The Case of Samuel Golubchuk: The Dangers of Judicial Deference and MedicalSelf-Regulation
Bibliographic record
Abstract
Jotkowitz and colleagues (AM. J. BIOETHICS, 2010) claim that the College of Physicians and Surgeons of Manitoba Guidelines 'represent a retreat from autonomy towards old fashioned paternalism.' This is descriptively false. Autonomy has developed solely as a negative right to be free from unwanted treatment. It has almost never been formally construed to give patients a positive right to demand nonindicated treatment. These guidelines are a clarification of the scope of autonomy, rather than any retreat from some positive rights that were previously recognized. Autonomy has long been and remains a very weighty principle – but it does not automatically trump other principles.Still, Jotkowitz and colleagues are correct that the Golubchuk case is special because of the religious nature of the request for life-sustaining medical treatment. While even Jotkowitz and colleagues concede that such requests can be (and should be) overridden in some circumstances, they rightly argue that such unilateral action must be carefully circumscribed. Provider arguments for overriding must be more compelling in futility disputes where the treatment request is religiously motivated.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.040 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.016 | 0.038 |
| Scholarly communication | 0.008 | 0.008 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.031 | 0.029 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".