Culture of Death: The Assault on Medical Ethics in America (Hardcover)

by Wesley J. Smith (Author) "My mother's doctor is refusing to give her antibiotics," the caller told me in an urgent voice..." (more)
Key Phrases: bioethics ideology, bioethics advocacy, dead donor rule, United States, Futile Care Theory, Peter Singer (more...)

Editorial Reviews

From Booklist
Smith offers a conservative perspective on medical-ethics problems such as failure to provide subjects in research programs with understandable consent forms. He fears that current utilitarian ethicists will create--some have already done so, he says--a hierarchy of human life that would basically be a descendant of Hitlerian eugenics. Doctor-assisted suicide, he believes, must inevitably lead to such a development, and he takes readers step by step on a probable path to it, inspecting each landmark court case (Cruzan, Quinlan, et al.) along the way. He grudgingly concedes that some amelioration with controlled substances be allowed for patients suffering overwhelming pain, but he assumes that current uncontroversial pain control is more effective than many others say it is. On another major flashpoint of ethical dispute, Smith emphasizes the important benefits of research on animals. Furthermore, he makes suggestions for bringing bioethics back to what he feels is a proper philosophic and practical position, one conducive to safe and acceptable lives for both patient and doctor. William Beatty
Copyright © American Library Association. All rights reserved

Review
One of the TEN OUTSTANDING BOOKS of the YEAR and BEST HEALTH BOOK. -- Independent Publisher Book Awards 2001

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Product Details

• Hardcover: 285 pages
• Publisher: Encounter Books (February 2000)
• Language: English
• ISBN-10: 1893554066
• ISBN-13: 978-1893554498
• Product Dimensions: 9.4 x 6.2 x 1.1 inches
• Shipping Weight: 1.5 pounds
• Average Customer Review: 4.5 out of 5 stars See all reviews (19 customer reviews)
• Amazon.com Sales Rank: #958,115 in Books (See Bestsellers in Books)

Customer Reviews

Most Helpful Customer Reviews

60 of 71 people found the following review helpful:

5.0 out of 5 stars Modern medicine at a crossroads?, January 22, 2001

By	Tim Drake "Author and Journalist" (Saint Joseph, Minnesota) - See all my reviews (REAL NAME)

In spite of the title, this book isn't about what most people would think it's about. It is not about abortion.

Rather, it is about what author Wesley J. Smith terms "futile care theory" - modern medicine's inaction due to the direction of bioethics and cost-benefit ratios.

Through compelling and often disturbing anecdotes Smith examines how "bioethicists" threaten patient welfare through redefinition, organ harvesting, and support for euthanasia.

Futile Care Theory, he explains, allows physicians to base care decisions upon the patients' "quality of life", thereby often deciding that no care is the best care.

I found Chapter 6 especially interesting, as Smith discusses how our culture protects animals at the expense of people. A similar action was taken by the National Socialist government in Germany just prior to the Nazi's creation of their "Final Solution" for the extermination of the disabled, gypsies, Jews, etc.

Smith includes an appendix which shows the payback in terms of medical discoveries and cures which have resulted from animal research.

In the end Smith advocates a "human rights" bioethics - one that will again value human life.

His work is eye-opening and demonstrates just how much we have embraced what Pope John Paul II has termed a "Culture of Death." I recommend this book quite highly.

17 of 20 people found the following review helpful:

5.0 out of 5 stars Important Look at Ignored Subject, January 31, 2001

By	S. Hayward (Mclean, Virginia) - See all my reviews (REAL NAME)

This is an eye-opening look at our increasing "thanatocracy" (Greek for "the rule of death"). With the ethic of "quality of life" riding high in America, Smith makes us confront some deeply troubling trends that seldom come up in serious conversation, because the issues involved have a high "yuck" factor, not unlike abortion. This book should be must reading for all medical ethicists, HMO executives, and legislators. It is not simply a matter that high-tech medicine generates more "dilemmas" over the care of the acutely or terminally ill. Increasingly, Smith shows, there is acceptance of devaluing human life, the veritable shredding of the historic Hippocratic Oath. This slippery slope points down a steep hill with no discernable bottom.

28 of 35 people found the following review helpful:

4.0 out of 5 stars The Dangers of Utilitarian Thinking, June 23, 2002

By	Sammy Jo "sammy_jo" (Midwest) - See all my reviews

Wesley Smith offers a chilling survey of the current state of bioethics, a field which is dominated by the utilitarian calculus. In that calculus, human beings are reduced to instruments which register pleasure and pain. The game of the calculus is to maximize the pleasure and minimize the pain. It is a game that inevitably leads us to devalue lives that are difficult.

Smith's book surveys the weaknesses of this approach to medicine as it relates to the dying and the handicapped. He traces out the slide from a justifiable desire to not artificially prolong the dying process through heroic intervention towards a world wherein doctors and bioethicists can choose to dehyrdate a dying woman against her wishes. As the economic pressures in the new world of HMO's mount, one can imagine that such scenes will only become more common.

The weakness in Smith's book is his failure to address the very hard issue of how to allocate scarce medical resources. One may rightfully deplore the spread of utilitarianism as the criteria for making these decisions, but until the humanitarian approach develops a way of measuring the trade-offs involved in medical care, the utilitarian approach cannot be dismissed entirely.

Smith points to, but does not develop, the issue of how our understanding of life and death and suffering is altered by the utilitarian calculus. Surely life is more than the sum of our pleasures and pains. The tragedy of the dominance of utilitarianism is that it leads us to place our pleasure and pain ahead of ourselves. Somehow our humanity is lost in the process.

Smith has written an important book that raises issues that can only become more urgent in the coming decades.