'Please let me die'


He is a young man, only 25, although there's no way of knowing this from his appearance. Fire has excavated almost to the bone both his face and body. Still, even in his blunted features, agony has found a way to express itself. The young man's suffering is captured in the flickering black-and-white images of a grainy tape filmed in a Texas hospital 25 years ago.

Once, Donald Cowart was an Air Force pilot who flew jets in and out of Vietnam; a handsome, strong-willed man with a passion for driving fast in his Alfa Romeo.

He is a young man, only 25, and he cries out in pain as other men in surgical masks place his atrophied 80-pound body onto a motorized lift. Slowly they lower him, naked and shivering, into a stainless steel tank of water laced with Clorox. Against the backdrop of his cries, they scrape the dead tissue from his burned body.

Once, Don Cowart was an athlete; a popular, fun-loving student; captain of the football team in high school and a champion rodeo cowboy in college.

He is a young man, only 25, who cannot see his hospital tormentors. His right eye is gone, his left eyelid sewn shut. Nor can he push them away with his maimed hands. But he can hear the ominous clanking noise of the pulley lowering him into the tank; the voices singing a hair-cream jingle on a radio; the water splashing as he enters it. Then the pain blocks out everything.

Once, Donnie Cowart was a towheaded 4-year-old, an independent boy who liked nothing better than riding his horse, Cactus, on the family's cattle ranch in East Texas.

"Oh, easy!" he cries. "Easy, oh, easy! Easy on the back of my leg!" The voice rises in agony: "Oh, God!"

"Sorry," says a masked attendant.

Perhaps the casualness of his response masks the terrifying thought that this could have happened to him.

In silence, the masked men do what they must. And when they finish, Don Cowart is taken back to his hospital room to scream in pain until, exhausted, he passes out.

When he wakens, the agony will begin again. And just as he has done almost daily since the explosion and fire that destroyed his body, Don Cowart will fight for his right to stop life-sustaining treatment and go home to die.

This is my body, he will tell the doctors, and I have the right to decide whether I want to live or die.

We don't believe you really want to die, the doctors will reply. It's just your pain and depression talking. One day you'll thank us for this.

He will plead with his mother and his lawyer to help him get out of the hospital. He will turn to ministers, nurses, family and friends. But no help will come.

It is 1973, and Don Cowart is a lone voice in the emerging struggle to establish a competent patient's right to make treatment decisions. He has experienced what everyone fears: A terrible accident has altered his body, and he has lost control of his life.

Two years will pass before the case of Karen Ann Quinlan focuses the nation's attention on a family's battle to remove their comatose daughter from life support, raising the complicated issues of an individual's right to die and the increasing role

played by medical technology in that dilemma.

It will be another 11 years before Elizabeth Bouvia, a young woman paralyzed by cerebral palsy and seeking to die by starvation, wins a 1986 landmark case in which a California state appeals court affirms her right not to be force-fed.

And not until 1990 will the U.S. Supreme Court affirm for the first time a person's constitutional right to refuse medical treatment in the case of Nancy Cruzan, a young Missouri woman who, after a car accident, lapsed into a vegetative state.

But what of the young man who was forced to live?

What became of Don Cowart, faced with the unimaginable task of inhabiting not only a changed body but a drastically changed life?

Twenty-five years have passed, and Don Cowart no longer exists. He is Dax Cowart now. And his case has become one of the most discussed and debated in the literature of medical ethics, raising profound questions about the issues surrounding a hastened death.

"Dax's case is a Rubik's Cube," says Southern Methodist University religion professor Lonnie D. Kliever, who edited a book of scholarly essays titled "Dax's Case." "If you wanted to design a case that would explore all the complex, ambiguous, insoluble issues facing humankind - medical, religious, ethical, legal, moral, emotional - you couldn't invent a case more eloquent and more daunting than that of Dax Cowart."

And in one of the many ironies that shape his life, Dax Cowart has become a symbol for those who oppose the idea of allowing a patient to decide his fate. They point to him and say: See how successful he is! He is living proof that we did the right thing in preserving his life - even against his wishes.

The problem is: Dax Cowart still doesn't agree.

It was a whim, really, that forever altered Don Cowart's life. And ended his father's.

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