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Donald "Dax" 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:

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 have got 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 en 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 fourteen months" 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. 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 live in a big stucco house near the Henderson Country Club. He is now apparently happy but still believes the doctors were wrong to follow his mother’s wishes over his. The case advanced respect for patient autonomy all around the country.

Cowart's life and his reflections on what has happened to him continue to challenge medicine's understanding of itself as a moral practice. [2] A documentary of his plight titled Please Let Me Die was filmed in 1974,[3] with a follow-up documentary titled Dax's Case filmed in 1984.[4]

The case illustrates several issues of patient autonomy.[5]


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