Medical Ethics – Refusal of Treatment

Topic: Family
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Last updated: May 22, 2019

Taken to the Limits: Pain, Identity and Self-Transformation Winslade argues that it is morally and legally impermissible to violate a competent patients right to refuse medical treatment. Through examples such as Dax Cowart, Winslade suggests that one should have the right to choose or refuse treatment rather than being forced to endure unwanted pain. Although he accepts the idea that Dax’s family members, doctors, and lawyers wanted to preserve Dax’s life for the possibility of a brighter future, Winslade firmly believes that Dax’s requests shouldn’t have been ignored.I will highlight both the physical and psychological transformations experienced by Dax, the doubt felt about the quality of his future life, the treatment and ignorance of his desires, and how his relationships were affected by the tragedy. Then, I will give multiple reasons of why I agree with Dr. Winslade’s argument and provide concrete recommendations for how to improve this ethical issue. When trying to identify Dax Cowart, Winslade offers insight on the meaning of physical life and emotional death.He suggests that Dax lost much more than his sight, hearing, and hands after suffering deep third-degree burns covering over 65% of his body.

Not only did this horrific tragedy seriously damage and destroy his physical appearance, but his identity as Donald “Donnie” Cowart was symbolically diminished as well. Although he survived the incident, Dax was emotionally distraught over the fact that he would forever be dependent on others. The fire engulfed him – it took his independence and freedom and left him as a burden onto others.

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Because of this, “he did not die.And yet he did” (Winslade 116). In changing his name from Donald to Dax, a psychological transformation was exposed.

He was no longer the carefree, happy, young man that he was before the accident. He transformed into a dark, suicidal, human who was alive in form but not in spirit. This helplessness left Dax in a cycle of depression that would prove difficult to overcome.

Feeling as though he had already lost himself in the fire, Dax continually refused medical treatment stating that he no longer had a life worth living. He never waivered in his decision, demonstrating a igh level of competence and appearing lucid and logical throughout. Although he was certain that he wanted to end his life, doctors believed that “even if Dax was competent, he was not rational, [giving the doctors] the authority to override his refusals” (121). Baxter, one of Dax’s physicians, admitted that he “literally ignored Dax’s initial request to die on the grounds that during the crisis phase of treatment Dax was in so much pain, shock and under the influence of narcotics that his judgment couldn’t not be trusted” (121).Winslade argues that physicians believe even totally competent patients are incompetent and irrational if they disagree with their doctors’ treatment requests.

This highlights the physician’s unwillingness to respect the patient’s desires and provides the basis for Winslade’s argument that physicians violated Dax’s right to refuse medical treatment. By treating a patient that does not want to be treated, what does the hospital gain? Is the victory of saving someone’s life more important than the value of the individual life itself?Both legal and ethical issues are raised. In many cases, the time, effort, and money put into the treatment process goes wasted and unappreciated. Doctors want the gratification of saving the life but do not consider the individual patient’s wishes. Still, many question if the hospital has the authority to make decisions on behalf of their patients. Sure, there are certain instances where the hospital must provide emergency treatment, but once the patient regains coherence the individual should have the ability to accept or deny treatment.

In Dax’s case, doctors, family members, and lawyers should not have forced or pressured him into unwanted medical treatment. After displaying clarity of thought, he should not have been held prisoner as a patient. I completely agree with Dr. Winslade’s belief that Dax’s “moral and legal rights were violated” when he was not “permitted to refuse treatment” (125). His personal freedom and civil rights were blatantly ignored.

Because nobody acknowledged the “emotional, rational, and, perhaps, biological bases for his desire to die,” Dax had to endure unnecessary procedures and treatments that would inevitably prolong his misery (126). Although some may argue for the sanctity of life, it is ultimately the patient’s decision to determine whether or not they believe the future of their life is worth the pain of treatment. Winslade admits that if it were he in Dax’s place, he would want the ability to choose for himself. I would ask for the same option as well.In order to combat this issue, ethical teams must evaluate the competence of the patient in instances where there is a physician/patient disagreement regarding treatment.

Three to five members should closely study the patient and determine if he is in the correct state of mind to decide on his own if he wants to accept treatment or not. The patient should be allowed 24 hours to consider his options. If the patient is competent and refuses treatment, he should be allowed to choose to die a natural or painless death. Winslade discusses the importance of patient’s rights and offers his stance on the issue.In cases such as Dax Cowart, both Winslade and I agree that moral and legal rights were violated. His personal freedoms and civil rights were completely ignored.

Dax should have had the opportunity to meet with an ethical team that would have been able to evaluate his competence. He was denied the opportunity to decide for himself whether or not to accept treatment that would prolong his life. Works Cited Winslade, William J. , Dr. “Taken to the Limits: Pain, Identity, and Self-Transformation. ” Dax’s Case (n. d.

): 115-30. Print.


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