There but for the gods of Grace goes life.
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............................Both Mr. Kravetsky and one of the three physicians said the death left key legal questions unanswered.
"The issue really comes down to this: Do you want to give up your right to make a decision on an end-of-life scenario?" Mr. Kravetsky said.
The physician said it was unfortunate there will be no further legal guidance. "We need resolution on this issue. These cases are just occurring over and over again."
The head of the local health authority said there will be discussions but no formal change in guidelines on dealing with end-of-life cases.
"As a community, we have to work towards an answer to this issue. I think there are ways to do that outside of the courts," said Dr. Brian Postl, president of the Winnipeg Regional Health Authority.
A source said the three doctors are expected to accept shifts at the Grace ICU again.
The source said a fourth doctor had prepared a resignation letter in recent days. But officials said they weren't aware of such a development.
"Were there other members of the health-care team at the Grace ICU who had concerns about the case? Absolutely. But there were just the three who resigned from the shift schedule," WRHA spokeswoman Heidi Graham said.
The case drew the attention of ICU specialists across the country. Some said it underlined the public misperception of critical care.
Intensive-care systems can prop up a patient's life functions, boosting the heart with an aortic pump, using a ventilator to pump oxygen into the lungs and helping kidneys with a dialysis machine.
But the technology cannot sustain people for long stretches, especially if the patient is already weak, said Dr. Yoanna Skrobik, an ICU practitioner at Hospital Maisonneuve-Rosemont in Montreal.
A ventilator would not save a patient whose lungs are too swollen with liquid because of renal failure or infections, she said.
Among patients who have to have a tube inserted for breathing or feeding for more than a week, 25 per cent will develop infections, she added. "Most people think a ventilator is a therapeutic tool. It's only a bridge to survival, until you can have another treatment."
In Mr. Golubchuk's case, court hearings were told that he arrived at the Grace ICU last November, already frail and suffering from pneumonia. In recent weeks, his infections were complicated by kidney failure, and the courts were told that it was unlikely he could ever leave the ICU.
Man's ICU death ends legal fight
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......................Kravetsky said hospital officials called the Golubchuk family late Tuesday morning and asked them to come to the Grace, but he died before they arrived.
The Golubchuk case sparked debates on a variety of topics related to end of life, including the costs of keeping terminally ill patients alive and the ethical responsibilities of physicians.
It drew international attention, and support for the Golubchuk family from the family of Terri Schiavo, whose end-of-life battle sparked the intervention of a United States president.
Bobby Schindler, Schiavo's brother, said he believed the situation facing the Golubchuk family was actually worse than the one his family faced trying to keep his sister alive.
Terri Schiavo died in 2005 after her feeding tube was removed. Her husband, Michael, had persuaded the courts that she had no hope of recovery from the persistent vegetative state she was in.
She had suffered brain damage in 1990 when her heart stopped due to a chemical imbalance.
During the seven years before Schiavo died, her parents, who opposed having the feeding tube removed, garnered the support of U.S. President George W. Bush.
Golubchuk suffered a brain injury in 2003, but he could still understand and communicate.After being admitted to hospital last October suffering from pneumonia and pulmonary hypertension, his condition deteriorated.
Man at centre of life support controversy in Winnipeg hospital dies
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