A group of eight students (mostly medical students, but one or two nursing students also) and one moderator meet and discuss an ethically-challenging case study. There is a rubric full of questions and issues to cover. If appropriate, I will share these cases with you. This way, I can think through what was discussed in class, you can see what medical students are seeing and thinking, and the discussion can continue here.
The first case was that of Dax Cowart. This man suffered 60% burns and was treated at Parkland's burn unit in the 1970s (narcotics were not well-understood) beyond his wishes. He made a video called "Please Let Me Die," which we were assigned to watch before the discussion. My thoughts:
- Mr. Cowart's case and video remind me of the patients I've visited in nursing homes. They're alone so often...it's heartbreaking. Who can live without love? I wish there had been someone with Mr. Cowart during all those sufferings.
- It isn't right to hand someone a gun so that they may kill themselves; however, it is right to allow a patient to decline reconstructive surgery. Somewhere in the middle, there is a line--where is it? What is heroic and what is not?
- I used to be pretty anti-autonomy, because I thought that "autonomy" only meant the patient coming to the doctor with demands (I need this prescription, I want this procedure...), which seems anti-medicine. But "autonomy" can actually means that the patient has the final choice about what is done to them. That's not so bad.*
What are your thoughts on Dax Cowart and autonomy?
* Our culture is more allergic than other cultures have been to the beneficent, paternalistic doctor. Reading Aristotle in isolation (which I have spent some time doing) makes it seem like the Greeks thought a patient should fling himself into the hands of the good doctor! The doctor was, after all, the Art personified.