Background
The experience of Donald “Dax” Cowart is interesting and inspiring from the medical and legal perspectives. It depicts the case of a man who suffered severe, agonizing, and life-changing wounds and was assessed by a psychiatrist and later found fully capable of making medical decisions for himself. Still, his caregiver and medical department ignored his rejections to undergo treatment further. Even though a patient later confessed that he was grateful to be alive, his refusal to receive proper healthcare and undergo treatment should have been honored. As a result, in retrospect, the case of Mr. Cowart serves as a case that necessitates changes in both legal and medical spheres that allow patients to remain autonomous and use their fundamental rights against incompetent healthcare providers.
Stakeholders
Among the stakeholders are the healthcare institution, society, and the patient named Donald “Dax” Cowart in the given situation. The party that was affected the most by the decisions of the healthcare professional was Mr. Cowart. In this sense, the patient was refused his fundamental right not to undergo treatment. Furthermore, the healthcare institution can be considered a stakeholder in the situation since it bears a certain level of liability for the rejection of a patient’s needs. Lastly, society is among stakeholders due to the policies and laws that apply to patients with severe burn wounds.
Facts
As for the facts, 25-year-old Mr. Cowart and his father got in an accident, in which the former received severe injuries, and the latter was killed. Donald was burned on 65 percent of his total body surface area, including third-degree burns to such areas as his face, hands, and ears (Gerrek, 2018). The young man had most of his fingers mutilated and lost eyesight in both eyes. Throughout his 14-month treatment, six of which were spent in the hospital and eight in a rehabilitation institution, Dax constantly demanded that the staff stop treating him (Gerrek, 2018). Mr. Cowart always accentuated the fact that he no longer desired to stay alive “as a blind and crippled person” and begged that he be allowed to die despite his mother’s agreement to rehabilitation (Gerrek, 2018, para.2). As per the account of the young man, the physicians typically rejected his demands, even when a reputable psychiatrist determined that he possessed decision-making capacity.
Dax, either personally or via his companions, voiced a desire to be permitted to die, and in both situations, his wish was not realized. As a result, it can be seen that the duration of Donald’s treatment was extended (Gerrek, 2018). Moreover, Mr. Cowart was not underage and did not require parental consent to reject treatment. Nevertheless, the demands of the patient to discontinue therapy were refused.
Norms
When it comes to the ethical principles and norms that are at stake, these include the violation of patient autonomy, the violation of fundamental rights of refusal, and healthcare professionals’ competence and paternalism. In this case, as a patient, Donal Cowart was denied his demands to stop undergoing treatment. However, the healthcare providers undermined his fundamental right, thus questioning their competence. The aforementioned scenario creates an ethical conflict when it comes to healthcare professionals.
Options
The National Institutes of Health (NIH) established a set of guidelines on supportive treatment in burn therapy in 1978. The guidelines stated that either physical or emotional shock, or a combination of both, in the burn patient deems the victim unable to carry out decision-making processes (Gerrek, 2018). Nevertheless, concerns about patient decision-making capacity should not be limited to the acute period solely. From the case involving Donald Cowart, it can be seen that the young man, being fully conscious, rejected his demands. As a result, such policies need to be modified, putting fewer restrictions on the burn victims and giving them more autonomy for their bodies.
Valid Informed Consent and Further Prevention
Valid informed consent refers to complete comprehension of the patient of the prescribed course of treatment, and it involves several essential components. The first component is full disclosure of the information regarding treatment (Pozgar, 2010). Moreover, it must be ensured that either a patient or a surrogate has the capacity for decision-making (Pozgar, 2010). Lastly, it is vital to ensure the voluntariness of the decision made by the patient (Pozgar, 2010). Thus, federal guidelines in the United States necessitate a thorough description of the treatment and other constituents and their possible dangers. In this case, the goal of the nurses and other medical professionals in the case of Mr. Cowart was to provide valid informed consent. In order to prevent a further situation like this, interprofessional collaboration, collaborative practice, and healthy work environment standards must be incorporated. These approaches in healthcare might help decrease the rate of medical mistakes, enhance the level of patient satisfaction, and provide better health outcomes for the patient, which can cut healthcare spending.
Hence, the case of Donald “Dax” Cowart is an example of how a burn patient, being fully conscious and of age, can be rejected his demands to stop receiving treatment. This case represents the violation of the patient’s autonomy, right to refusal, and healthcare professionals’ competence and paternalism. In this situation, it is vital to ensure that valid informed consent is obtained and the patient comprehends the implications of the treatment. Furthermore, interprofessional collaboration and a healthy work environment can help improve patient satisfaction and reduce the number of medical mistakes.
References
Gerrek, M. L. (2018). Getting past Dax. Journal of Ethics.
Pozgar, G. D. (2010). Legal and ethical issues for health professionals (2nd ed.). Jones and Bartlett Publishers.