The Appeal to Fear and the Practice of Pundits: Why Some Books Should Not Be Published

Wesley J. Smith. 2000. Culture of Death: The Assault on Medical Ethics in America. San Francisco: Encounter Books. xv, 285 pp. $23.95/Can $36.75.

Smith's first sentence, in the grand old conspiracy-theory tradition, makes it very clear what he's up to: "Unbeknownst to most Americans, a small but influential group ofphilosophers and health care policy makers are working energetically to transform our nation's medical practice and health care laws" (ix). He borrows his main thesis directly from Neuhaus' 1988 essay "The Return of Eugenics": "Thousands ofethicists and bioethicists, as they are called, professionally guide the unthinkable on its passage through the debatable on its way to becoming the justi-fiable, until it is finally established as the unexceptional" (Neuhaus, 19; cited in Smith, 8).

The rest ofthe book marches to that tune, fuming against what he solemnly swears are overt, insidious "assaults" promoting a "culture ofdeath" that has been and remains, he alleges, the explicit aim and purpose of "bioethics." Despite the "subversive" nature ofthis "movement" (234), its design and method are plain as potatoes to the skilled, the still-caring, and the informed—that is, to Smith himself. For it is he who, consistent with this kind ofconspiracy criticism, has all by himselfextracted the truth. The "medical cleansing" (219) resulting from the past four decades has been, amazingly enough, accomplished by a nefarious, "relatively small 'insider' clique of elite and powerful philosopher, academic, attorney and physician practitioners" (x). From first to last, Smith doggedly pursues his aim, always ofcourse in the "best interests" ofan unknowing and uninformed American public that presumably needs him badly. In short, a key point Smith alleges against so-called "bioethics"—that "it" or "they" have slyly misled a gullible public—is true in spades about Smith himself. But more of that later.

If all this sounds strange, I agree. Ifit sounds a bit deranged, I'm less certain; this attorney for the International Anti-Euthanasia Task Force writes well and often coherently. Indeed, not only does he cite a good many writings from "depraved" "bioethicists," but he has apparently even interviewed some ofthem. Finally, ifreaders detect the aim to cultivate a climate offear, I can only reply that while I can find no reasons for fearing the likes of Joseph Fletcher or other "bioethicists," Smith sees them as truly hell-bent on promoting criteria to define who gets in and who gets out ofthe human community. Characteristic of the conspiracy-theory genre, fear is of course precisely what he seeks to promote.

The "high priests" (4) ofthe "clique" include Jonsen, Veatch, Beauchamp, Callahan, and Childress among oth-ers—most ofwhom will surely be surprised to find themselves characterized as not only supporting but actively promoting such outrages as involuntary euthanasia for people in recoverable comas (70-74, 105-118); obtaining organs from not-yet-dead donors (181-185); routine and intentional dehydration ofcognitively disabled people (123-154); and, in lockstep with Singer (Smith's main bête noire), promulgating stronger protections for research animals than for research people (189-218).

Smith is willing to go to considerable lengths to persuade others about all that wrongdoing, and he urges his readers to go and do likewise (219-239). His accusations against "bioethicists" run a gamut that is not surprising once his introduction is read. The "high priests" are accused ofmuch evil, from explicit rejection ofanything Hippocratic, to the curious notion that to be in "bioethics" is perforce to entertain merely "conditional" love for fellow human beings. Indeed, some ofthese "subversives"— Singer especially, Smith contends—love some animals a good deal more than the "least of us."

I must confess to being not a little puzzled by all these sweeping allegations. I confess as well to being considerably miffed at both Smith's loose hand with abstractions such as...