Today's Winnipeg Free Press 
reports that two more doctors have resigned from their critical care rotations at Grace Hospital. There is a lot going on here. I just want to flag four interesting issues:
- The doctors had acceded to family demands because Samuel Golubchuk's level of care had remain unchanged. But, more recently, Golubchuk's level of health has been declining. Dr Dave Easton explained: now, there is an "insurmountable problem with wound infections and resultant sepsis and renal failure. The patient now had required an escalation in medical support to sustain life, which . . . would only increase suffering and provide no benefit."
- Dr. Easton asked "Do protential legal consequences and threat of 'jail' take precedence over my duty to not inflict further harm to the patient?" While Easton's answer is "no," most U.S. doctors would (and do) answer "yes." Moreover, most doctors in most similar situations would only face some potential exposure to tort liability. Dr. Easton is violating a court order.
- The duration of the preliminary injunction in this case has already been more than six months. The resignations show that is too long. Indeed, in most cases, the preliminary relief is dispositive, since the patient dies before a full hearing on the merits. In effect, injunctions ordering continued life-support pending trial are de facto final rulings in favor of surrogates and against providers.
- If the Grace ICU really must close, that presents a new argument in favor of empowering providers to refuse inappropriate treatment. Others in the Grace catchment area may be adversely affected because Golubchuk, in effect, scared away all the critical care physicians.
