Case Study
Dax Cowart
In 1973, Dax Cowart and his father went to view some property near their Texas home. They parked their car in a dry creek bed. This was not uncommon as, in parts of the desert areas in Texas, there aren’t roads, or only some dirt roads. After surveying the land, the men returned to their vehicle. They were unable to get their vehicle started so they started working on its spark plugs. As chance would have it, under the creek bed was a faulty gas line. A spark from the accelerator resulted in an explosion that left Dax Cowart’s father dead. Sixty-seven per cent of Dax’s body sustained second- and third-degree burns. Prior to this he was a healthy young jet pilot and amateur rodeo performer. Crawling from the scene of the accident he was, by chance, seen by a ranger. He begged him to shoot him. When emergency paramedics arrived he again made this request.
Dax’s prognosis for survival was approximately 20%, but his potential quality of life was deeply compromised. He repeatedly requested to die and these requests were all denied. He unsuccessfully attempted suicide by, for example, trying to crawl out of his hospital bed in an attempt to throw himself down the staircase. He was grossly infected by the time he left the hospital and hoped that he would die from sepsis. He didn’t. Against his will, he underwent 232 days of treatment in Parkland Memorial Hospital in Dallas. The types of treatment available at that time we might consider as quite “barbaric”. Immersion in tanks of saline, continuous debridement and medications now considered inappropriate were then the best known way to manage such extensive burn injuries. Also, at that time, there was a great fear that hospitals might inadvertently be producing “drug addicts”, so analgesia was kept at a minimum. At the time of his hospital admission, Dax was in a critical condition and his mother was appointed as his proxy decision maker. So her wishes concerning his care