were philosophical treatises. Indeed, the most frequently cited authority was not a statute, a law case, or even a legal essay but a philosophical discourse on the modern meaning of the “sanctity of human life” contained in a book—Life’s Dominion: An Argument about Abortion, Euthanasia, and Individual Freedom—written by the attorney/bioethicist Ronald Dworkin in 1993. Dworkin’s thesis: A true adherence to the sanctity of life ethic requires that all be permitted to “decide for ourselves” about abortion and euthanasia and that such decisions be accepted by society and tolerated by those who disagree; otherwise society is “totalitarian.” The majority opinion cited Life’s Dominion so frequently and applied its reasoning so enthusiastically that the Ronald Dworkin’s philosophy may now be the court-mandated health care public policy of the entire state of Montana without a single vote even being cast—quite a triumph for a philosopher who is little known outside the world of the academy and another step down the road toward the new medicine of mainstream bioethics.
As this book will demonstrate, bioethicists and their allies are pushing the laws of the nation and the public discourse increasingly toward accepting killing and death as a legitimate answer to life’s difficulties. This is leading to a rising human toll:
• Oregon, which has legalized assisted suicide, decreed that the act is a form of “comfort care” that must be paid for by Medicaid; this in a state that denies some curative treatments under the state’s Medicaid health rationing scheme.
• Desired medical treatment is refused in hospitals and nursing homes around the country to patients who are dying or disabled, with the intent that the patients die. This abandonment is justified as ethical under a new theoretical construct known as futile care theory (FCT), which proclaims the right of doctors (and health care executives) to refuse wanted care based on their subjective views of the value of their patients’ lives.
• Doctors, nurses, and other hospital staff in hospitals and nursing homes often pressure family members of stroke victims, demented patients, and other cognitively disabled people to permit their brain-damaged relatives to be dehydrated to death by removing tube-supplied food and water.
• In New York, a man who smothered his wife with a plastic bag after her purported assisted suicide attempt failed, and who then covered up the crime with a falsified death certificate and a quick cremation, was given a mere two-week jail sentence.
• In Canada, Robert Latimer was convicted of murdering his twelve-year-old daughter by asphyxiation because she had cerebral palsy. Instead of receiving significant punishment, he was embraced by a majority of Canadians as a “loving father,” resulting in his “mandatory” ten-year sentence being reduced to one year by a judge who labeled the girl’s murder “altruistic.” Latimer remains free on appeal nearly ten years after his daughter’s killing.
• In England, the parents of an infant born with Down syndrome and the treating doctor who intentionally allowed the baby to starve to death were acquitted of all criminal wrongdoing.
• In the United States, the requirements of the Nuremberg Code to protect human beings in medical experiments are routinely violated without legal consequence. Indeed, thanks to the advocacy of “animal rights” activists, animals often receive greater protection in medical research than do people.
This growing indifference to the value of human life within the health care system and courts should be big news. Yet most people are but dimly aware of what is happening. There are several reasons for this. Popular culture promotes many of these practices as a positive, thereby camouflaging the evil that is taking place. Nonjudgmentalism reigns supreme as the growing relativism of our culture increasingly incapacitates people from “imposing their own beliefs on others” by making well-honed moral judgments. The mainstream media neither cover these important issues adequately (or sometimes even at all) nor place them in a proper and understandable context when they do. Thus, while stories involving death culture issues sometimes make the news, they are generally covered as if they have occurred in isolation. The overarching themes that would alert the populace to the bigger picture are generally ignored, and the dots remain unconnected. In this sense, we are like the proverbial frog slowly being boiled to death, unaware that the water is getting hot and that destruction is fast approaching.
A prime purpose of this book is to cast a bright light on the rising steam of the not-yet-boiling pot. Also, by focusing greater attention on the culture of death, I hope to help lead our society away from the immoral path we are on and toward a more profound commitment to the sanctity of human life, not necessarily in the spiritual sense but as a societal commitment that each and every one of us are moral equals. Just as we should not discriminate against each other on the basis of race, religion, nationality, or gender, neither should we cast aside people in the health care system because they are disabled, elderly, brain-damaged, or dying, these latter forms of invidious discrimination being mainstays of the culture of death movement.
Although I quote many philosophy treatises, this is not a philosophy book. And while I explore many laws and ethics protocols, this book does not get bogged down in specific policy proposals. Nor, I hasten to add, am I under the illusion that I can change the minds of the inbred denizens of the ivory tower who move bioethics forward in their never-ending discourse in academic journals and books, and at symposia; most are far too committed to their cause for that. Rather, this is a book primarily about how bad ideas lead to harmful consequences that hurt real people, inviting the people of the general public into the important debates that are already occurring beneath—or, better stated, above—the radar, debates that will not only determine the future of their health care but also the very morality of the society their children will inherit.
One last note before we get under way. In these pages, I take no position on whether abortion should be legal or illegal. I know this will frustrate some of my readers, but I am convinced it is the right thing to do to best accomplish my objectives. Abortion is the black hole of public discourse from which little light escapes. Were I to discuss the issue in depth, any publicity this book eventually receives would likely focus on that issue and divert attention away from the many important bioethics policies upon which this book seeks to shine the bright light. Moreover, many articulate and thoughtful voices already address abortion from both sides of the issue, and nothing I have to say would add substantially to that which has already been written. Finally, Roe v. Wade has settled for the foreseeable future whether abortion will or will not be a legal right. Thus anything I might write, either for or against abortion, would be quite superfluous and beside the point of what I hope to achieve in this writing.
That is not to say that Roe v. Wade is irrelevant. In a way, this book can be said to begin at the exact point where Roe leaves off. The people endangered by the culture of death policies about which I write (e.g., born people) are protected under Roe v. Wade but endangered by policies and protocols with which this book is filled. Indeed, whether one is pro-life or pro-choice, it is my sincere hope that the book’s readers will agree with me that, regarding born people, each and every one of us should be treated as an unqualified equal in the health care system. None of us is expendable. No one should be abandoned to death because he or she fails to pass the muster established by the few elite academics and philosophers who, for the last thirty years, have taken upon themselves the power to decide when a life is not worthy to be lived.
WESLEY J. SMITH
Oakland, California
March 2000
“My
