THE UNIVERSITY OF DODOMA

SCHOOL OF NURSING AND PUBLIC HEALTH,

DEPARTMENT OF PUBLIC HEALTH AND COMMUNITY

NURSING.
Group no. 4
CASE STUDY (Dax Cowart)
 Ethical issues illustrated in Dax case
1. Autonomy, refers to an individual's right to make
decisions about their own life and body. In this case, Dax
Cowart made it clear that he wanted to die and refused
medical assistance. But for ten (10) years, his doctors
forced him to receive treatment against his will, ignoring
his autonomy.
2. Non maleficence, Dax described the medical
treatments he received as extremely painful, comparing
them to being "skinned alive." Despite his persistent
requests to end the treatments and allow him to die, the
doctors subject him to painful procedures
 Cont…
3. Paternalism, refers to the practice of ignoring
someone's autonomy or judgment in order to promote one's
own interests. Cowart's doctors took a paternalistic
approach and continued treating him against his desires,
even after he issued repeated and requested to stop the
treatment and be allowed to die.
4. Quality of life, the value of life is a crucial factor in
medical ethics. Cowart had enormous difficulties in his daily
life as a result of the severity of his burns and the loss of
his hands, eyes, and ears. It's possible that his belief of his
diminished quality of life contributed to his wish to die.
 Cont...
5. End of life issue, Dax brings up significant dying-related
topics. He was kept alive against his will, even though he had
indicated his desire to die. This demonstrates the difficulty of
making end-of-life decisions, the need of medical
professionals, and the requirement for clear moral standards
and regulatory structures to deal with these kinds of scenarios.
6. Beneficence, refers to the duty to act in the patient's most
beneficial interest. It is arguable if Cowart's doctors thought
that by giving him life-saving medical care, they were working
in his best interests. But given Cowart's continually asking to
discontinue treatments, it is unclear if their actions were indeed
in his best interest.
 Cont…

7. Public awareness and advocacy, The public became aware

of Cowart's story and began to advocate for patient rights. His
experiences and later advocacy work have brought attention to
the need for better end-of-life decision-making procedures as
well as the significance of preserving patient autonomy and
informed consent. The public conversation about patient rights
and medical ethics has benefited from Cowart's stories.
What are ethical considerations in reproductive
technologies, such assisted reproductive
technologies, surrogacy, and genetic testing?
Assisted Reproductive Technologies (ART):
Informed Consent: At the heart of ethical practice lies
informed consent. Patients undergoing ART deserve a
comprehensive understanding of the procedures, their potential
risks and success rates, the emotional toll they may entail, and
any ethical issues involved (Bayham et al., 2017).
Access and Equity: Unfortunately, the high cost of ART
presents a significant barrier for many individuals and couples,
raising concerns about equity and fair access (Jurecic et al.,
2020). Inequalities in socioeconomic status directly translate to
disparities in accessibility, potentially exacerbating existing
social and economic injustices (Asad et al., 2018).
 CONT….

• Multiple Pregnancies and Selective Reduction: In vitro

fertilization (IVF) and other ART procedures often lead to
multiple pregnancies, which carry increased health risks for
both the mother and the fetuses. In such cases, the option of
selective reduction emerges, introducing sensitive ethical
debates about the relative value of individual lives and the
responsibilities of healthcare providers (Smajdor et al.,
2015).
 Surrogacy

1. Autonomy and Consent:

 Respecting individual choices: At the core lies the principle of autonomy and
informed consent for all parties involved - intended parents, surrogate mothers,
and potential donors. This requires ensuring complete understanding of the
process, potential risks and benefits, and the implications for each individual's
life. (Bayham et al., 2017; Connell et al., 2016)

 Power imbalances and vulnerability: Addressing issues of power dynamics

and potential coercion becomes paramount. Careful safeguards are necessary
to prevent the exploitation of individuals, particularly those in economically
vulnerable situations. (Asad et al., 2018)
 CONT…….
2. Commercialization and Parental Rights:

 Commodifying reproduction: Commercial surrogacy, where financial

compensation is provided to the surrogate, raises concerns about the
commodification of reproductive services. Ethical considerations revolve
around ensuring fair compensation for the surrogate while safeguarding against
exploitation. (Jurecic et al., 2020)

 Navigating legal and parental responsibilities: Establishing legal and ethical

parental rights in surrogacy arrangements can be intricate. Clear agreements
and robust legal frameworks are crucial to address issues of custody, parental
rights and responsibilities, and potential conflicts between intended and
biological parents. (Smajdor et al., 2015)
 Genetic testing
1. Informed Consent and Privacy Crossroads:

 Transparency and understanding: Any form of genetic testing,

especially preconception and prenatal tests, hinges on informed consent.
Individuals and families must fully understand the implications, limitations,
and potential ramifications of receiving genetic information. (Bayham et
al., 2017; Connell et al., 2016)

 Guarding the vault: Protecting the privacy of genetic data is paramount.

Ethical concerns revolve around ensuring secure storage, responsible
use, and preventing unauthorized access or discrimination based on
genetic information. (Asad et al., 2018)
 CONT……
2. Pandora's Box of Genetic Information:

 The weight of knowledge: Genetic testing can unveil susceptibilities to

diseases, carrier status, or predispositions to specific traits. Responsible
communication of this information becomes crucial, considering the
potential for psychological impact, anxiety, and unforeseen medical
implications. (Jurecic et al., 2020)

 Genetic discrimination's shadow: The fear of discrimination based on

genetic characteristics hangs heavy. Ethical considerations demand
safeguards against potential prejudice in employment, insurance, or social
interactions. (Smajdor et al., 2015)
 CONT…
3. Eugenics and the Future of Humanity:

 Engineering generations: Advances in genetic technology raise the specter of

eugenics - attempting to "improve" the human population through selective
breeding or gene editing. Ethical concerns grapple with the potential for
exacerbating social inequalities, stigmatization of certain traits, and unintended
consequences for future generations.

 Bridging the equity gap: Concerns loom around access and affordability of
genetic testing, potentially creating disparities in healthcare and widening the
gap between socioeconomic groups. Ethical considerations highlight the need
for equitable distribution of resources and ensuring diverse populations benefit
from these advancements.
THANKS