Abstract
After nearly 50 years, the case of Dax Cowart still engages ethicists, lawyers, health professionals, students, and the general public. Why? Dax Cowart, who died of cancer on April 28, 2019, at the age of 71, became a stalwart champion of personal autonomy after his experience as a burn patient who unsuccessfully refused treatment in the early 1970s. The doctrine of informed consent was already fairly well developed by then. But what about the concept of informed refusal? Dax was clearly competent and had decision-making capacity, despite the views of his physicians. We now view this as an axiomatic truth in bioethics—that a patient who has decision-making capacity has the legal and ethical right to refuse any and all treatment, even lifesaving treatment. Yet, this seemed like a radical notion to some in the early 1970s.