A Review of the Book Culture of Death: The Assault of Medical Ethics in America

Culture of Death: The Assult on Medical Ethics in America (by Wesley J. Smith, San Francisco: Encounter Books, 2001)

Author Wesley Smith is no stranger to controversy, and his book Culture of Death: The Assault on Medical Ethics in America is no exception. Reviews of Culture of Death reflecting diverse opinions have appeared in print publications and on-line forums. It comes as no surprise to those familiar with Smith’s writing to learn that some people disagree with his assessment of bioethics, sometimes to the point of wondering who Smith thinks he is to criticize the field.

And, who Smith is is part of the story. As a card-carrying Naderite (that is, a colleague of Ralph Nader) who has authored several books on law and consumer advocacy (some co-authored with Nader), he has also written two books defending the sanctity of human life. Smith is a man who appears to be standing in two different worlds—a fact that may make him uniquely equipped to criticize life-threatening trends in bioethics. Armed with the clear and concise writing style of a journalist and the passionate drive of an activist, Smith tackles a myriad of ethical hot topics in Culture of Death.

Smith’s training in law and background in consumer advocacy well equip him to challenge the “brave new bioethics” of utilitarianism, the quality of life ethic, and futile care theory. Through historical references, personal interviews, and current events, Smith makes his case against what he sees as alarmingly dangerous trends in today’s medical ethics. Smith’s knack for seeing the larger picture—while documenting the details that paint it—provides readers with a credible overview of the increasing attacks on the value of human life, as well as with suggestions for how to respond.

In some ways, Culture of Death picks up where Smith’s previous book, Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder, leaves off. Forced Exit primarily examines the “death mentality” as reflected in euthanasia, assisted suicide, and withdrawal of treatment cases. Culture of Death builds on these themes while confronting other dangerous trends rooted in a disposable view of human life. For example, Smith dedicates a chapter to the twisted notion that the rights of “non-human animals” can supercede the rights of Homo sapiens.

Culture of Death opens with Smith’s critique of bioethics, which he describes as “the relationship between medicine, health, and society.” Smith sees this as a detrimental mix that enables bioethics to “create a new morality of medicine that will 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.”

Ultimately, Smith describes an emerging discipline that is more ideology than science, complete with its own pipe-smoking elitists who advocate sociological change over individual patient needs. To be sure, Smith does not write from a distinctly Christian perspective. He does, however, aptly represent the Sanctity of Human Life Ethic in secular terms—terms that resonate with those who are adverse to Christian notions. That fact alone makes Culture of Death a book well worth recommending to Christians and non-Christians alike.