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Dax Cowart Essay Summary

IntroducTon In 1973 Dax Cowart was in an explosion that was the result of an accidental propane gas leak. The explosion leF Dax with severe burns over 65 percent of his body including severe damage to his eyes, ears, and hands. To keep Dax alive a regiment of painful lifesaving procedures were immediately implemented. These procedures included intravenous ±uid therapies, the inser²on of an intertracheal tube, the inser²on of catheters, the applica²on of an²bacterial drugs to exposed wounds, and the administra²on of prophylaxes to prevent tetanus and infec²on. AFer Dax was stabilized the excrucia²ng pain from his injuries did not stop. The pain from his extensive burns would con²nue long aFer his life was no longer in immediate danger, as his body fought to slowly recover. ³urthermore, addi²onal frequent and painful treatment was necessary to prevent infec²on and the deteriora²on of Dax’s condi²on, the result of which would be death. The treatment would last a total of fourteen months and from beginning to end, but for brief periods of acquiescence, Dax asked, pleaded, and demanded that the treatments end and he be allowed to die. Even now, despite an arguably successful recovery and, op²mis²cally, happy outcome, Dax maintains that he should have been allowed to die. Dax’s case is unique in that the tragic accident that resulted in Dax’s need for life saving treatment may have been less tragic than the subsequent administra²on of that treatment. The nature of Dax’s case proves to be a veritable quandary for a mul²tude of ethical issues. Many of which are beyond the scope of this essay. However, at the heart of Dax’s case is the overarching ques²on regarding the ethical nature of Dax’s treatment. Explicitly, was the treatment and care given to Dax ethically permissible according to the context of his case? In this essay I will argue that the lifesaving treatment that was given to Dax Cowart against his wishes was unethical given the circumstances of his case. Speci´cally, I will illustrate that Dax was capable of making autonomous decisions regarding his care, that the care Dax received was congruent

Dax Cowart (born Donald S. Cowart, 1947) is an American attorney noted for the ethical issues raised by efforts to sustain his life against his wishes following an accident in which he suffered severe and disabling burns over most of his body. His case is often cited in discussions of medical ethics.[1]

Accident[edit]

In 1973 Cowart, then a 25-year-old Air Force reserve pilot, visited with his father a tract of land his father was considering for purchase. The land lay in a small valley and, unbeknownst to the Cowarts, a gas leak had filled area with heavier-than-air propane gas. When the two men started their car the propane was ignited, severely burning them. Cowart's father died.

Cowart's injuries included loss of both hands, eyes, and ears, and two-thirds of his skin area. He wrote later:

I was burned so severely and in so much pain that I did not want to live even in the early moments following the explosion. A man who heard my shouts for help came running down the road, I asked him for a gun. He said, "Why?" I said, "Can’t you see I am a dead man? I am going to die anyway. I need to put myself out of this misery." In a very kind and compassionate caring way, he said, "I can’t do that."[2]

Fearing he would be unable to regain his former level of activity, he refused treatment en route to the hospital but nonetheless survived.

Cowart says that in the hospital he was "forcibly treated for 10 months" despite continually begging his doctors to end treatment and allow him to die. He likened some of the treatments – such as bandage replacement and chlorinated baths – to being "skinned alive". He was given limited painkillers because of a poor understanding of their risks, and was denied access to legal assistance, by which he might have forced treatment to end.[2] He attempted suicide several times.

Later life[edit]

Although blind and without functioning hands, Cowart earned a law degree from Texas Tech University in 1986, and now has his own practice. He changed his first name to Dax because after being repeatedly embarrassed when responding to "Donald", only to find that someone else was being addressed.[2]

Damages recovered from the oil company responsible for the propane leak left him financially secure. His first marriage, in 1988, ended in divorce.[when?] He married again in 2003 and now lives in San Diego.

Cowart has been a frequent participant and speaker at The Trial Lawyers College in Dubois, Wyoming, with Gerry Spence.[who?] In addition to his practice he now speaks on patient rights in the United States and abroad.

Cowart's life and his reflections on what has happened to him continue to challenge medicine's understanding of itself as a moral practice.[3] A documentary of his plight titled Please Let Me Die was filmed in 1974,[4] with a follow-up documentary titled Dax's Case filmed in 1984.[5]

The case illustrates several issues of patient autonomy.[6]

References[edit]

  1. ^Jonsen, Albert; Siegler, Mark; Winslade, William. "Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, Fourth Edition". McGraw Hill Professional. 
  2. ^ abcUniversity of Virginia, October 2, 2002. Retrieved March 7, 2009.
  3. ^ResearchChannel - Dax's Story: A Severely Burned Man's Thirty-Year Odyssey
  4. ^Please Let Me Die
  5. ^Dax's Case
  6. ^James F. Childress, Practical reasoning in bioethics, Indiana University Press, p122.

Further reading[edit]

External links[edit]

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