A faithful and inspiring Catholic man was battling cancer earlier this year. Looking for hospice care, he and his legal guardian considered one provider. It soon became clear, however, that the hospice would not provide him with life-sustaining basic nutrition. He went with another option of care. Tragically, it is not rare for health care entities to refuse patients life-sustaining nutrition. As a result, patients can end up dying not because of an illness but because of starvation. This kind of passive euthanasia is just the tip of the iceberg of the throwaway culture that pervades much of American health care. The United States urgently needs to revitalize its respect for the dignity of patients and protect their human and civil rights. This effort will require: educating the public on the dignity of the human person in all stages of life; the renewal of health care law and policy; and forming a coalition of civil support.
The casual acceptance of dehumanization in medical care is metastasizing like cancer. Unethical practices such as abortion, transgender procedures, passive euthanasia, assisted suicide, and the unjust discriminatory denial of care for patients with disabilities and patients in hospice or palliative care are a consequence, in part, of moral relativism, Marxism, bankrupt bioethical theories, disordered financial incentives, and a legal and economic framework that objectifies the person.
This dehumanizing attitude in health care demonstrates a grave animosity to the dignity and sanctity of the human person, especially the unborn, the materially poor, the chronically ill, immigrants and racial minorities, the aged, and patients with disabilities. As Dr. Leo Alexander warned over seventy years ago, the American health care system is growing increasingly hostile to patients deemed too expensive and too inconvenient. Some within our government and health care industry are convinced that certain lives are not worth living.
During my service at the U.S. Department of Health and Human Services and currently at the Christ Medicus Foundation, I have seen cases where medical professionals, ethicists, health administrators, or government officials determine that certain vulnerable patients are unworthy of care. Sometimes it’s because of their so-called “low quality of life.” For example, during the Covid-19 public health crisis, troubling reports arose of unjust and at times categorical discrimination against elderly and disabled patients. Thankfully, HHS took expansive enforcement action to stop this health care discrimination. However, a study published in Health Affairs last year affirms that some medical professionals are biased against patients with disabilities and that such bias can cause patients to be denied care. The throwaway culture is further evident from reports of continued racial and socio-economic bias and discrimination in medical treatment. A recent opinion survey suggested that 25 percent of immigrant adults in the U.S. experienced bias or discrimination in health care. According to the survey, this bias or discrimination was connected to a lack of health insurance, inability to pay, their accent or lack of proficiency in the English language, or because of their race, color, or ethnicity.
The foundational moral obligation to love and care for every patient, especially the most vulnerable, is eroding. What can be done to safeguard the life and human dignity of all people in health care?
First, our nation needs to culturally proclaim the beauty and sanctity of human life and the redemptive value of suffering. This reclamation and renewal of human dignity in medicine will require broadly educating the public about a patient’s dignity from conception to natural death, and about how each person’s right to life and dignity continues even in times of sickness and pain. A comprehensive reform of bioethical standards and protocols is also urgently needed. This bioethics reform must eradicate the utilitarianism often used to justify physician assisted suicide, “medical assistance in dying,” or passive euthanasia. Additionally, an overhaul of bioethical training for medical professionals as well as better formation on human dignity for law students is needed. Love, charity in truth, and “doing no harm” must be restored as the ethical foundation of caring for patients.
Second, our nation needs a renewal of health care law and policy centered on the life and dignity of the patient and on family rights. This renewal of health care law and policy should be anchored by first principles. These first principles include respect for each patient’s right to life and to ethical care, as well as respect for the patient-doctor relationship, the patient’s right to exercise control over his or her medical care, religious freedom and conscience rights for patients and medical professionals, and the preferential option for the poor. This restoration of human dignity will require a new federal health care civil rights statute to expand legal protections for vulnerable patients.
Third, our nation needs an even larger coalition of civil support to renew a culture of life in health care. The task of this coalition must be to restore the life and dignity of the human person as the central concern of medicine. The Catholic Health Care Leadership Alliance’s recently launched Institute for Policy and Advocacy is helping to lead the charge in this legal and policy counteroffensive.
The modern culture of death in America began with a racist and evil eugenics movement in the early twentieth century and grew with the legalization of abortion. The culture of death must be countered with a true culture of life. Ultimately, I believe that if we reclaim love, caritas, and human dignity as the foundations of medical care, we can redeem the American health care system. If we also justly reform the health care laws and policies governing American health care, we will resurrect a culture of life in America.
Louis Brown Jr. is executive director of the Christ Medicus Foundation, and associate director of the Center for Law and the Human Person at Catholic University of America Columbus School of Law.
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