The most relevant ethical dilemma presented by Mr. Cowart’s case is patient autonomy and end-of-life patient care. Both issues are based on the ethical perspective in healthcare and pose a significant challenge to physicians when they faced the same ethical issues in their line of duty (Hurst, Mahanes & Marshall, 2014). Patient autonomy gives the patient the freedom to choose the mode of healthcare to be given to them and the physicians to treat them. On the other hand, end-of-life care is ethically arguable if it’s a right idea or a wrong idea health wise to take away a patient’s life at their will when faced with an intense health challenge (Herlitz, Munthe, Törner & Forsander, 2016).
The most relevant stakeholder is the primary stakeholder, in this case Mr. Cowart and the physicians. Dax Cowart, a patient faced with a terrible explosion that resulted in the loss of over 65% of his skin, loss of his eyes, hands, and ears, a health condition that made him wish to die (Hurst, Mahanes & Marshall, 2014). Mr. Cowart was never allowed to contact the attorney, and he tried suicide severally but was prevented from taking away his life. Even after surviving, Mr. Cowart maintained that physicians would have allowed him to take away his life. Cowart’s attending physician kept that his patient, Mr, Cowart was not in a position to make sound decisions regarding his health condition because of pain that traumatized him psychologically and physically. Also, Dr. Robert White, the attending psychiatrist termed Mr. Cowart as incompetent in his decisions following his health conditions (Hurst, Mahanes & Marshall, 2014).
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Based on the principle of autonomy, Herlitz, Munthe, Törner & Forsander (2016) contends that any rational patient should be allowed to be self-determining. The case at hand about Mr. Cowart, he was capable of deciding independently regardless of his health condition as stated by his attending psychiatrist. The decisions of Dax unwaveringly stated that he wished to discontinue his medical treatment and his wish can be termed as authentic and independent. On the other hand, his attending physician, argues that Mr. Dax is incompetent health wise and that high level of pain on his body influences his decision to discontinue treatment. The sole idea of his physician is linked to the theory of beneficence that states that all medical actions are ethical if only performed to improve the well-being of the patient (Martela, Ryan & Steger, 2017). The view is termed as paternalistic in that, one individual acts for the best interest of the other person. In this case, the paternalistic view was appropriate in enforcing treatment on Mr. Dax to ensure that he remains alive and also free form infections.
Furthermore, Kant’s moral theory which states that the rightness or wrongness of a decision or an action is independent of their results but depended if our duty is fulfilled. In applying this approach, it is arguably the healthcare staffs taking care of Dax duly performed their responsibilities to their level best in promoting Mr. Cowart’s health condition as legally outlined in healthcare ethical code of conduct (Vaughn, 2015).
The paternalistic decision of the physicians to offer Dax treatment is contrary to his will as unethical, and I great feel that the decision was wrong and unacceptable from trained medical practitioners (Faravelli, Man & Walsh, 2015). Even at a point when Dax would be considered as incapable of informed consent, healthcare was appropriate to ensure the best interest of the patient’s health, in this case, allowing the patient to die and saving his life from pain as well as disability.
From this case, the attending physicians as part of the healthcare team handling Mr. Dax’s case would suffer moral distress since they acted in contrary to the patient’s will and justified their actions based on religious perspective forgetting the fact that Dax was not a religious person. Therefore, based on the analysis of this case, healthcare providers should take actions depending on the client’s wishes when they are incapable of informed consent. From this case of Mr. Dax, all the treatment was to be suspended as per his request since he was proven as competent at that particular time. The case of Mr. Dax Cowart, I have learned that as a healthcare provider, the decisions made by the patient are paramount and are to be respected at all time.
Forced feeding is an act of feeding an individual or an animal against their wish. In a medical set-up, forced feeding is done using small plastic tubes through the patient’s mouth (orogastric) or the nose (nasogastric). In every state, a competent patient has the right to refuse forced feeding as contended by the (Korb, 2015). However, the decision of forced feeding may not apply entirely to unconscious patients who may not make a sound decision whether to accept or refuse the procedure (Korb, 2015). Therefore, the attending physician is allowed to make a decision that is non-maleficence and beneficial to the patient as well as ethical. In so doing, issues of a dilemma in a healthcare setup regarding forced feeding are significantly reduced.
References
Faravelli, M., Man, P., & Walsh, R. (2015). Mandate and paternalism: a theory of large elections. Games and Economic Behavior , 93 , 1-23.
Herlitz, A., Munthe, C., Törner, M., & Forsander, G. (2016). The counseling, self-care, adherence approach to person-centered care and shared decision making: moral psychology, executive autonomy, and ethics in multi-dimensional care decisions. Health communication , 31 (8), 964-973.
Hurst, A. R., Mahanes, D., & Marshall, M. F. (2014). Dax's case redux: when comes the end of the day?. Narrative inquiry in bioethics , 4 (2), 171-177.
Korb, S. (2015). Forced Feeding: The Torture of Keeping Detainees Alive. Virginia Quarterly Review , 91 (2), 210-217.
Martela, F., Ryan, R. M., & Steger, M. F. (2017). Meaningfulness as satisfaction of autonomy, competence, relatedness, and beneficence: comparing the four satisfactions and positive affect as predictors of meaning in life. Journal of Happiness Studies , 1-22.
Vaughn, L. (2015). Doing ethics: Moral reasoning and contemporary issues . WW Norton & Company.
