Health Care Ethics

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Ethical Controversy: Patient Rights

For this paper, read the following case study, watch the videos “Dax Cowart and Dax Cowart (2)” , and answer the questions following the case study.The link(s) will take you to you tube where you can view the videos.

https://www.youtube.com/watch?v=WAQHuaua4W0

https://www.youtube.com/watch?v=lSsu6HkguV8

Be sure to read the specific requirements for the paper at the bottom of this page. Many of the points students lose on these papers are due to APA formatting issues (see below) and grammar! If you have questions, ask.

Case Study – DAX

In 1973, Donald Cowart (“Dax”), age 25 was severely burned in a propane gas explosion. Rushed to the burn treatment unit of Parkland Hospital in Dallas, he was found to have severe burns over 65 percent of his body; his face and hands suffered third degree burns, and his eyes were severely damaged. Full burn therapy was instituted. After initial emergency treatment, Dax’s prognosis for survival was approximately 20 percent. After 6 months of intensive care, his prognosis for survival improved to almost 100 percent. In the early weeks of his hospitalization he was possibly mentally incapacitated at the time critical decisions had to be made, however, he was later found to be mentally competent by two different psychologists. After an initial period during which his survival was in doubt, he stabilized and underwent amputation of several fingers and removal of his right eye. During much of his 232-day hospitalization at Parkland Hospital, his few weeks’ stay at Texas Institute of Rehabilitation and Research at Houston, and his subsequent 6-month stay at University of Texas Medical Branch at Galveston, he insisted that treatment be discontinued, and that he be allowed to die. Dax’s mother, however, was opposed to termination of medical care for religious reasons. Thus, despite his demand that treatment be stopped, wound care was continued, skin grafts performed, and nutritional and fluid support provided. A question about his mental capacity came to the fore in the early days of his refusal of care. Had the physical and emotional shock of the accident undermined his ability to decide in his own best interests? Initially, it was assumed that he did not have capacity to make his own decisions, at least about refusing life-saving therapy. The doctors accepted the consent of Dax’s mother, rather than his rejection of treatment. He was discharged totally blind, without use of hands or arms, badly scarred, and dependent on others to assist in personal functions.

He was a popular, athletic young man, just discharged from the Air Force where he served in Vietnam. He worked in a real estate business with his father (who was also injured in the explosion that injured Dax and died on the way to the hospital). Thus, before his accident, Dax’s quality of life was excellent. During the course of medical care, he endured excruciating pain and profound depression. After the accident, even with the best of care, he was confronted with significant physical deficits, including notable disfigurement, blindness, and limitation of activity.

The cost of 16 months of intensive burn therapy is high. The distress caused to medical and nursing personnel by Dax’s refusal to cooperate with treatment might have influenced their attitudes towards him.

THE QUESTIONS:

So you be the judge, should people like Dax be allowed to die?

If so, at what time should they be allowed to die and what should the benchmark for such issues be? How should he be allowed to die? What method would you employ?

If not, then why should people be allowed to go through painful and tortuous treatments and live a life of pain and disability, disfigurement and segregation?

What are the ethical issues involved in this debate?

What ethical principles are violated in this case?

Students are to write a 2-3 page research paper on the topic ***NOT INCLUDING REFERENCES***. Students are to cite research in answering the above questions for the paper.

The paper should be submitted in MS Word. You are expected to cite 2-3 references for this paper utilizing APA format (Refer to APA publication manual and sample paper listed in attachment). No title page, table of contents or abstract is needed for this assignment. Simply put your identifying information in the upper right hand corner of the first page. Remember this is a 2-3 page assignment (not including references)!

§ Standard paper size (8 ½ x 11 paper)

§ 12-pt. Times New Roman font

§ Double spaced

§ 1 inch margins on top, bottom, right, and left

§ Indent all paragraphs 5-7 spaces or ½ inch

§ Page numbers in upper right hand corner of page, use Arabic numerals

§ Reference in text using appropriate APA style and include reference page at the end of the paper. When citing internet resources, only web sites that end in “.edu”, “.org”, or “.gov” will be accepted as references. Also, Wikipedia in any form will NOT be accepted as a reference.

2-3 pages, NOT INCLUDING REFERENCES

***DO NOT PLAGIARIZE***

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