The Complexity of Morality in the Neonatal Unit

by Michael Sean Winters

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Normally, it would not occur to me to read, let alone recommend, a book of moral theology. Better to put pins in your eyes than read through another dry analysis of the moral law. Besides, morals have always bored me. It has never seemed that difficult to figure what is bad and what is not, and my Wildean inability to resist temptation keeps me frequently enough at the confessional that I am always reminded that the remedy for evil-doing is, in the end, the mercy of God.

Charles Camosy’s new book of moral theology, Too Expensive to Treat? Finitude, Tragedy, and the Neonatal ICU, however, is not just any book. As Congress continues to debate the health care bill, when the Phoenix hospital case places some of the tricky issues involved in health care before us in all their excruciating difficulty, when conscience protections are worked out, and when both for the Church and for the country, a discussion about the distribution of limited health care resources is just beginning, Camosy’s book comes just when it is needed. And, courageously, Camosy, who teaches at Fordham and who has appeared in these pages with other young theologians from the Fordham Conversation project, heads straight for the most treacherous waters, where advances in medical technology have turned theoretical arguments about the moral status of the unborn child into a very practical issue.

Second, Camosy’s book is, quite unlike most such tomes, fun to read. He jumps back into history to explain how and why other cultures adopted such practices as infanticide and exposing children to the elements. He spends a great deal of time at an actual neonatal ICU to witness firsthand the miracles wrought by modern technology. He stages ad hoc debates between some leading moral theorists. Sometimes, such diverse literary skills can keep an author from maintaining his argument, but here Camosy brings those skills in aid of his argument.

Actually, first Camosy employs those literary skills in detailing the arguments of others and he does so with great sympathy. The mark of a good teacher is surely that they can make other points of view from than their own appear as convincing as possible, and Camosy has you half-convinced of positions he is about to critique. Instead of looking only for the chink in the armor of those with whom he disagrees, Camosy also looks for the moral insights those alternate views contain. Not once does he present someone else’s theories in a tendentious way.

This book focuses on many issues, but centrally, it reminds us Catholics that there is no escaping two human realities that our American culture tends to neglect, the social character of the human person and the inevitability of tragedy in human life. “Human dignity cannot be seen outside its social context,” Camosy writes, and one of the central themes of his book is that while it makes us all queasy to raise questions about the cost of care, the allocation of finite resources demands such questions because issues of justice are involved. (Incidentally, although this book is in no way a political screed, Camosy also shows throughout the text how our current health care system involves rationing of resources at every turn.) As for tragedy, well, go try and find a sympathy card at your local drug store that even mentions death. Our culture is allergic to tragedy: Look at how some on both the left and the right evaluated the Phoenix hospital situation by skipping over the wrenching human tragedy in those circumstances and heading straight for the abstract principles. In real life, as Camosy shows, those principles are not only venerable, and not only useful, they are capable of getting dirt on their hands in the muck and mire of human circumstance and helping us all to reach humane conclusions.

Some absolutists will reject Camosy’s subtle arguments. And, to be clear, who wants to be told that it is too expensive to care for their 26 week old, premature child? Who wants to think of cost at such a time? But, cost there is and at a time when millions of Americans die for lack of care, pumping billions of dollars into neo-natal care is a decision proper to society, not just to the market. You may agree with Camosy and you may disagree, but you cannot ignore his arguments nor, just as importantly, avert your eyes from the complicated, difficult issues he examines and which the rest of us would prefer to forget.

So, I highly recommend this book, especially to bloggers and reporters whose jump it is, in part, to simplify information and who, therefore, need to be reminded by academics like Camosy that simplifications comes with a price. The price of Camosy's book, however, is not so large and you can find the book on Amazon by clicking here.

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