[.ca] The Culture of Death: The Assault on Medical Ethics in ... (ISBN 189355449X)

The Dangers of Utilitarian Thinking:
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.

It is the doom of men (and women) to forget.:
Let's think about the Schiavo case for a moment here. Not to be completely political but frank: what is the value of a life? Can you buy it back? Can you sell it? Dare we call it worthless? If only one of us was 'written off', then what about the rest of us? Aren't we all in the same boat? If we believe that some people can't be saved, that they are better off dead, how close are we to Euthanasia? To a new Nazi or Communist Regime? Questions that should be asked, if I dare say so myself.

Honest account of problems with euthanasia and PAS:
Euthanasia and physician assisted suicide are highly emotional issues. Often both sides a bit shrill in pleading their case. Smith offers a reasonable accounting of the arguments for standing against the "Culture of Death" and a chilling warning about how that culture is slowly insinuating it self into everyday life. While he does give many human accounts of the problem he maintains a lawyers clear course to the facts and argues his case well. So well in fact that his work seems to be a primary target of the pro-PAS legions. The terms "culture of death" and "slippery slope" are often used in a sneering manner to discount those who do not believe as they do. To me this says they are very afraid of what he has to say. That would say volumes about the strength of his argument. I'd also recommend his "Forced Exit" and "Power over Pain" co-written with Eric M. Chevlen MD. (one Hell of a resource for anyone who deals with pain issues professionally or personally). Smith is a very readable writer and obviously has done his homework on the subject. Folks the problem is real, TAKE MY WORD FOR IT. As a friend recently pointed out even if we are not currently elderly or disabled we are almost all headed that direction. Take the time to educate yourself rather than to just react. This book is one of the best places to start.

Essential work on euthanasia, end-of-life care, etc.:
Wesley Smith has written a readable treatise on euthanasia, physician-assisted suicide (murder), the devaluation of the handicapped, and the idiocy of the animal "rights" movement. If you are interested in these areas, or writing a paper or researching an article on these fields, this book is essential reading. Smith has termed the assault on basic human values led by the twisted values of the Kevorkians and Singers as the "culture of death". This term is accurate and portrays this sub-culture as it really is. Smith starts with cases of neglect where physicians or others try to kill or let die others due to a variety of reasons. Some of these cases are disturbing in hind-sight because you invariably can see the Ghosts of the Nazi ethicists lurking behind the scenes. Smith then includes chapters on euthanasia, physician-assisted suicide, withholding life-sustaining measures (like food and water), and finishes with chapters on organ donation and animal "rights". He presents lots of evidence and direct quotes from both sides. His treatment of the legal cases and legal reasoning involving these issues is especially strong. Now, on a personal level, I am a physician who deals with these issues daily and there is truly a culture of death out there. Every day I fight a mostly losing battle with a system that argues more about pharasaical "rights" than what is best for the patient. Recently some family members of a dying patient kept vigil on a comatose relative so that he wouldn't "suffer" from the nurses turning him and wiping his butt after bowel movements. Mercifully, he died before I had to call in the police to remove them from the hospital. The family somehow felt that their "rights" to decide their loved one's care trumped common sense and decency. One fault of this book is that it doesn't discuss the greatest culprit in the devaluation of life - abortion. "I will give no deadly drug to any - even if it is asked for. Similarly, I will not aid a woman to procure abortion." These lines from the Hippocratic Oath were the bulwark of medical ethics. Most doctors no longer take this oath, but a bastardized, liberal monstrosity that is meaningless. My advice is if your doctor doesn't believe the original oath then find another, because he doesn't have your best interests at heart. In short, this book lacks pro-life information essential to this topic. That's why I gave it 4 stars. However, it does an excellent job showing how our society devalues life in the areas of euthanasia, physician-assisted murder, and the harm that the animal movement is doing to human beings.

A fantastic expose of the lack of ethics in medicine:
Shocking and informative, this book is written with conviction and a powerful sense of wrong and right. A must-read for anyone interested in end-of-life care.