Lessons from the burning man

July 12, 1996

A RIGHT TO DIE? THE DAX COWART CASE, By David Anderson, Robert, Cavalier & Preston K. Covey, Routledge (+44 171 583 9855), Pounds 35 + VAT (single user) Macintosh/Windows CD, ISBN 0 415 91753 0 (single user), ISBN 0 415 91754 0 (multiple user), ISBN 0 415 154 7 (teacher's guide)

Nearly all universities in the United Kingdom and in North America now have a great variety of applied ethics offerings. These include modules in medical ethics, business and professional ethics, media or journalism ethics and engineering ethics.

Most of the time these are offered by philosophy departments; sometimes they are offered by professional schools, for example, the medical or business school or engineering departments in the university.

The main goal of these modules is to consider ethical issues professionals will face on the job. One way of trying to reach this goal is for students to read theoretical articles on a topic. Another way, often complementary, is to examine actual or imaginary cases illustrating theoretical principles. So, as well as investigating in the abstract a topic such as the right of a patient to refuse life-saving medical treatment, students also consider an appropriate concrete illustration like the classic Dax Cowart case.

Instructors and textbooks in applied ethics have used various means to present these cases. Some medical ethics textbooks, for example, contain short, bare, descriptions like this one for the Dax Cowart case: "Before the accident, Donald C (Dax Cowart) was a healthy young man with a promising life. Unfortunately he suffered very severe burns over two-thirds of his body in a propane gas explosion. He now finds the treatments for these burns so painful that he has asked his physicians to stop treatment. He knows that he will die if they do this and will live if they continue the treatment. Should the physicians continue the treatment despite Donald C's objections?"

Alternatively, students might be given a much lengthier, but still written description of the case to study. For the Dax Cowart case this might include information about his life before the gas explosion, his treatments and his reaction to them, perhaps brief paraphrases of the views of his physicians, and other details.

Sometimes such information is presented in a digested and organised form, and sometimes in an messy and disorganised form closer to what professionals would see on the job. Harvard University's business school is famous for using printed cases which are rich in details presented in this realistic way. On the other hand, some medical ethics case textbooks provide this kind of detailed kind of information for famous incidents, but in a digested and structured format.

Instead of, or in addition to their printed materials, students can view videotapes. These can provide background or interviews with some of the main characters in a case. In engineering and business ethics, for example, an extensive set of videotapes covering the Challenger space shuttle explosion and the role of engineers like Roger Boisjoly is available. For ethics in scientific research, there are television documentaries covering famous examples of scientific fraud. In Dax Cowart's case, two videotapes have been available and used at many universities for a number of years.

As yet another way of studying cases in applied ethics modules, some universities have run simulations involving students or have used live actors to play out a case. For the Challenger incident, for example, one simulation asks students acting as managers to decide whether they will have their drivers run a racing car in extreme conditions, just as the engineers and their managers were asked to launch a rocket in extreme cold. When live actors are used, they not only act out their parts in the case but sometimes try to study their roles well enough to answer students' questions about the case.

A Right to Die? is an interactive multimedia presentation of the Dax Cowart case which offers yet another way of studying an applied ethics case. It includes background material on the participants, interviews with Dax Cowart's physicians and nurses, his mother and friends, and scenes of his painful burn treatments, all immediately accessible at the click of a button. A typical interaction with this presentation ends with Dax Cowart saying that although he is now alive and has a good life, he still believes his physicians should not have treated him against his wishes.

A session with this CD-Rom is not quite like interacting with the real participants or knowledgeable actors playing the participants but that is what it sets out to simulate.

With all these different means available for presenting an applied ethics case, what is to be said for the interactive multimedia method for the Dax Cowart or other cases? Some might say that there is too much in a multimedia presentation that distracts from the important facts and ethical principles. There are, for example, those gruesome visuals of Dax's treatment, accompanied by his screams. And there are numerous interviews which must be listened to carefully to extract relevant information.

Much better, critics might say, are the short, bare, written descriptions of the case with just the essential features; or perhaps a lengthier version, with more details, in an organised and digested form.

Both these arguments are wrong. Will not students, once they become professionals, make decisions about what it is right to do while seeing and hearing the kind of things they see on this CD? If they are medical professionals, they will have patients in great pain. If they are in other professions, they will have to make ethical choices in other disturbing circumstances. And is not one of the most important skills that students should acquire in applied ethics the skill of extracting important facts and applying ethical principles in messy undigested real cases?

*More information, including b/w versions of video clips from the CD, is at http://www. thomson.com/routledge/indepth/ dax_main.html Leslie Burkholder is a tutor in the departments of philosophy at the University of Leeds and the University of British Columbia.

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