Discuss in detail patient autonomy

Case Study # 2 (Autonomy Part 2) – Dax’s Story
Please watch the movie clip of Dax Cowart referenced here below. You may also view in substitute for answering the questions in the assignment:

https://www.youtube.com/watch?v=M3ZnFJGmoq8

PLEASE NOTE – video may contain images that a viewer might find disturbing. Viewer discretion is advised.

You are also welcomed to watch/ listen which is an update of Dax which is found here:
https://vimeo.com/64585949

Maintenance of patient autonomy is one of the major ethical focuses of physicians. Therefore, a second discussion was also held that focused primarily on patient autonomy. This discussion also took a superficial look at euthanasia. For this discussion, a 58 minute video, Dax’s Case (produced by Unicorn Media, for Concern for Dying ; produced by Donald Pasquella, Keith Burton ; directed by Donald Pasquella New York : Filmakers Library, c1984) was used. The video tells the story of Dax Cowart, a man who was severely burned by an accidental propane explosion. The burns disabled Dax, and the physicians forced treatment on him. Though he survived the treatment, he still argues that he should have been allowed to refuse it so that he could die. The video is very useful; however, the videos of Dax’s burn treatments are very graphic and the video should be reviewed before it is shown to a group of students.

Questions:

• In the video, one of the physicians says that burn patients are incompetent to make decisions when they first enter the hospital because they are in such a great deal of pain. However, patients such as Dax can be in a great deal of pain for a very long time. In such cases, what should be done to determine competence, and when should this be done?
• Do you think the fact that Dax could not see a future for himself should have been taken into account when determining his competency? Could this have clouded his judgment? (He thought that he would end up on the street corner selling pencils)
• Do you think that the fact that Dax was going to recover, and had the possibility of living a happy life, made not treating Dax like suicide… or murder? What if he did not have this possibility?
• After his recovery, Dax attempted suicide. Should the physicians have let him die? Is it ever correct for a doctor to allow a patient to kill himself?
• Do you ever think that it is correct for a physician to break a competent patient’s autonomy? If so, is this one of those cases?
• Do you think that in this case, that the ends justified the means?