Faith and Medical Ethics: Losing Our Dignity

Losing Our Dignity: How Secularized Medicine Is Undermining Fundamental Human Equality
by Charles C. Camosy

I'm considering a Faith and Modern Life class that would be a kind of intersection between government and policy and faith. My Catholic theologian husband said if I wanted to talk about medical ethics, this book should be on the list.

Dr. Camosy explains how the philosophy of secularized medicine developed, and how that philosophy is not neutral in making medical decisions.

...here's the bottom line: it is impossible to care for the health of a single human being (much less design and work within a health-care system with limited resources that must yet provide for millions) without incorporated such goods and values and purposes. (p. 39)

Then he presents studies around famous cases to show how that philosophy leads to poor decisions for vulnerable patients. There are chapters about Jahi McMath, Terri Schiavo, "Roe Baby," and Alfie Evans. There's also a chapter on patients with dementia.

New Jersey law requires insurance companies to continue medical care even if religious beliefs of the family conflict with medical professionals. The executive director of the group that wrote the law, Alan Weisbard, said:

[T]he people who have done the deep and conceptual thinking about brain death are people with high I.Q.s, who tremendously value their cognitive abilities--people who believe that the ability to think, to plan, and to act in the world are what make for meaningful lives. But there is a different tradition that looks much more to the body. (pp. 50-51)

He concludes with some ideas about what we can do to reverse the concerning trends as individuals, communities, and society in the short and long term. 

Dr. Camosy doesn't always present the one and only answer for difficult situations. He emphasizes that each situation requires careful consideration of the individual, the family, and the resources available but always with the needs and dignity of the most vulnerable patients given the priority.

Medical science and tests can be used to determine whether death has taken place, but deciding what death is in the first place can be determined only by asking theological questions. (p. 47)

I think this book is essential reading for anyone in medicine or anyone considering a career in a medical field, especially for Catholics. It's actually a great book for any Catholic. Highly recommended.

I have received nothing in exchange for this post. I purchased the book. Links to Amazon and Bookshop are affiliate links.

The Last Acceptable Prejudice: The Tyranny of Merit

The Tyranny of Merit: What's Become of the Common Good?

by Michael J. Sandel

In this book, Dr. Sandel argues that meritocracy (the idea that we can "go as far as our talents and hard work will take us") has failed. More importantly, he argues persuasively that such an ideal is flawed even if it could be implemented perfectly.

In fact, there is less economic mobility in the United States than in many other countries. Economic advantages and disadvantages carry over from one generation to the next more frequently than in Germany, Spain, Japan, Australia, Sweden, Canada, Finland, Norway, and Denmark. (pp. 75-76)

Later, he writes, "By these measures, the American dream is alive and well and living in Copenhagen."

If our talents are gifts for which we are indebted--whether to the genetic lottery or to God--then it is a mistake and a conceit to assume we deserve the benefits that flow from them. (p. 123) 

I find myself overwhelmed at the thought of addressing everything in this book. You can read an excellent summary and review of it in The Guardian (better than the one in the New York Times). Briefly, a meritocracy leads to two main devastating effects: 1) those who fail to earn a decent living are forced to believe it is their own fault (though it's usually not), and 2) those who succeed erroneously believe success is based entirely on their own efforts and therefore denigrate (subconsciously or consciously), those who are not as successful.

Moreover, the elites are unembarrassed by their prejudice. They may denounce racism and sexism but are unapologetic about their negative attitudes toward the less-educated. (pp. 95-96)

The book criticizes both sides of the political debates in the United States (also the UK and Europe), but its focus is on liberals, not because Sandel agrees with conservatives, but because he blames the liberal elite for the series of attitudes and policies that led to the development of a populist uprising that has (so far) elected Trump in 2016 (and fought for him after the election in 2020) and voted in favor of Brexit. 

Sandel describes a professional and wealthy class that responds to arguments with a subtle but substantial bias against anyone who is less academically educated. I have seen that bias myself, essentially throughout the mainstream media, but also directly from friends on social media, but I think it extends just as much to those who profess a religious belief, even if they hold graduate degrees. Although Sandel briefly mentions faith occasionally (and even approvingly cites Church documents and Papal speeches or letters), he rarely links religious beliefs with this prejudice.

If you read mainstream news articles about abortion, the pro-life position is always presented as if those who hold it are ill-educated. This is a dangerous discrimination. Eventually people stop believing anything they read from those sources. The reasons are two-fold: 1) If they're so wrong about abortion, why should I believe them about anything?, but more pertinent to the book,  2)Why should I listen to anyone who obviously thinks I'm an idiot? I think this leads directly to the difficulty in open discussions of medical practices and the best ways to safeguard our own health and that of those around us. I see this repeatedly in discussions around vaccines and everything Covid related. It doesn't matter who is right if no one will believe a single word anyone else says.

In many ways, this book brings together many of the ideas and thoughts that have been coalescing in my mind for years, not all of which are shared in this blog: the struggles of the working class, the search for a consistent life ethic, frustration at the failure of the higher education system to live up to my ideal of education, the denigration of the dignity of work, and the fractures I feel keenly between many of my family and friends. The clash in 2020 of the pandemic and an intense presidential election forced these misgivings into my daily life--and not just on social media. It suddenly felt like no one could even agree on the most basic truths, and no source of information was universally trusted.

I think I'm going to assign this book to my children when they are seniors in high school, as part of a government credit.

I often felt unsettled while reading this book. Even though I had read and thought much about these topics, this book in particular made me question my own prejudices. I encourage everyone to read this book, and then tell me what you think about it! I found myself constantly asking myself, What would [friend/family] think about this? The chapter on Success Ethics is a bit dense, but the rest is remarkably readable.

I have received nothing in exchange for this post. Links to Bookshop are affiliate links. I checked this book out from our public library.