Culture of Death: The Assault on Medical Ethics in America by Wesley J. Smith Encounter Books, 2001 285 pages, $23.95

“Traditional morality and medical ethics are crumbling before our very eyes,” writes Wesley J. Smith in Culture of Death: The Assault on Medical Ethics in America.

“Twenty years ago,” he notes, “it would have been unthinkable to dehydrate people to death by removing their feeding tubes because they were cognitively disabled. … Today, due in large part to vigorous advocacy by bioethicists, which in turn has led to court cases and then to new laws permitting the practice, it is routine in nursing homes and hospitals throughout the country.”

Likewise, legalized assisted suicide was “virtually unthinkable” 15 years ago. Now it's a reality in Oregon. Taking organs from a patient in a coma? Very soon it too will be a reality, if the bioethicists who currently advocate it in medical journals have their way.

Traditional medicine, based on the Hippocratic Oath, has been transformed by bioethics over the last few decades. Bioethics “focuses on the relationship between medicine, health, and society,” writes Smith. “This last element allows bioethics to espouse values ‘higher’ than the well-being of the individual.”

Smith paints a frightening picture — one in which doctors no longer pledge to “do no harm” but instead presume to determine the quality of an individual's life and judge whether it is worth preserving or ending. In fact, as Smith notes, most doctors no longer take the Hippocratic Oath upon becoming physicians, as many “no longer see it relevant to their profession.”

Without a license or even a “formal university discipline” — most bioethicists are trained in elite philosophy departments — bioethics has infiltrated our nation's hospitals. And it is a small “insider” clique of “name” bioethicists who give congressional testimonies, write books and “materially influence the opinions and practices of the thousands of men and women who labor in the trenches of clinical medicine at hospitals, nursing homes and HMOs. They testify as ‘expert witnesses’ in court cases or write ‘friend of the court’ briefs in important litigation involving health care. And they exert a steady and growing influence over the public health laws, the application of medical ethics, and the protocols of hospital care.”

With their “new morality of medicine,” bioethicists “define the meaning of health, determine when life loses its value, and forge the public policies that will promote a new medical and moral order.” Most bioethicists are atheists or agnostics, who view religion as “mumbo-jumbo.” This “near-absolute rejection of religious values as a moral framework for debating and creating secular public policies” has overtaken even some of the religious in its midst. Smith writes, “even those who maintain strong spiritual beliefs — including some Catholic priests — are so anxiety-ridden about imposing their religion upon secular society that they leave their personal, faith-inspired values at the door.”

Smith does an adequate job of chronicling the damage bioethics has done in medicine, advancing the culture of death. He steers clear, however, of abortion, not wanting to have his book branded as “pro-life.” It's an attempt to reach a wider audience, although it may seem to many readers a bit unnatural since abortion is so much a part of the culture. Still, there is so much else that is wrong, that even without abortion, there is more than enough to cover. Perhaps readers who are drawn in by Smith's book will come to the right conclusions themselves. (He does not fail, it should be noted, to call partial-birth abortion infanticide.)

Smith concludes Culture of Death on a somewhat optimistic note, despite the “ethical abyss” we are rapidly heading toward, stating that he believes we haven't yet reached “the point of no return.” Smith suggests a strategy of containment, which would consist of shining a light on the current culture of new medicine and being prominent in the debates over stem-cell research, cloning, assisted suicide and all the other life issues.

Smith, a lawyer and a Naderite — no typical pro-lifer, he — has written a book that can serve as an important, coalition-building step toward a “revitalized Hippocratic tradition.”

Kathryn Jean Lopez is an executive editor of National Review Online (