Charles Camosy Tracks Health Care Ethics’ Downward Spiral in New Book
BOOK PICK: The Fordham theologian and bioethicist calls for a countercultural Catholic ethos in ‘Losing Our Dignity: How Secularized Medicine Is Undermining Human Equality.’
Losing Our Dignity
How Secularized Medicine Is Undermining Human Equality
By Charles C. Camosy
New City Press, 2021
224 pages, $22.95
To order: amazon.com
“After the people of that place recognized him, they sent word throughout the region and brought all who were sick to him, and begged him that they might touch even the fringe of his cloak; and all who touched it were healed” (Matthew 14:34-36).
Jesus Christ healed bodies and souls. The Gospels reveal that he not only restored the health of the sick and sight to the blind, he made it possible for his disciples to encounter the disabled infant and the frail elderly, the unborn and the widow as God created them, made in his image and possessed of the same inviolable dignity as every other person on the planet.
From the early Church, Jesus’ ministry inspired Christians to resist widely accepted pagan practices of infanticide, euthanasia and abortion. That profoundly countercultural ethos led Catholic communities to devote themselves to the sick and the vulnerable and religious orders to open clinics and hospitals, laying the practical and ethical foundations for the modern health-care system.
And yet, even as that system continues to achieve once-unimaginable breakthroughs in cures for lethal diseases and chronic conditions, a utilitarian mindset has crept in, weakening and slowly dislodging the Christian duty to care for each person, irrespective of their physical or cognitive status.
Patients who do not have the ability to exercise their autonomy, to make rational choices, can be depersonalized and their care restricted. A mother seeking a routine medical procedure for a daughter with a degenerative neurological condition may be told that already-strained medical resources discourage treatment for such children.
Charles Camosy, a theologian and bioethicist at Fordham University who is active in the pro-life movement, has been carefully tracking the health-care system’s shifting ethical framework. And in his fascinating and timely new book, Losing Our Dignity: How Secularized Medicine Is Undermining Human Equality, Camosy warns that a poison “hostile to the theological ideas undergirding fundamental human equality” has spread into “our most powerful cultural and medical institutions.”
Sounding the alarm, the author asks whether society still has the heart and the will to care for “inconvenient” lives.
Camosy explores this urgent question in a series of chapters that address specific issues in bioethics: abortion, patients living in a so-called “vegetative state,” children with neurodegenerative disease, and adults with late-stage dementia. In straightforward, jargon-free language that is fully accessible to laypeople, the author examines these issues through the harrowing personal stories of adults and children who have become household names in the battle between the culture of life and the culture of death.
Brain Injury and Disorders of Consciousness
One of the most interesting chapters, “Terri Schiavo and the Vegetative State,” traces the seven-year legal and political fight over whether Schiavo’s husband, Michael, had the right to order the removal of the feeding tube from his brain-damaged wife, in defiance of the wishes of her devoutly Catholic parents.
The broad outlines of the case and the public debate it spawned are already familiar to many Catholics, but Camosy offers fresh information that sheds new light on the case’s broader significance.
Michael Schiavo and many of his supporters in the bioethics community contended that a severely brain-damaged patient like Terri was no longer a person, just a body, and thus there was no duty to maintain even ordinary care.
“Even minimal awareness would support some criterion of personhood, but I don’t think complete absence of awareness does,” Bill Allen, a bioethicist, tells patient advocate Wesley Smith, who fights the culture of death, on Court TV.
Media outlets that sided with Michael Schiavo, and dismissed or even derided the faith-based beliefs of Terri’s parents and their supporters, also raised concerns about the financial burden that Terri and patients like her place on familial and governmental resources. An additional argument supporting the removal of the feeding tube touched on the desperate plight of patients waiting for lifesaving organ transplants.
Looking back on that watershed case that ended with Terri Schiavo’s death by dehydration and starvation, Camosy notes that the controversy introduced the public to the medical community’s view of persistent vegetative state (PVS) as an irreversible condition. And, yet, subsequent research would upend this dark prognosis.
Losing Our Dignity shares the expert testimony of Dr. Joseph Fins, a leading authority on the ethical and policy issues posed by brain injury and disorders of consciousness, who would later confirm that some patients diagnosed with PVS can and do recover.
In 2018, the American Academy of Neurology, the American College of Rehabilitation Medicine, and the National Institute on Disability, among other professional organizations, jointly issued updated research findings and treatment guidance for patients with consciousness disorders, advising expanded rehabilitation and medical treatments.
The new guidelines offered an indirect acknowledgement that many such patients had received substandard care and were essentially abandoned as they resided in long-term nursing facilities.
Fins noted that the new findings have yet to broadly impact treatment protocols, a sign of inertia or resistance that could reflect the biases of health-care providers. And he also references the political and legal fallout from the medical community’s initial failure to provide a more evidence-based prognosis for patients with PVS.
The flawed belief that PVS was fixed became “the moral predicate upon which the legal right to die was established and sustained,” explained Fins.
Camosy hopes for a more radical shift in how health-care providers understand and treat such patients.
“[R]ecognizing that someone in a vegetative state had an injury in the first place demonstrates that we understand her nature to be quite different from that of a vegetable,” he writes. “[W]e should acknowledge that moral status — and fundamental human equality — is based on the nature of an individual, based on the kind of thing they are … a human animal.”
Turning to the even more fraught subject of abortion, the author examines how a similar confluence of inaccurate medical information and murky political and legal goals resulted in a sweeping attack on the personhood of the unborn child.
Though Roe v. Wade has long been characterized by those in the “pro-choice” camp as an endorsement of a woman’s right to personal autonomy to choose what happens to her body, Camosy shows how the landmark majority opinion, penned by Justice Harry Blackmun, actually focused on very different concerns: “protection of physicians from prosecution, respecting the moral authority of physicians, controlling the births of human beings generally, controlling the births of disabled people in particular, and the economic and social status of women in relation to men.”
Camosy begins with the story of Norma McCorvey, the troubled young woman who tried and failed to obtain an illegal abortion in Texas. Desperate to end her pregnancy, McCorvey lied, saying that she had been raped, and she was then introduced to two female lawyers who had been looking for a sympathetic case to overturn Texas’ restrictive abortion law.
The feminist movement had made legal abortion a critical goal in its effort to level the playing field for women entering the workplace.
But other parties with competing interests joined McCorvey’s case, including James Hubert Hallford, a “licensed physician” who had been arrested for violating Texas abortion laws.
In his majority opinion in Roe, Justice Blackmun, who had once served as the general counsel for the Mayo Clinic, cited the medical community’s evolving consensus on abortion and placed the right to privacy, the new foundation for a legal right to abortion, within the confines of the patient-physician relationship.
“The abortion decision and its effectuation,” wrote Blackmun, “must be left to the medical judgment of the pregnant woman’s attending physician.”
In the companion case, Doe v. Bolton, Blackmun went further, insisting that an abortion could be legally terminated in the third trimester if the physician believed it might threaten the patient’s physical or emotional health.
This sea change in abortion law, as Camosy shows, actually began in the post-war era, amid fears of rapid population growth overwhelming the globe’s limited resources.
In the 1950s, Dr. Alan Guttmacher, the president of Planned Parenthood and the American Eugenics Society, pressed hard for a right to abortion.
And by 1970, the American Medical Association had officially altered its position on abortion, calling for abortion decisions to be between “a woman and her doctor,” a move that reportedly influenced Blackmun’s own decision in the case, though the AMA did not file an amicus brief in Roe.
By 1973, access to abortion was not only viewed as an antidote to overpopulation, it was seen as a backstop for contraception and preventing unplanned births that would result in increased welfare rolls, drug addiction and incarceration rates.
Such arguments underscore Camosy’s point that legal abortion was never just about securing women’s equality.
Any attempt to challenge the unlimited abortion license, whether it has come from the vivid images of developing human life on sonograms or the testimony of abortion survivors, immediately provokes a counterattack from special interests that seek to maintain the status quo.
Even today, as the abortion debate focuses on Texas’ new law effectively restricting the procedure to the first six weeks of pregnancy, abortion-rights activists have warned that the narrow timeframe will make it impossible for women to take advantage of tests typically performed later in pregnancy to identify possible birth defects, including Down syndrome.
Change Is Still Possible
Yet the author has not lost hope that change is still possible, and he shares the stories of loving caregivers who testify to the inviolable dignity of a child or spouse or neighbor.
Some are people of faith whose luminous example leads others to take up the same path. Others, like John Lydon, the former Sex Pistols’ rock star, better known by his stage name Johnny Rotten, speak in simple, personal terms about their love for a beloved spouse who has Alzheimer’s.
“That person I love is still there every minute of every day,” Lydon, the full-time caregiver of his wife of 42 years, told a reporter. “It’s unfortunate that she forgets things. Well, don’t we all?”
Still, Camosy is worried that two parallel developments — a rapidly aging population and increased government control over health-care decisions and spending — could result in more draconian restrictions on care down the road.
He asks his readers to become more intentional and proactive, using every opportunity to defy the utilitarian ethos that depersonalizes patients like Lydon’s wife.
Readers should begin, he suggests, by considering the future needs of older family members and make provisions now, such as living closer together and thinking through career plans.
Other options include volunteering at nursing homes and linking up with religious orders and movements, like Focolare, that have a special mission for ministering to the sick.
There are readers who will be well-placed to advocate for expanded government resources to help families care for loved ones and improve the quality of care in nursing homes.
More broadly, the author calls for faith-based advocacy, as well as interfaith dialogue, which can identify areas of unity and common purpose that affirm and protect the dignity of all life. And he urges professionals and academics to challenge and shape the practices of the medical establishment and promote interdisciplinary work that broadens medical students’ exposure to countercultural values. Thus, he calls on Catholics and others of goodwill to “live our lives as signs of contradiction.”
Finally and most importantly, we are reminded of the power of evangelization, which can draw family members and physicians, nursing-home caregivers and hospital administrators close to the heart of the Savior. In this way, they can see Terri Schiavo and Baby Doe as he sees them.
This is how we will effect a paradigm shift that truly embraces the “fundamental equality” of every person “simply because they share in the dignity stemming from a common nature that bears the image and likeness of God.”
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