Unbeknownst to most Canadians and Americans, many physicians now routinely terminate life-saving treatment without the consent of the patient or the patient's family. It's an insidious development that Wesley J. Smith, a lawyer and associate of Ralph Nader, has exposed in Culture of Death: The Assault on Medical Ethics in America.
Smith cites several examples, including the sorry death of a Montreal man, Herman Krausz. In 1998, Krausz was in Montreal's Jewish General Hospital, dying from a respiratory infection that was complicated by a burst vein in his lung.
In an interview, Krausz's son, George, told Smith: "Dad wanted to stay alive long enough to see his estranged brother." So what happened?
Smith relates: "Doctors at the Jewish General Hospital did not allow Herman, age 76, that last wish. Over 15 hours, they slowly turned off his respirator against the family's expressed wishes and, George contends, against his father's stated desires."
Herman Krausz was conscious, alert, and mentally competent, but needed the respirator to live. At a coroner's inquest into his death, his doctors claimed they were "unconvinced" that he wanted treatment to continue.
Smith comments: "Still, instead of definitely determining their patient's desires, they simply turned down the respirator. It took less than a day for Herman to die."
In a story last May on the outcome of the inquest, Canadian Bioethics Report, a publication of the Canadian Medical Association, stated that the coroner's report, "did not make a determination as to whether a dying patient's consent is necessary before doctors can remove life support when the medical opinion is that the prolonging of life would be medically futile."
Isn't that shocking? In essence, Canadian physicians have arrogated to themselves the right to kill a patient with life that they consider no longer worthy of life. These physicians are following in the footsteps of Karl Binding and Alfred Hoche, authors of Permission to Destroy Life Unworthy of Life: Its Extent and Form, a book first published in German in 1920. Smith relates that Binding, a prominent lawyer, and Hoche, a well-reputed physician and humanitarian, professionalized and medicalized the idea that physicians have a duty to kill people with lives unworthy of life so scarce resources can be diverted to more important needs.
In The Nazi Doctors: Medical Killing and the Psychology of Genocide, Robert Jay Lifton describes Binding and Hoche's book as the "crucial work" that led to the horrors of Nazi medicine. For several decades following the Second World War, the idea of human life unworthy of life was anathema. Yet today, many physicians in Europe and North America have once again blithely embraced essentially the same perversion of medical ethics. Instead of upholding the sanctity of all human life, they have no compunction about deciding, without so much as consulting a patient or the patient's family, that it is appropriate deliberately to kill off the patient on grounds that prolonging his or her life would be futile.
Most physicians do not make these God-like decisions alone. They follow guidelines set down by a hospital bioethics committee. But for patients, that's no consolation. Smith reports that many members of these bioethics committees are ill-trained. Others have the most sophisticated academic credentials, but also denigrate human life.
Peter Singer, the Ira W. DeCamp Professor of Bioethics at Princeton University, is a case in point: He is an unabashed exponent of outright infanticide as well as assisted suicide, so-called mercy killing and abortion.
In Applied Ethics, a book of readings edited by Singer, a British bioethicist, John Harris, advances a modest proposal for eliminating the shortage of transplant organs. Harris writes: "Everyone (shall) be given a sort of lottery number. Whenever doctors have two or more dying patients who could be saved by transplants, and no suitable organs have come to hand through 'natural deaths,' they can ask a central computer to supply a suitable donor. The computer will then pick the number of a suitable donor at random and he will be killed so that the lives of two or more others may be saved."
Of course, no country is likely to adopt this barbaric scheme any time soon. Still, it's a measure of the degradation of our civilization that such an egregious plan could be seriously advanced in a philosophical primer. "To the radical utilitarian Harris," explains Smith, "saving two or more lives at the expense of one murder would bring greater overall happiness than the suffering caused by the killing of one man or woman. And since under utilitarianism, no individual possesses human rights per se, why not go ahead and perform the human sacrifice?"
Why, indeed? Utilitarianism is the hallmark of the "Brave New Bioethics" dissected by Smith in Culture of Death. The book is an eloquent and compelling jeremiad that eminently fulfils Smith's stated aim: "to alert my readers to the intentional undermining by bioethicists of the fundamental moral principles that have long governed our society, and to invite them into the crucial, ongoing debates about their health care -- debates that will, quite literally, determine the future of Western medicine."