1. Ethical Analysis:
Ethics and the Right to Life
Ruqayya Salam

2. The Right to Life
• Each person has an essential right to live
and not be killed by another human being.
• Pro-life concepts are central to debate on
the issues of:
• Euthanasia
• Abortion
• Capital Punishment
• Self defense

3. The Case of Samuel Golubchuck
and the Right to Live
• 84-year old patient
• Orthodox Jew from Manitoba, Canada
• His neurological function was open to
debate.
• Neither brain dead or in a vegetative state.
• Artificially ventilated and fed by a
gastronomy tube.

4. The Case of Samuel Golubchuck
and the Right to Live
• The physician requested to remove Mr.
Golubchuck from life support.
• The family opposed that the removal of life
support because:
– Mr. Golubchuck himself would oppose the
removal of life support.
– It goes against the Orthodox Jewish law of
withdrawing ventilation and tube feeding with
the intent of hastening death.

5. The Case of Samuel Golubchuck
and the Right to Live
• In 2008, the College of Physicians and
Surgeons of Manitoba released a new
guideline:
– The physician has the final decision to draw
life support regardless of family wishes.
– If the family disagrees, the physician must
consult with another physician.
– If the consulted physician agrees, life-
sustaining therapy may be withdrawn.
• Mr. Golubchuck died on June 24, 2008.

6. Patient/Family Perspective
• Mr. Golubchuck’s son and daughter
opposed the removal of life support.
– Mr. Golubchuck lived during the Holocaust.
• They also stated Mr. Golubchuck would
oppose the idea as well.
• The family obtained a legal injuction
against the discontinuation of life support
twice.

7. Provider Perspective
• Physicians are given the decision making
power even if it goes against the patient or
family’s wishes.
• In their opinion, they can give Mr.
Golubchuck’s ICU bed to another patient
with higher priority.

8. Social Perspective
• There is a potential negative impact on
giving physicians decision-making power.
– Decrease of trust in the healthcare system
– Patients also wondered if they would be
denied care under the new guidelines

9. Legal Perspective
• The Manitoba ruling granted physicians
the authority to make the ultimate ethical
decision.
– The ability for physicians to predict life
expectancy in terminally ill patients is limited.

10. Financial Perspective
• Canada has socialized medicine and is
limited to the resources they can offer.
• They set societal priorities on what
resources can be provided.
• In response to financial pressures, they
limit health care expenditures.

11. Principle of Autonomy
• Person’s right to make choices based on
their values and belief system.
– Exercised through informed consent.
– Patients should play a role of primary decision
maker.
• In this case, the guidelines:
– Were not sensitive to the patient’s culture.
– The physician did not obtained informed
consent.

12. Principle of Beneficence
• Action that is done to benefit others.
– These actions can be taken to prevent or
remove harm .
• The removal of life support goes against
this principle because:
– Physicians have an obligation to help and
promote the welfare of their patients.
– They should also defend the rights of others,
including the Right to Life.

13. Principle of Nonmaleficence
• “Do no harm.”
• Harm can be defined as death (removal of
life support) and deprivation of freedom.
• The life-sustaining therapies did not show
any potential risks or as being ineffective
treatments.

14. Principle of Justice
• Fair distribution of resources and benefits
offered by a society and respect for a
person’s rights.
• The removal of life support should be
decided by the patient, family or guardian,
not solely by the physician.
– Mr. Golubchuck’s physician was given all
decision making power.
– The physician did not need obtained informed
consent.

15. Conclusion
• Life has its purpose regardless if it’s physically
challenged or normal.
– The Right to Life should be respected and preserved.
• The physician’s main role is to treat patients
fairly and respect their autonomy as well as the
choices they make.
– It is not their role to play God, legislator or judge.
• A patient’s values and health care beliefs should
be respected so they can live accordingly.

16. References
1. Jotkowitz A, Glick S, Zivotofsky A. The Case of Samuel
Golubchuck and the Right to Live. The American Journal of
Bioethics. 2010; 10; 50-53.
2. The Right to Life. Ascension Health Web site. 2013. Available at:
http://www.ascensionhealth.org/index.php
?option=com_content&view=article&id=205&Itemid=172.
Accessed on January 13, 2013.
3. Key Ethical Principles. Ascension Health Web site. 2013.
Available at: http://www.ascensionhealth.org/index.php
?option=com_content&view=article&id=47&Itemid=171. Accessed
on January 13, 2013.