Ever since John Paul II popularised the concept of a “culture of death” in the 1995 encyclical Evangelium Vitae, it has become a well-used part of the rhetorical toolbox for Catholic critiques of contemporary society. In the encyclical, the Pope defines the culture of death in a sophisticated way, indicting not so much individuals as the way societies are organised and the kind of lifestyles and values that our way of life appears to make necessary. He draws on the words of God in Deuteronomy 30v19: “I have set before you life and death, blessing and cursing: therefore choose life, that both thou and thy seed may live.”
It is undoubtedly a useful notion. People who live in our socially chaotic and technologically complex societies do face what has been called a “Moloch problem”. The term comes from the Allen Ginsberg poem Howl, in which he uses the ancient demon Moloch as a symbol for an inhumane consumerist society whose miseries are multifaceted and multicausal (and hence hard to address). A Moloch problem is when we have an unhealthy and damaging state of affairs in which most people are not really aiming to do wrong, but are stuck in a system of very bad incentives from which they cannot extricate themselves.
However, there is a danger in careless or excessive use of the idea of the term “culture of death”. Regardless of what John Paul II might have intended with his careful sociological analysis, the phrase can be employed rather loosely by individual Catholics, to describe any medical decision-making that seems at all unsatisfactory to them, whether or not that decision-making actually goes against the teaching of the Church. This is particularly evident in medico-legal dilemmas involving unresponsive patients. The most recent of these is the Archie Battersbee case, at the centre of which was a young boy being kept alive through a ventilator after sustaining a severe brain injury. After numerous court hearings, his doctors successfully obtained a judicial declaration that they could withdraw life support, a decision opposed by Archie’s parents (the boy was declared dead on Saturday 6 August, shortly after life support was withdrawn). This follows the somewhat similar cases of Charlie Gard and Alfie Evans in 2017 and 2018 respectively. All three have divided opinion in Christian pro-life circles.
I don’t wish to relitigate any of these tragic situations. I do note, however, that many of those who opposed the withdrawal of treatment from Gard, Evans and Battersbee were going beyond Catholic teaching, which permits the withdrawal of treatments such as artificial ventilation when they are futile and burdensome, and yet claiming the imprimatur of the Church for their position, while painting those who disagreed as weaklings, fools and traitors to the faith. It seems likely that one cause of this belligerent over-confidence was their reliance on “culture of death” rhetoric, which can lead people astray by encouraging them to understand Catholic medical ethics as always and everywhere the business of keeping people alive at all costs irrespective of any other consideration.
I am not saying it is wrong to talk about a culture of death. What I am suggesting is that we must not be like the proverbial man with the hammer to whom everything looks like a nail. The Catholic moral tradition gives us a wide array of useful categorical distinctions and philosophical tools for discussing and resolving hard bioethical problems.
Bioethics can be extremely complicated, so precision and clarity are very important. For example, conflating intentional killing with the withdrawal of certain kinds of treatment – as many Christian commentators on the Gard, Evans and Battersbee cases have done – plays into the hands of pro-euthanasia advocates, who frequently use this conflation to caricature the Christian position as a crude vitalism, a demand for constant over-treatment.
In these difficult scenarios, sweeping condemnations of paediatric doctors and nurses, judges and even bishops as heartless agents, or dupes, of a culture of death bent on ending lives wherever possible do little to counter this caricature, but rather succeed in confirming it. That cannot help but erode the credibility of our witness.
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