Samuel Golubchuk can't talk and barely moves, but he is forcing a legal battle that some experts say hits on our most fundamental right to life.
On one side of the debate are doctors at Winnipeg's Grace Hospital who say 84-year-old Golubchuk has minimal brain activity and should be taken off life support.
Arguing against this are Golubchuk's son, Percy Golubchuk, and daughter, Miriam Geller, who say they have seen improvement in their father and that he responds to their presence. They want him kept alive.
The family's lawyer, Neil Kravetsky, told The Epoch Times that when doctors first informed the Jewish family their father would be taken off life support, they requested a delay until after the Sabbath. This allowed them time to get a court injunction to stop the removal. Also weighing in on the debate is the College of Physicians and Surgeons of Manitoba. The professional organization recently released a policy for its members on when and how they should withhold life-saving treatments.
The policy gives doctors the sole right to decide when patients should be taken off life-support. While the policy directs doctors to consult the family, it says doctors can decide independently after consulting with one other physician if the family disagrees with them. In some cases doctors have to give the family four days notice; in others, treatment may be stopped immediately.
While the policy spells out a clear process for how doctors should go about withdrawing life support in various scenarios, it has no stipulation for any objective testing to determine a patient's condition.
Kravetsky says this leaves the decision to withdraw life-support and effectively end a patient's life solely in the hands of doctors relying on their subjective opinions.
"This whole issue about doctors being able to make decisions for patients that are the most important decisions in the patient's life … It would be a complete and utter backward step from what a democracy is supposed to be about," he said.
Kravetsky added that leaving the decision solely in the hands of doctors without any oversight or objective testing is dangerous because it allows doctors to be selective about whom they give or withdraw treatments from.
"I think they are misguided in their view," said Kravetsky, referring to the notion that doctors can decide independently when to end a patient's life.
And apparently the courts agree. Last week, as doctors were going to withdraw Golubchuk's life support, Kravetsky was standing before a judge to get an injunction. The lawyer said he had to threaten legal action to get doctors to wait until after the judge made his decision.
The judge granted an interim injunction that prevents doctors from withdrawing life support until a full trial can take place. However, Kravetsky said the hospital might appeal the injunction.
As the College's policy stands now, doctors may withdraw treatment whenever they see fit but must give the family four days notice if the patient meets certain requirements: achieves awareness of self, achieves awareness of environment, and experiences his or her own existence.
Kravetsky says those requirements are at best vague and at worst leave far too much room for subjective opinions to play a part.
He says he also worries some doctors could choose to withdraw treatments from patients they don't like and provide treatments to those they do like.
Dr. Bill Pope, Registrar with the College, said the policy doesn't spell out specific tests because there are far too many scenarios and technology is always changing. He also took offence at recent media reports suggesting doctors were killing patients, saying there is a vast difference between withdrawing treatments and killing.
Dr. Margaret Somerville, one of the country's foremost experts on bioethics, also disagrees with the College's position that doctors can be the sole deciders of when to withdraw life support and effectively end a patient's life.
"Doctors are involved in those decisions but I don't think the final decision making belongs to the doctor," said Somerville, a professor and founding director of the McGill Centre for Medicine, Ethics and Law.
Somerville said there is a significant difference between a patient who is brain dead and a patient who may be responding to the presence of family members. She also draws distinctions between withdrawing futile treatments and withdrawing treatments that are keeping someone alive.
Like Kravetsky, Somerville feels the issue being decided could have much broader ramifications. She's particularly concerned in light of the rise of transplant tourism and other practices that tend to treat the human body as a commodity.
"What does it do to our values if we say we don't care what you want or what you think or what your religious beliefs are that would want you to do this," she said, referring to patients and families requesting treatments. "What does that say about our general values?"
Somerville said that if doctors are withdrawing life sustaining treatments with the intention that the patient should die, that would be euthenasia, a practice she has grave concerns about.
"For thousands and thousands of years we've known that there's something really wrong about euthanasia, and nothing's changed," she said. "So why are we thinking it's a good idea now?"
Somerville cited studies that found most people, if they were not in pain, would want to live. She said the current debate on euthanasia reflects a change in society.
"We've lost our moral compass in this society. We've got to be really careful not to dull that moral intuition."
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