Dax's Case Summary

Dax’s Case is a biography based on the life of Donald Cowart illustrating his experiences in hospital as a severe burns victim and the viewpoints of his mother and the people who looked after him whilst undertaking care. Although I felt uncertain during the interview sessions, through the use of powerful visuals, the incident in which I felt the most unease was when the debridement process was shown. The scene opens with a close-up shot of Dax’s severely scarred face and his graft-covered eye socket. I felt anxious when watching this scene, as I have never witnessed something like this before, I felt fearful for what would come next. I could never imagine the pain Dax was going through. The camera slowly zooms out to show his third-degree burns,

which covers approximately two-thirds of his body, his raw wounds and his maimed hands. I watched in distress at the painful procedure wherein Dax had dead tissue scraped off his wounds while being bathed in a solution of water and bleach. The shock I experienced in this scene was sinisterly juxtaposed with a voice over of Dax speaking calmly about his desire to discontinue treatment and die.
On reflection, I felt confused at the conflicting viewpoints of Dax, his mother, lawyer and health care team.

Throughout the years Dax spent in the burn ward, he continually refused treatment due to the intense pain he experienced and attempted suicide multiple times. Despite being declared competent by not only one, but two psychiatrists, the doctors ignored Dax’s requests and continued treatments until the skin grafts were treated and Dax regained the ability to move and walk. I previously learnt that all doctors should adopt a high standard of care by responding to their patients’ needs whilst simultaneously do what is best for their patients. However, as the documentary progressed, I felt as if I was alternating between taking Dax’s side and the doctor’s side. I felt conflicted and presented with moral dilemmas as Dax’s case challenges four principles of medical ethics – autonomy, non-maleficence, beneficence and

justice.
There are several problems which arise: whether or not Dax’s autonomy should outweigh his doctor’s opinion in terms of life-saving treatment, especially as he was deemed competent, whether the principle of non-maleficence was violated by forcing Dax to undergo painful treatment, whether the most benevolent act was to allow treatment to continue for Dax or let him die and if justice was provided for Dax.
I believe the doctors made a morally correct decision in terms of treating Dax despite his competence and request to cease treatment.

Even though Dax was declared competent, the pain and emotional trauma he experienced from the accident and treatments may have clouded his judgment. His doctor, Robert White said he “would surely survive and could probably achieve some degree of normalcy in his life...yet he wanted to die”. He justified his decisions in Dax’s situation by saying that he was going try to help Dax accept the possibility of continuing his treatment to the point where he was physically ready to leave the hospital and independent enough to sufficiently move about and do things for himself, and then, if he wished to end his own life, he

could.

As an aspiring health professional, I have learnt that the treatment of burns victims is a very grey area and it is extremely difficult to understand the feeling of a patient’s pain. It is wise not to make assumptions about a patient’s feelings and concerns, but instead, address their issues. In future, I need to understand that every patient is unique and that medical ethics is complex and at times, it cannot always be followed. My belief is that medicine has evolved complexly over time and there is an expectation of a stronger rapport between doctors and patients who have to come up with a mutual treatment plan with the patient’ best interest in mind. In order to be a competent doctor, I need to develop the ability to respond flexibly and take into consideration every patient’s differences and needs.