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Annotated by:
- Jones, Therese
- Date of entry: Feb-21-2012
- Last revised: Aug-31-2006
Summary
Ten months after being burned over 68% of his body, Dax Cowart was interviewed on videotape at the University of Texas Medical Branch in Galveston by Dr. Robert B. White. Blind, disfigured and helpless, Dax had consistently asserted his right to refuse medical treatment, including further corrective surgery on his hands (useless, unsightly stumps) as well as the daily, excruciatingly painful baths in the Hubbard tank.
At the time of his admission to UTMB, he had become adamant that he be allowed to leave the hospital and return home to die--a certain outcome since only daily tankings would prevent overwhelming infection. Dr. White had been called in as a psychiatric consultant, and much of the twenty-nine minute documentary is a conversation between patient and psychiatrist.
Calm and coherent, Dax states his wishes clearly and presents his case compellingly. He does not "want to go through the pain"; he does not "want to go on as a blind and a crippled person"; and he does not understand or accept any physician’s "right to keep alive a patient who wants to die."
Miscellaneous
Primary Source
Dr. Robert B. White, UTMB at Galveston; tel. 409-747-8367
Commentary
Please Let Me Die is one of the most significant and most disturbing stories in contemporary biomedical ethics. The documentary itself captures the past and present lives of Dax Cowart by juxtaposing the still images of a young, dashing fighter pilot staring directly at the camera, a high school football hero posed for the yearbook, and a bronco-riding rodeo star caught in mid-air with the daily clinical ritual of transporting, submerging, anointing, and bandaging the burned and naked body of a blind and immobile patient.
In the summer of 1973, twenty-six year old Dax Cowart was critically injured in a propane gas explosion that killed his father. For more than a year, he underwent extraordinarily painful treatments in the acute burn ward of two hospitals. From the day his world exploded into flames, Dax expressed a desire to die, to leave the hospital, to end his suffering. Despite repeated declarations of competence by his psychiatrist, Dax’s pleas were rejected. In 1974, he and Dr. Robert White made Please Let Me Die, and in 1984, he made a second video, 0114 (see this database). Both films have served as illustrations of medical paternalism and as arguments for patient autonomy.
Despite a positive outcome that should have quelled the moral ambiguity and ethical disagreement of Dax’s case, there remains sharply divergent perspectives regarding it. Graduating with a law degree in 1986 and becoming an advocate for patients, Dax Cowart affirms that while he is now happy, the end in no way justified the means. Just as he is forced to undergo the unimaginable suffering of unwanted medical treatment, the videotaped record of that treatment forces viewers to experience his suffering vicariously with the interminable bandaging of his burned limbs, the intolerable close-ups of his disfigured hands, and the heartbreaking moans of his pain that close the documentary.
Twenty-five years after his accident, Dax is adamant that he would still want the same thing under identical circumstances, that he would still want the freedom to refuse treatment and die: "Another individual may well make a different decision. That’s the beauty of freedom; that’s his or her choice to do so." (see p. 18 in "Confront Death: Who Chooses, Who Controls?," Hastings Center Report 28/1: 14-24, 1998)