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Old 08-17-2012, 01:52 PM   #16
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i remember watching a documentary on this particular case. it's harrowing, and brings up much more complex issues surrounding euthanasia and situations that aren't nearly as seemingly simple terminally-ill-and-suffering cases.

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Dax Cowart

Dax Cowart (born Donald Cowart) is an attorney noted for the ethical issues raised by efforts to sustain his life against his wishes, following an accident in which Cowart suffered severe and disabling burns over most of his body. Cowart's case has become highly famous in the realm of medical ethics.

In July 1973, Cowart, then a pilot in the Air Force reserve, and his father were visiting a tract of land that his father was thinking of purchasing. The land lay in a small valley and, unbeknownst to the Cowarts, a gas leak had caused the valley to become filled with propane gas. After surveying the land, the Cowarts returned to their car, and the sparking of the ignition set the gas on the floor of the valley ablaze, severely burning both men. According to Cowart:

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I was burned so severely and in so much pain that I did not want to live even in the early moments following the explosion. A man who heard my shouts for help came running down the road, I asked him for a gun. He said, 'Why?' I said, 'Can’t you see I am a dead man? I am going to die anyway. I need to put myself out of this misery.' In a very kind and compassionate caring way, he said, 'I can’t do that.'[1]
Cowart's father died on route to the hospital, but Cowart himself survived the ride to the hospital, despite the fact that he was refusing medical treatment because he felt he would not be able to regain his former level of activity. Cowart's injuries included the loss of both his hands, eyes, and ears, and the loss of skin over 65-68% of his body.
While in the hospital, Cowart continued to insist then that he wanted to die; his doctors refused. Cowart says that he was "forcibly treated for 10 years" although he continually begged his doctors to end treatment and allow him to die. Instead, Cowart was subjected to medical treatments, which he likened to being "skinned alive" on a regular basis, including being dipped in a chlorinated bath to fight infection and having the bandages covering his body regularly stripped and replaced. He was provided with only a limited supply of painkillers, since their risks were not well understood at the time. He was denied access to means of communication by which he might seek legal assistance in ending the treatments.[1] He attempted to commit suicide on several occasions, but was prevented each time.

Cowart eventually healed enough from his injuries to be released from the hospital.

Although blind and without functioning hands, he was able to earn a law degree from Texas Tech University in 1986, and now has his own practice. Cowart legally changed his name to "Dax" because he was often embarrassed to respond to "Donald" only to find that a different person was being addressed.[1]

He successfully sued the oil company responsible for his burns, which left him financially secure. He attempted suicide twice after his rehabilitation period. He eventually finished law school and married. Cowart met Lois "Randy" Randall, a nurse of 46, as a result of his video Please Let Me Die. She called him up and proposed they meet. Married in 1988, they lived in a big stucco house near the Henderson Country Club. Sometime after, Dax and Lois divorced due to unknown reasons.

Cowart has been a frequent participant and speaker at The Trial Lawyers College in Dubois, Wyoming with Gerry Spence. There he met Samantha Berryessa, a California attorney. They were married in 2003, and now live on a ranch outside San Diego California.

Dax Cowart - Wikipedia, the free encyclopedia
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Old 08-17-2012, 01:57 PM   #17
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Pretty amazing story.

I think that everyone who has given this any thought at all, from both a moral and legal perspective understands that it is a very, very complex issue. To treat it simply is to not address it at all.

But the complexity also doesn't mean that a real dialogue can't and shouldn't be had. There are now jurisdictions where assisted suicide is legal - lessons can be learned, good and bad, from them and how they've addressed the issue.
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Old 08-17-2012, 02:57 PM   #18
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i found the Dax case mind boggling.

do you (in effect) torture a man for 10 years so that he can live, because you know that he will recover from his injuries? or do you let him end his suffering, as is his wish?

i know that if i were Dax i probably would want to die. and though i watched the documentary probably 15 years ago, i think he stated that he still wish he had died, despite his wife and law degree and how he has turned his life around. that it still wasn't worth the 10 years of pain.

but then if i were Dax's doctor, i don't know if i could have euthanized him.

anyway, this is one of those things that keeps me up at night, and as me saying the phrase, "but not for the Grace of God there go I ..."

it also makes me wonder about the zombi attack victim in FL. his face is gone, but he's going to live.

this is the stuff that gives me nightmares.

anyway ...
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Old 08-17-2012, 04:07 PM   #19
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I can understand hesitating if there's a chance for the person to recover. I mentioned Terri earlier, she'd been pretty much brain dead for, what was it, 10, 15 years and the chances of her recovering were exceedingly slim, at best. This guy made an impressive recovery considering the circumstances, he had much more of a chance than she did.

But at the same time, again, if the person wishes for death, I also think it'd be cruel to ignore their wishes and put them through pain for so many years, too. And it sounds like he's still very much haunted by the stuff he went through all those years. I feel bad for him.

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It is curious that we are all in favour of allowing our pets a dignified death when they are suffering beyond comprehension and without any chance for improvement, but when it comes to humans, many of us totally lose all rationality with respect to this debate.
Fully agreed on this. I don't get it, either.
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Old 08-19-2012, 03:50 AM   #20
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What would have happened if Stephen Hawking had been euthanized years ago? His is almost the same thing - he has ALS and is also paralyzed with no means of communication other than his voice box. What would have happened if Christopher Reeve had been euthanized after his accident? He was also paralyzed from the neck down with no hope of survival....

I am so very very sorry for this poor man's condition but I believe that, instead of wanting to end his life, perhaps he could use his circumstances to help other people in his condition - like Christopher Reeve did.
The article said that his mind isn't affected and his condition isn't terminal so I believe that he should fight on.

The murder (in my opinion) of Terry Shiavo was an absolutely horrible story. She was alive, she responded to the outside (we all saw her eyes following the balloon over her head) and in the end she was selfishly and cruelly starved to death. You can look at all my posts in the Shiavo thread from a few years ago and you can see how critical I am of euthanasia(sp?) which, in my opinion, is a fancy term for murder.

All that being said......if he wants to end his life then he should just do it himself and not involve anyone else who might get prosecuted because of him.
However, I really don't want him to die - I hope he lives long enough to be treated and eventually cured.
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Old 08-19-2012, 03:58 AM   #21
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It's extremely easy for you to say he should fight on. That's cold comfort to him.

I'm not suggesting doctors be forced into doing it, but I'm sure there are people out there who could end this man's life because he doesn't want to live in hell any more.
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Old 08-19-2012, 07:12 AM   #22
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Stephen Hawking may not be the best example. He's a major physicist with a global reputation and I would imagine considerable means at his disposal. There must be compensations there for his physical condition. I mean there must be, because he is still around. That is not necessarily a typical situation (incidentally his condition typically is terminal, and within quite a short time).
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Old 08-19-2012, 09:29 AM   #23
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This condition is very, very different from Terri Schiavo.
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Old 08-19-2012, 09:50 AM   #24
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Euthanasia is something that the individual would have to elect after having undergone extensive psychiatric evaluation to determine that he or she is not depressed, coerced, etc. What does this have to do with Stephen Hawking? I don't think that he's calling for assisted suicide.

It's also very patronizing IMO to tell people that they need to fight on. Why not all those kids dying of cancer whose parents make the decision to stop treatment? Should those kids suck it up and continue because it ain't over until you're actually dead?
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Old 08-19-2012, 10:20 AM   #25
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If a physically healthy person wants to get out of this world, they commit suicide.

If someone isn't able to do that, but still has very rational reasons for wanting to be dead, who are we to deny them that? Why should we force them to live the shitty life they don't want to live anymore?
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Old 08-19-2012, 10:29 AM   #26
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Originally Posted by AchtungBono View Post
What would have happened if Stephen Hawking had been euthanized years ago? His is almost the same thing - he has ALS and is also paralyzed with no means of communication other than his voice box. What would have happened if Christopher Reeve had been euthanized after his accident? He was also paralyzed from the neck down with no hope of survival....

I am so very very sorry for this poor man's condition but I believe that, instead of wanting to end his life, perhaps he could use his circumstances to help other people in his condition - like Christopher Reeve did.
The article said that his mind isn't affected and his condition isn't terminal so I believe that he should fight on.

The murder (in my opinion) of Terry Shiavo was an absolutely horrible story. She was alive, she responded to the outside (we all saw her eyes following the balloon over her head) and in the end she was selfishly and cruelly starved to death. You can look at all my posts in the Shiavo thread from a few years ago and you can see how critical I am of euthanasia(sp?) which, in my opinion, is a fancy term for murder.

All that being said......if he wants to end his life then he should just do it himself and not involve anyone else who might get prosecuted because of him.
However, I really don't want him to die - I hope he lives long enough to be treated and eventually cured.
Niklinson can't help others. His only way of communication is to blink and that doesn't help much. He is a prisoner of his own body.

I'd like to see this man be cured too, but when will that happen? Are doctors and scientists any where close to curing his disease or paralysis? I haven't seen any reports indicating that they are. So, how long do we have to wait? 10 years? 20 or 30? Let's say Niklinson dies naturally along the way - it would be like all the waiting for nothing.

ETA: I just want to say that I think modern medicine seems like a double edged sword. There are ways to keep people alive after paralysis, major brain damage, etc., yet they are trapped in their bodies. 50 years ago, they would've died. Seriously, science has to get moving with stem cell research and the like to get people like Niklinson out of their hellish existence.
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Old 08-19-2012, 11:37 AM   #27
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Locked in syndrome is perhaps the worst thing that could happen to a person. Out of all the heinous afflictions - cancer, AIDS, MND, Parkinsons, Alzheimers etc - locked in is probably the worst because it's usually sudden so there is no time to prepare/adjust. My deepest sympathies go out to this man. I don't think he can be asked to "tough it out" because how could any able bodied person have the slightest comprehension of what he's going through? Also the poster who said he should take his own life - how exactly? Refuse food? The doctors would only feed him intravenously. For extreme (and thankfully very rare) cases such as this, the laws on assisted suicide should be ammended. It is devastating not only for the victim but also their family.
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Old 08-19-2012, 02:47 PM   #28
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I suppose you could just not care for a locked in patient, it would just take a lot longer for him to die.
It sounds like that's exactly what the other patient who was petitioning the Court alongside Nicklinson was seeking. But apparently that's not legal either, I guess because the condition necessitating the feeding tube/IVs wouldn't in itself be terminal or life-threatening.

From cobl's article:
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Martin, 47, also has locked-in syndrome and asked for the court to allow professionals to help him die either by withholding food and water or by helping him go to a clinic in Switzerland to die. His wife said she respects his wishes, but does not want to help kill him.
ETA -- According to this textbook (Ethical Issues in Neurology), US courts have in some cases permitted this:
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Two locked-in patients were similarly permitted to die when they refused life-sustaining therapy. Hector Rodas was a young man who was chronically locked-in following a brain stem stroke. A Colorado district court found [1987] that he had the right to refuse hydration and nutrition because he was "mentally capable of refusing treatment." Under the circumstances, his decision was "rational and reasonable." Murray Putzer also was in a locked-in state and refused hydration and nutrition for the same reason. The New Jersey Supreme Court [1987] upheld his right to refuse treatment because it was a rational choice not to want to live in a chronic locked-in state and because refusing therapy in this context did not count as suicide.
However the text also notes that in other, similar cases, such as that of Elizabeth Bouvia, a court did not uphold the patient's right to refuse hydration and nutrition:
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On September 3, 1983, Bouvia, at the age of 26, admitted herself into the psychiatric ward of Riverside General Hospital in Riverside, California. She was almost totally paralysed by cerebral palsy and had severe degenerative arthritis, which caused her great pain. Bouvia was alienated from her family and husband, and had been entertaining thoughts of suicide. She requested hospital authorities to allow her to starve to death. When they refused and ordered her to be force-fed, Bouvia contacted the American Civil Liberties Union, which assigned her a lawyer. In the subsequent lawsuit, the court upheld the hospital's decision and ordered force-feeding to continue. Following the court case, a bitter dispute broke out among physicians regarding the Bouvia case. Bouvia tried to resist the force-feeding by biting through the feeding tube. Four attendants would then hold her down while the tubing was inserted into her nose and liquids pumped into her stomach. Some physicians called this battery and torture, while others claimed that the hospital was right to err on the side of continued life. Bouvia appealed the lower court ruling and lost. Now, in addition to the force-feeding, she was hooked up to a morphine drip to ease the pain of her arthritis.

Eventually, she appealed again and this time the court ruled in her favour that the force-feeding constituted battery [1986]. After the court case, Bouvia decided that she would live. [Specifically, she stated that she found the resulting process of starvation, in tandem with the morphine side effects, too painful to bear. ~y.] In 1998, she appeared on 60 Minutes, saying that she was still in pain and had felt great pressure to continue living; she expressed the hope that she would soon die of natural causes. She was still living in 2002. In its obituary for USC professor Harlan Hahn, the Los Angeles Times on May 11, 2008, reported that Bouvia was still alive.
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Old 08-19-2012, 06:31 PM   #29
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Life in itself, not quality of life seems to be held above everything else. I often struggle with this in my area of work being a nurse on a respiratory ward. There is very little acceptance of death among the consultants, and a lot of the treatment given to some of our patients who have terminal illnesses and are at the end stage of the illness are very unnecessary, IV medications given 10 times a day, NG tubes inserted, non-invasive ventilation masks that will be required to be worn 18 hours a day that leave sores on your face, unable to communicate properly, and entirely dependent on the mask for breathing. We'll drag people's lives out for another couple of weeks in a barely coherent state with no real plan for attaining a certain standard of life.

I've watched Motor Neurone's disease patients nearly choke to death on a small bit of phlegm. With all our medical advances we have merely sought to extend life into a state of limbo, a half life and we watch the slow torturous degradation of people all the time, repeat admissions getting worse all the time.

Before the medical profession even thinks about implementing euthanasia, it needs to look hard at how we actually manage the majority of end of life patients and how to let go better. That said the junior doctors I work with seem more open to idea of less intensive and invasive treatments towards the end of life.

I also find DNR orders less than useful, as they may stop a resus attempt being made but up til then it still allows for some pretty invasive and extensive treatment to take place that often borders on the cruel. There has to be more value in a good death well prepared death than a pain filled or vacant life.
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Old 08-19-2012, 09:22 PM   #30
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I also find DNR orders less than useful, as they may stop a resus attempt being made but up til then it still allows for some pretty invasive and extensive treatment to take place that often borders on the cruel. There has to be more value in a good death well prepared death than a pain filled or vacant life.
As a lawyer I am well aware of this and also of my rights. If I were diagnosed with a terminal illness, one of the first things I would take care of is to ensure that I had a legally binding document that clearly outlined which procedures are not to be done on me.

It is astounding to me that we keep people alive at all costs when their quality of life is nonexistent and their prognosis is death. Dying with dignity and on my own terms is of paramount importance to me.

I remember the last weeks and days of my grandmother's life and I hold the medical profession, at least the doctors involved in her care in great contempt for the suffering and needless procedures she endured to get a few more weeks of agony. My other grandmother, who had very clear directives and who had the luck of living in a country where patients' rights are respected, died very peacefully, when her time came.
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