Golubchuk and the Manitoba Guidelines

I just finished listening to a broadcast from the CBC's February 4th The Current. It is a nice 23-minute well-balanced coverage of the issues in the Golubchuk case and the Manitoba licensing board rules.

The Golubchuk's lawyer Neil Kravetzky describes the factual background in that case. He then critiques the Manitoba Guidelines, particularly (i) the totally subjective nature of the inappropriateness determination, and (ii) their release during ongoing litigation of the precise issues addressed by the Guidelines.

Bill Pope from the College of Physicians defends the Guidelines. Among other thing, they make things transparent; they afford proxies the opportunity for outside review; and they create uniformity across the province.

Arthur Schafer, a Manitoba ethicist also defends the Guidelines. The clarify what is already widespread; they rationally allocate resources; they give resources to only those who will benefit and avoid giving care to those who will suffer. Moreover, while the Guidelines are mandatory for physicians, the real "last word" still lies with the courts.

Kerry Bowman, an ethicist at the University of Toronto, is more critical of the Guidelines. He notes that these are not purely clinical decisions, emphasizing the value judgments at stake. He also thinks that there is "the potential for Charter challenges."