Conservative voice on the board.

“The tree of liberty must be refreshed from time to time with the blood of patriots & tyrants. It is it’s natural manure.” ~Thomas Jefferson

#20 G1223

G1223

    The Blunt Object.

  • Dead account
  • 16,164 posts

Posted 22 June 2008 - 11:45 PM

So the doctors here should have kept the brain damaged  slowly rotting to death body alive? Because the oath seems to be keep people alive and let them suffer. So we drop the do no harm part of the oath to keep a person alive in this condition?
If you encounter any Trolls. You really must not forget them.
And if you want to save these shores. For Pity sake Don't Trust them.
paraphrased from H. "Breaker" Morant

TANSTAAFL
If you voted for Obama then all the mistakes he makes are your fault and I will point this out to you every time he does mess up.

When the fall is all that remains. It matters a great deal.

All hail the clich's all emcompassing shadow.

My playing well with other's skill has been vastly overrated

Member of the Order of the Knigths of the Woeful Countance.



Also tagged with one or more of these keywords: Medical Ethics, End of life, 2008

0 user(s) are browsing this forum

0 members, 0 guests, 0 anonymous users