Unbeknownst to most Americans, a small but influential group of philosophers and health care policy makers are working energetically to transform our nation's medical practice and health care laws. They are turning away from the "do no harm" model established by Hippocrates more than two thousand years ago, and toward a stark utilitarian system that would legitimize medical discrimination against—and even in some cases, the killing of—the weakest and most defenseless people among us. The first time most people become aware of this development is when they or a loved one experience a health care crisis. It is then, when they are at their most vulnerable, that suddenly they come face to face with the monster they did not know was lurking in the shadows.
Why are the long-standing ethics of our health care system suddenly so threatened? Part of the reason, no doubt, lies in the culture of the times, in which objective truths are passé and the very concept of right and wrong is under assault. But the problem involves more than societal drift or some slow-motion cultural evolution. The challenges to medical ethics explored in this book are purposefully promoted by a cadre of "experts": moral philosophers, academics, lawyers, physicians, and other members of an emerging medical intelligentsia, known generically as "bioethicists."