Background
The transcript of public remarks made by Dax Cowart and Robert Burt presents a dialogue that unearths the morality behind physician-assisted suicide. As defined by the American Medical Association, physician-assisted suicide occurs when a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act (AMA). In the case of Donald (Dax) Cowart, the ethical issues raised by efforts to sustain his life against his wishes have made him famous. After a propane gas explosion, despite Dax’s insistence to be left for dead, he was rushed to the hospital alongside his father who died en route. Dax’s hospital treatments included immersion in chlorinated baths and having bandages stripped and replaced. Dax was left blind, without the use of his hands and with more than two-thirds of his body burned (RD p. 1). Throughout this nightmare Dax continually demanded to die by refusing consent to his treatments but his wishes were not approved.
Dilemma
As has been the trend up until this point in class, the two main issues at stake here revolve around the two ethical principles of autonomy and beneficence. The general definition for the ethical principle of beneficence rationalizes it as an “action that is done for the benefit of others,” actions that “can be taken to help prevent or remove harms” as well as actions done “simply to improve the situations of others” (UCSF). On the other hand, autonomy (respect for persons) can be defined as acknowledging a person’s right to make choices, to hold views, and to take actions based on personal values and beliefs (Bishop).
The main issue brought to light incorporates these two principles in an effort to determine whether or not Dax’s physicians had the right to go against his wishes. The dialogue proves Dax’s insistence of requesting to be let die – “I don’t want treatment” – however, Dax was put through the treatments regardless (RD p. 5). While Dax has been blessed after the accident with a life full of achievements, the debate in regards to this case questions whether or not the actions taken by the physicians were justified.
It could be argued that the action most in line with the principle of beneficence would have been for the physicians to respect Dax’s wishes and let him die. Dax’s suffering was evident to the physicians not only through his physical conditions but also through his constant emotional pleas – “the immediate issue, the urgent issue, was that my pain was not being taken care of. That was why I wanted to die (RD p. 15).” In letting Dax die, the physicians would be choosing the course of action that would be done for Dax’s benefit, help to remove and prevent harm, and also simply improve his situation by ending his suffering.
Additionally, in terms of autonomy it could be argued that Dax’s competence rules him to be completely capable of making his own life decisions.
Reflection
In this case, the dilemma revolves around the balance between the principles of beneficence and autonomy – the physicians are faced with a tough choice in confronting death. Looking back on the situation, I think it is important to consider Dax’s mental state at the time regardless of his state of mental competency. Take into account the reflection that Dax presents in the case – “I tried to take my life twice – three times if you count the time I crawled over the hospital bed rails trying to get to the window to jump out an eight-story window” (RD p. 21). A man willing to go to such extremes is clearly experiencing a great deal of pain and suffering – is it possible that he is not mentally competent and instead is so caught up in the pain and suffering felt at the moment that he cannot see a future? The doctors disagree with Dax’s grim outlook on life – their main reason for continuing with the surgeries and procedures despite his objections. Although the physicians’ decision did not respect Dax’s autonomy and did not immediately relieve Dax’s suffering, I believe they made their choice with a clear outlook on his future and therefore I stand with their decision.
Works Cited
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. Seventh ed. New York, NY: Oxford UP, 2001. Print.
“Beneficence vs. Nonmaleficence.” UCSF School of Medicine . N.p., n.d. Web. 20 Mar. 2015. <http://missinglink.ucsf.edu/lm/ethi cs/Content%20Pages/fast_fact_bene_nonmal.htm>.
Bishop, Laura. “Principles — Respect, Justice, Nonmaleficence, Beneficence.” Ethics Background. N.p., n.d. Web. 28 Jan. 2015. <http://nwabr.org/sites/default/files/Pri nciples.pdf>
“Opinion 2.211 – Physician-Assisted Suicide.” American Medical Association. N.p., n.d. Web. 16 Mar. 2015. <http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2211.page?>.
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I think you raised a good point by questioning whether Dax’s attempt to take his own life would raise concern regarding his competency. Is it possible to look at this example from a perspective that highlights the excruciating pain Dax was enduring? Dax states, “the pain was so excruciating, it was so far beyond any pain that I ever knew was possible, that I simply could not endure it” (RDp.17). Since the physicians were unwilling to alleviate his discomfort to a great enough degree and were refusing to participate in physician-assisted suicide, I do not blame Dax for attempting to take matters into his own hands. Furthermore, Dax was deemed competent on more than one account and thus I do not believe that we should use his attempts to relieve his pain (suicide) to now classify him as incompetent.