Emarchez Riley
A Milian Argument Pertaining to the Case OfDax Cowart
Dax Cowart was a man recognized for his case in which ethical issues were raised by efforts to sustain his life against his wishes after an accident in which Cowart suffered severe and disabling burns over most of his body. Despite Dax’s argument for them to let him die because of the fact that he was in excruciating pain and that he would not be able to return to his former level of activity, he was still taken to the hospital where they began to treat him for his wounds. John Stuart Mill in “On Liberty” presented his argument against paternalism, which is the policy or practice of governing another person without giving them rights or responsibilities,in order to validate a person’s right to refuse medical treatment. Mill believes that one is not obligated to take action concerning their own healthsolely on the fact that others believe that it is wise, or the rightful thing to do because no one knows you better than you know yourself. Coercion by others toward the individual is only acceptable when an individual poses a threat to other people. Mill states that the argument that a certain law or public opinion might be for an individual's own good or welfare does not serve to justify that law or public opinion as a powerful force.
Mill’s argument goes as follows; a restraint of liberty is an evil, andtherefore, the burden of proof is on those who propose restraining liberty. Since paternalistic restraint does not concern harm done to others, we cannot appeal to self-protection of others to justify the evil of restraining liberty. In reference to Dax Cowart’s case, Mill would state that Dax’s right to patient autonomy has been violated even before he was hospitalized. After the explosion that burned away Dax’s skin, Dax stated that he was burned so severely and in so much pain that he did not want to live and if it was up to him he would have put himself out of the misery that he felt at that exact moment. After the accident when a man responded to Dax’s screams for help, he asked the man for a gun. He stated that he was going to die anyways, but the man refused.
Right then and there, Mill would have granted him his wishes instead of helping to prolong his life. According to Mill, anyone that restrictedDax’s right to liberty would be justly accountable for the pain that Dax has endured from that point on. Not only can you cause evil to others through action, but also your inaction and since that man did not help to carry out Dax’s plan, he therefore committed an unjust act towards Dax.Since the doctor’s also practiced paternalism,violatingDax’s patient autonomy by giving him treatment against his own will, Mill would say that they did him more harm than good.
No one is more invested in yourself and your well-being than you; therefore, no one can actually know what is best for you unless you state it. Mill’s argument is that we cannot benefit an individual by restraining his liberty, or any attempt to do so will involve evils which outweigh the gooddone. Being as though Dax specifically said that he did not want to live, Mill would agree that the best thing they could have done for Dax was to grant him his wishes and let him die. In addition, what Dax was asking for would not harm anyone else, but it would have saved him from the misery only he experienced. He was not putting anyone else in danger for the simple fact that what he was simply asking them to do was to help him put himself out of despair, which did not cause them any risk to their own lives.
In introducing his case, Dax starts off by telling us who he was before the accident happened. He was an active duty airport pilot in the air force reserve aiming to become a commercial airline pilot. He was an “outdoors” person, very active in sports, and absolutely loved to fly. A person such as this can be described as very mobile. They like to get up and go, and they often times lead adventurous lives. However, after the accident, Dax was incapable of moving on his own, and the thought of never being active again shattered his heart and right then and there, he was asked to be put out of his misery.
According to Mill, every person has the right to the liberty of their own tastes and pursuits. This means that they have the right to framing their own life to fit their own character. Therefore, in Dax’s case, Mill would agree that being paralyzed was not how Dax envisioned himself in life. To go from being a very active person, to barely moving is torture for Dax within itself and it would cause more harm than good to keep him alive and forcing him to live a life that he did not visualize for himself. Mill says that any justification fr paternalistic restraint must appeal to the individual’s own good, however, in Dax’s case, he was clearly kept alive against his own will. Even before receiving treatment he wanted his life.
According to Dax, their way of “treating” him was pure torture. They would first begin with brushing away the dead and infected skin with brushes and sharp instruments. Then they would proceed to use Clorox as a disinfectant and bandages soaked in saline solution. In doing so, they would restrain his arms and legs while he screamed at the top of his lungs to the point where other patients or people in the hospital would question what they were doing to him. To Miller, the public, or in this case the doctors have no right to interfere with personal conduct, or Dax’s readiness to die. He then goes on to say that when the public do interfere, more than likely they interfere in an unjust manner and in the wrong place. This goes back to Mill’s argument that when a person’s liberty is restrained, the good actually outweighs the bad. This plays itself out in Dax’s case because he experienced more pain than he had to if they were to just fulfill his wishes by letting him die comfortably.
However, there are some arguments for [limited] paternalism. Dworkin’s argument, for instance, goes as follows: There are goods, such as health, that all people recognize as good. He then argues that at particular moments, however, certain individuals these as good. On instance in which people may not recognize these “goods” is if they were incompetent and in these such cases; interfering with a person’s expressed will is not interfering with their judgment of what is good.
Now, the question of whether Dax was really competent comes into play. To be competent is simply defined as being efficient and capable. Although the psychologist at the burn ward declared Dax incompetent, two other doctor’s refuted this by saying he was indeed competent. Day in and day out, he was capable of feeling the pain endured by the treatment, his body clearly objected to the pain as he screamed out in agony due to its abrasiveness. He was able to speak out about what he wanted done, in addition to being able to reaching out for help from different lawyers.
Now, a person that was deemed incompetent would not be able to do these things. Dax, for instance, cannot be compared to a person that is in a coma. A person that is in a comais unconscious and will not respond to voices, other sounds, or any sort of activity going on around them. The person is still alive; however they are incompetent becausetheir brainis functioning at its lowest stage of alertness.This is clearly not the case for Dax. He responds to the pain he endures in more than one instance and constantly asks for his wishes to be fulfilled, which were to stop “treating” him, to keep him comfortable, and to let him die.
Now that the only exception to the rule of patient autonomy has been addressed, it can be concluded did Dax did indeed have the right to die because he was competent and fully aware of what was going on with his body.He should not have been held against his own will. According to Mill, no one has the right to restrict another person’s liberty and in doing so, they are really doing more good than harm. Mill stresses the fact that no one knows you better than you. Therefore, no one should be allowed to make decisions concerning you against your own will because in reality that is not what is in the best interest of the patient.
Therefore, as we have come to the conclusion that Dax was indeed competent and rational, we can also conclude that the doctors were wrong for denying his request of death.Dworkin argues that all rational people recognize that there are goods, such as good health.Mill argues that if the individual’s actions are not going to harm another person, then we should act on their wishes. In Dax’s case, he should not have been denied his wishes to be left to die. He was clearly able to make a sound decision based on the pain he endured and being as though he was very cognizant of what was going on with his body, the doctors had not right to restrict his right of patient autonomy.
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