One of my interests is medical ethics. I’ve gone through much of the contemporary Orthodox bioethical literature, subscribed for many years to Lancet and New England Journal of Medicine, and am a voracious reader of all most things medical (well, dermatology’s just not my thing).

There are some advantages to reading what the professionals read: I’ve been able to help a number of family members and friends to research diagnoses and treatments, as well as benefiting from a realistic, unvarnished image of the biases and conflicts within the profession. (In the December 2000 issue of Jewish Observer I published a small piece entitled Ethics, Ethics, Everywhere, describing the efforts of my grandfather’s doctor to “let him go” after he suffered a stroke.)

I have great respect for doctors and the knowledge they carry. But they’re only people, with all the opinions, biases, and weaknesses that implies.

This week Jerusalem Post health reporter Judy Siegel reported that Samuel Golubchuk, the 84-year-old frum Jew from Winnepeg, whose doctors seek to remove him from his ventilator and feeding tube, had awakened. Mr. Golubchuk is now described as “awake, alert, has returned back to his baseline, sitting up in a chair at times, more interactive, and shaking hands purposively.”

Nevertheless his doctors still seek to kill him, and are contesting the matter in court, including moving to exclude the affidavits of experts on the grounds that they arrived too late. Apparently winning to them is more important than Mr. Golubchuk’s life. Indeed in a similar case recently in Calgary, involving an elderly Chinese man, whose family contested the doctors’ decision to cut off life support, and won, the patient eventually improved so much that he was able to walk out of the hospital and return home. Nevertheless the doctors continued to pursue an appeal. Presumably they wanted to bring him back to the hospital and kill him. [via CrossCurrents]

Jonathan Rosenblum is writing a little sarcastically here, but that shouldn’t disguise the fact that this is a really, really important case, and one which the religious Jewish community has been following closely for a week or so now. (The Golubchuk family asserts, without contradiction, that their father would want lifesaving measures taken, were he able to express himself.) I am not Canadian, and don’t know where one would begin making one’s voice heard on this issue, but I do know that we must not watch silently.

Why? Because this is not just “somebody else’s” problem. Because unless you hold deeply Galtonian Social Darwinist beliefs, it should matter to you that your own personal wishes for your care be respected. If you are, G-d forbid, ever unable to speak for yourself, you do want your Living Will to be consulted, don’t you? And you would like to have the person to whom you’ve granted power of attorney for healthcare matters consulted and their decisions followed, don’t you?

There’s a tricky side to this: vulnerability.

A GUI (graphical user interface) that offers too many options is just plain overwhelming. Keeping the interface simple and straightforward reduces stress, encourages uptake, and is conducive to a more positive user experience. It is not easy to create an interface that is simple and straightforward, and at the same time offers powerful user control over details (Apple is remarkable for their ability to successfully design software this way).

Now think about a person whose “task function” is to make life-and-death decisions on behalf of someone they love very deeply. Even a well-prepared child will not find it easy to decide whether it is kinder to “stop the suffering” or to “do everything possible” or something in between. Under stressful conditions, the burden is almost unbearable. Following the advice of a knowledgeable doctor is the equivalent of simplifying the GUI. It makes the decisions straightforward and far simpler, while reducing the burden of responsibility. And the doctor should know, right?

Well… there’s the rub.