In the past blogs, the idea of non-maleficence vs autonomy has been discussed to determine a course of action for a patient. However, this week, the readings look at the idea of beneficence and its role in guiding decisions. While the principle of non-maleficence tells us to not harm the patient, the principle of beneficence demands that an actor also perform positive steps to help a patient. For this week’s blog, I read the case involving the dialogue between Dax Cowart and Robert Burt. After a propane gas explosion, Dax’s father had died but Dax had been admitted into the hospital for treatment. However, throughout his treatment Dax made claims of wanting to die rather than to continue living. He tried to take his own life on multiple occasions and it was evident that he was in immense pain. However the doctors refused to let him die and treated him until he was able to carry out day to day tasks on his own.
This case study looks at the dilemma the doctors were presented with on whether treating Dax had been the correct decision. Dax’s autonomy had been violated but the doctor’s acted appropriately when accounting for the principle of beneficence. The dilemma of this case revolves around the idea of whether the patient’s right to die needs to be respected. Though he had been labeled as clinically competent, doctors did not agree with Dax’s terms of dying even though Dax wanted them to stop treating him. Dax may have been viewed as being too emotional to weigh the costs and benefits of treatment due to his dad’s recent death but being labeled as clinically competent puts an interesting twist on this case. It could be argued that it was Dax’s autonomous decision to die and the doctor’s decision not to respect that wish violates a moral parameter.
By comparing the principle of beneficence to the principle of autonomy, I believe that the doctors made the right decision in treating Dax. The doctors followed their own moral compass on not only conducting actions that were to the benefit of the patient but also not putting the patient in greater harm. When admitted into the hospital, Dax was very emotional due to the family death. However, the achievements that Dax accomplished after his treatments and his changed view of life show that the doctors made the right decision. Though Dax’s autonomy had been violated, the decision his clinical providers made turned out to impact Dax’s life in a positive way both physically and with his new career maybe even mentally.
Works Cited
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. Seventh ed. New York, NY: Oxford UP, 2001. Print.
Cowart, Dax, and Robert Burt. “Confronting Death Who Chooses, Who Controls?” JSTOR. The Hastings Center, n.d. Web. 18 Mar. 2015. <http://www.jstor.org/stable/3527969>
I agree with your post and your emphasis on the doctors making the correct decision by choosing to treat Dax despite his wishes. However, an aspect of your post that I somewhat disagree with is the sentence, in the last paragraph, which mentions Dax’s achievements after his recovery. I do not think you can use his successful rehabilitation as support for the physicians’ decision to continue treating him. As per the case, Dax vision was affected by the accident and he could barely use his hands. Therefore, the doctors could not predict that his recovery would be as successful as it turned out to be. There was the possibility that he would end up suffering for the rest of his life. If that did happen, then one could easily argue that the medical staff made the wrong decision to ignore Dax’s wishes. Ultimately, I still believe that, in this situation, the physicians made the right decision, but not because of the fact that Dax’s life turned out well despite the injuries that he sustained and the long and painful recovery that he experienced.
I see your point on how that sentence could be seen as post treatment results validating the decision calculus of the physicians. However, the point I was trying to make was that sometimes doctors are able to see the bigger picture based on previous cases. Though there is no knowledge of precedent in this case, I believe that after many years of medical training, doctors are able to use clinical intuition to determine what patients to keep treating. Clinical intuition is definitely a vague and abstract idea but it did drive medicine before our current era of evidence backed medicine.
I think that the doctors were morally correct in treating Dax because their job is to save people’s lives. Although it violated Dax’s autonomy, we cannot assume that he was in the position to give informed consent because his judgement could have been clouded by pain and the loss of his father. However, I agree with the comment above in that the reason that the physicians made the right choice is not that Dax ended up living a good life. I wonder if you would make a different choice about this case if you knew that Dax would die shortly after or live a life of low quality.
I think it is important not to discount emotion as a part of Dax’s illness experience. Oftentimes when we discuss the autonomy of patients that are depressed,or anxious we characterize them as having “clouded judgements.” Who is to say that Dax being emotional about his dad’s death and his own drastically altered quality of life should not impact his decision to be or not to be treated? Losing one’s parent or one’s sight is a very difficult process. Perhaps Dax believes that a life full of sorrow is not a life worth living. If Dax was in shock I would agree that he was not capable of making an autonomous decision. However, if a patient is not in shock, their emotions should be taken into consideration and recognized as an integral part of the illness experience, rather than the patient being deemed as non autonomous.