Are there some newborn infants whose short- and long-term care costs are so great that treatment should not be provided and they should be allowed to die? Public discourse and academic debate about the ethics of newborn intensive care has often shied away from this question. There has been enough ink spilt over whether or when for the infant's sake it might be better not to provide life-saving treatment. The further question of not saving infants because of inadequate resources has (...) seemed too difficult, too controversial, or perhaps too outrageous to even consider. However, Roman Catholic ethicist Charles Camosy has recently challenged this, arguing that costs should be a primary consideration in decision-making in neonatal intensive care. In the first part of this paper I will outline and critique Camosy's central argument, which he calls the ‘social quality of life (sQOL)’ model. Although there are some conceptual problems with the way the argument is presented, even those who do not share Camosy's Catholic background have good reason to accept his key point that resources should be considered in intensive care treatment decisions for all patients. In the second part of the paper, I explore the ways in which we might identify which infants are too expensive to treat. I argue that both traditional personal ‘quality of life’ and Camosy's ‘sQOL’ should factor into these decisions, and I outline two practical proposals. (shrink)

Secular bioethics fails to grasp the central moral and spiritual realities of medicine. As the authors in this issue of Christian Bioethics argue, contemporary healthcare practice is often based on the false premise that medical science can secure the safety of human life. Yet, the standard “biopsychosocial model” of medicine fails to grasp the theological dimensions of healthcare often harming patients and their families in the process. Indeed, as the articles explore, all too often secular bioethics manipulates medicine to achieve (...) immoral purposes, such as active euthanasia of the sick or elderly. Such spiritual decay is acutely manifested in the pressure put on patients to accept an economically efficient and medically expedient assisted death as well as in how society often treats the human body as mere res—a thing unimportant in itself apart from animation as a living person. Together the articles illustrate that without careful religiously grounded advice modern medicine is often spiritually disorienting for both patients and practitioners. (shrink)