A. Miller_ Exercise 5_RGS6036.E1_Fall_2023
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Philosophy
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Jan 9, 2024
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Aisha Miller
Exercise 5
1.
The major ethical question in
DAX'S CASE
revolves around the right of a person to refuse medical treatment and be allowed ultimately to die. Each person involved in this case made his/her choice to ignore Dax's wishes and "treat" Dax. Write a paper explaining viewpoints and identifying the theory most clearly defines the action that the person took with regard to Dax for Ada, Rex Houston, and one of his doctors.
Donald (Dax) Cowart is known as the preeminent activist debating patient’s rights. During a pipeline explosion in 1973, Dax and his father were caught in an explosion that
resulted in severe burns covering 65% of Dax’s body and the death of Ray, his father. Dax’s Case is a collection of essays that inspect the many ethical considerations to law and medicine to patient rights by exploring the actions of his mother, the medical staff at the treating facilities, and is injury case lawyer. In Dax’s case, Ada Cowart is described as a devout religious woman who had the unfortunate fortune of losing her husband and seeing her son suffering from severe burns covering 65% of his body. During this tumultuous time, the hospital and rehabilitation staff relied on her consent for proceeding with Dax’s treatment due to his consistent assertion to stop treatment and allow him to die. Although Ada had lost much, she had not lost her religion of which states that both killing and suicide are sins. She leaned into these beliefs each time Dax implored her for respite from the agonizing burn treatment and acquiesced with the prescribe course of treatment. Additionally, as a woman of God and mother, she wanted to provide her son more opportunity for Dax to grow his faith in God so that if he did die, he would reside with God in the afterlife.
She is noted to have thought it would have been easier if Donald had also died with his father. But later quoted saying that “I think I made the right decision” based on his future state of marriage and business endeavors (Kliever, 1989, 35). Ada’s decisions regarding her son’s treatment are best aligned with the Divine Command Theory. Her ethical considerations of right and wrong were shaped by God, by His Will, by His directive and as previously described, suicide or in this case assisted suicide contradicts
the will of God. Ada believed Dax’s death would be decided by God and it was her role to preserve it until God decided otherwise.
Rex Houston assumed many roles within the Dax Case. He was the family lawyer for the death/disability pipeline explosion case and functioned as a personal family friend to
the Cowart’s. Regarding Dax’s treatment, Houston was known to assist in any way to improve the burn treatment but would disregard any pleas of help from Dax to end the treatment and allow him to die. Houston fought hard and acted quickly for Dax wining a sizable settlement in the disability case, but then failed his other ethical legal duties in helping Dax leave the hospital or at minimum find a lawyer who might. (Kliever, 1989, 99). Additionally, a conflict-of-interest looms over Houston in his unwillingness to fight for Dax’s right to end his life impacted could impact the value of the disability case. Houston’s fee was a percentage of the award value and by this, Houston would not be incentivized to help Dax terminate his life as the award value would be less if Dax were dead. Later in life, Houston continued to provide counsel to Dax, encouraging him to pursue law and use the settlement money to make a life for himself.
Houston decisions throughout the Dax Case appears to be both benevolent and fraught with serious ethical concerns. Houston ethical approach in the Dax Case is what is referred to as Utilitarianism. Utilitarianism produces the greatest maximum good for the maximum amount of people. This does not necessarily mean the good is equally or appropriately distributed as in Dax’s rights should out weight the ethical concerns of his
mother or the medical staff. Houston ‘s overall approach is to ensure a balance of good over all individuals. Dr. Robert White, a psychiatrist brought in to assess the mental competence of Dax during the early days when Dax was adamant about wanting to die. Dr. White eventually found Dax competent and facilitated both pain and mental health care for Dax during his time at Jennie Sealy Hospital. In fact, White was able to move Dax from as a severely depressed, unwilling to comply patient to man that would accept his wound care and could be transferred to the University of Texas Medical Branch under Dr. White’s care. White secured changed in Dax’s pain medication before and after the tankings, connected Dax to an attorney to discuss his case to be able to leave the hospital, and helped with Dax’s sleep. Dr. White, along with the other doctors primary modus operandi were to follow the d
eontological theory. With this theory, you are ethically bound. Meaning the moral action is centered on the action versus the outcome. One is bound by duty, rules within the society, and obligations. These doctors were bound by the duty to do what is best for the life of the patient; heal the body.
2.
Describe Dax Cowart’s decision to die using the Warner Ethical Conduct Paradigm. Discuss each step of the paradigm and explain what you think had an influence on Dax's desire to die rather than be treated. (Obviously, you are not able to have all the information about Dax and his innermost thoughts. However, you have been given many hints from the book that should enable you to piece the information together for a good profile.) 4-6K (2-4 typed pages).
The Ethical Paradigm describes the framework of how ethical decision come to bear. The Paradigm discusses five mind filters that influence and shape our ethical decisioning framework: values and beliefs, wants and needs, relationships, intelligence,
and discipline. In 1973, Dax Cowart was caught in a pipeline explosion that resulted in severe burns covering 65% of his body. In this paper, Warner’s Ethical Conduct Paradigm will be applied and discussed regarding Dax’s consistent and persistent desire
to die rather than be treated for his burns. Warner’s version of values and beliefs is derived from folkway, customs & traditions,
social norms, law, and religion; each having individual weight and emphasis in a person’s life. Prior to the accident, Dax was full of life. He was adventurous and athletic,
a prior air force pilot, and perceived himself as good-looking. These where the things he
valued in life. When he reached the farmer on the road at the explosion sight, he protested that he was already a dead man. This was emblematic of the shift he had in the value of his life. If he could not pursue traditional things like love, family, career, then life no longer had value.
Warner describes needs and wants as “by definition, we will assume that an individual will sacrifice values and/or beliefs for a need…wants, on the other hand, will be defined as those things that an individual would like to have but would not sacrifice values or beliefs in order to obtain” (Warner, 1984, 11). After the accident, Dax’s need category grew extensively. Dax lost his vision, his hands and would be forever dependent on another to for even the basic functions. Additionally, the trauma to his body would mean having to manage pain. He knew it would be life-long need to manage
the pain. He believed he would have to focus the lion share of his life on addressing his needs and would not be able to enjoy any of wants, “the lusts of life.” Realizing this as his future, the only way to absolve himself of this future would be to die.
Warner’s third mid filter is relationships. For Dax saw a transition in his relationships after the accident. For example, Dax’s mother, lawyer, Rex Houston, and in medical doctors move from mother, adviser, healer, respectively into a “domineering paternalism” role (K 1989, 104). This only intensified the desire to end Dax’s life as those who should be advocating with him are as he perceived advocating against him. Additionally, the medical staff were routinely providing examples of life beyond burn accidents. The staff trying to push Dax in a group association he had no desire to belong
and no desire to be a future use case for future victims. This only embolden Dax’s desire to die as the group only highlighted what he did not want.
Warner’s fourth filter, intelligence, is encompasses three factors: knowledge, experience, and perception. The last filter is discipline. Intelligence and discipline increase with age and practice, and both are often ignored or uncontrolled during a crisis leading to rash decisions. Dr White talks of Dax’s rage were childlike tantrums and
as Dax was severely depressed application of intelligence and discipline would be insurmountable during this time. Even knowing about the successful lives being lived by
burn victims, or the fact that in time things do get better where repressed. Beyond that, being depressed clouds the ability to see past the immediate sorrow and only be able to view through the lens of the right now. And right now, all Dax Cowart wanted to do was die. In every turn within the Ethical Paradigm, Dax’s desire to die rather than be treated for his burns is consistent and persistent. His values and beliefs, wants and needs, relationships, intelligence (or lack thereof), and discipline (also or lack thereof) exudes his rational on his ethical decision to give up the ghost and simply fade away from this earth.
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References:
Warner, D. (1984). The Basis For Ethical Conduct: An Introduction To The Ethical Conduct Paradigm & Ethics For Decision-Making Case Studies
. Amberton University.
Kliever, L. (1989). Dax’s Case: Essays in Medical Ethics and Human Meaning
. Southern
Methodist University Press.