Computers & Texts No. 14
Table of Contents
April 1997

Review: A Right to Die?

The Dax Cowart case, an ethical case-study on CD-ROM

Stephen Clark
Department of Philosophy
University of Liverpool

Dax Cowart was burnt alive in a gas explosion: he recalled running away from the fire, feeling his eyeballs melting. Immense efforts were put in to save his life: two-thirds of his body were covered in second and third degree burns; one eye was irreparably and the other probably destroyed. His chances of returning to his active and athletic life seemed poor, and the treatment - including regular baths in saline - was intensely painful. He begged the doctors to discontinue treatment, and to let him go home to die, most probably of infections in his wounds. They, and his mother, declined to believe that he was competent to make such a decision, and persisted with the treatment over his continuing protests. Ten years later, he had recovered sufficiently to marry again and to have a life as a lawyer specialising in patient rights: he remained convinced that he should have been allowed to die.

A book on the subject could address the details of treatment, and its legal or moral justification. The production of this CD-ROM, by David Anderson, Robert Cavalier, and Preston K. Covey, allows the parties to the affair to speak their piece, and the student to be guided through the complexities of debate. Students are prompted to express their opinion (should he be allowed or helped to die or not?) at each stage of the presentation, and challenged when they seem to have contradicted themselves: 'you agree that Dax should be allowed to die, but - if you had been a nurse on the case - you say you wouldn't have helped him to die?'. The guidance is perhaps somewhat slanted: although the burns doctor, the psychiatrist, the nurse, the mother all express their conviction that Dax couldn't really have wanted to die, or that his real wish could not be taken for a serious, rational choice, the script leaves little doubt that it was indeed his choice, even though he might later admit that his life was more enjoyable than he had expected.

The issues which students are encouraged to address concern the rights (or otherwise) of people to make their own decisions about the amount of pain they might be willing to endure, and for what reason, and also the responsibilities of medics to do their best to save a life. 'Letting Dax die', some say, would be tantamount to helping him to suicide: better they first make him well, and then he can kill himself elsewhere. One issue that is not addressed - perhaps because it did not apply in Dax Cowart's case - is our responsibility to others: if there were others dependent upon him, and he had some good chance of meeting that responsibility, his life, perhaps, was not 'his own' to end. Another issue that would be familiar to healers and helpers in a 'less civilized' community, would be the responsibility such healers and helpers have for the life they have saved. Those who made Dax live should perhaps not be permitted to disown responsibility: they chose that he should live, not he himself. Perhaps they should pay the debts thereby incurred.

The CD-ROM also contains some details of related cases and court judgements, but it must be admitted that a book would hold far more. The advantages of a CD presentation - in effect, a half-hour documentary to be viewed in any order - lie in the sight and sound of the participants, and a challenge from the text itself to read more closely. The philosophy text that talks back (and so contradicts Plato) is still some way away, but this case-study is a useful trial. It includes a chance for the reader to record responses, and look back on them thereafter - to build a larger text for group discussion.

Running it on my machine - with some initial difficulty - I found the videos, and the voices, fuzzy. That is no doubt a flaw in my machine. It can be installed and used on either a PC (using Microsoft Windows) or an Apple Mac, with the appropriate video, audio and mouse attachments. It can be recommended for group discussion in medical ethics courses, and in introductory philosophy courses.

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[Table of Contents] [Letter to the Editor]

Computers & Texts 14 (1997), 17. Not to be republished in any form without the author's permission.

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