Daniel Callahan: R.I.P.

By Dave Andrusko

You might understandably ask why post a second time about the passing of a man who died two years ago?  The answer is simple. It would be close to impossible to exaggerate the influence of Daniel Callahan in directing “bioethics” in a direction that people like you and me abhor. We had coffee once years ago, and he was a pleasant man. His ideas, however, were not.

It isn’t often that someone genuinely merits the title of “giant” in his or her field. Too often we affix that label to women and men who make significant contributions but not path-setting ones. If anyone earned that description, however, it would be philosopher and bioethicist extraordinaire Daniel Callahan, who passed away in July  2019.

Callahan co-founded the gigantically influential Hastings Center whose Hastings Center Report has hatched an untold numbers of awful and dangerous ideas. We’ll get to those momentarily.

Those of us who have been around since the 1970s and 1980s recall “Abortion: Understanding Differences,” a collection of first-rate essays from both sides that Callahan and his equally brilliant wife, Sidney Callahan, edited. As I re-read their description of their 1984 book, I couldn’t help but smile:

SIDNEY CALLAHAN AND DANIEL CALLAHAN: This book, like many other things to do with abortion, is a product of long controversy. Though carried out with cooperation, it was conceived in conflict. The conflict between the coeditors has persisted for years–in fact, for at least half of their thirty-year marriage. One, Sidney, is prolife; the other, Daniel, is prochoice. Ever since the topic of abortion became of professional interest to us, in the 1960s, we have disagreed. At one time, while Daniel was writing a book on the subject, “Abortion: Law, Choice and Morality” (1970), we talked about the subject every day for the four years of the book’s gestation. On many occasions during the 1970s, prolife articles written by Sidney were passed out at Daniel’s lectures in order to refute his pro choice views.

What about those awful ideas? One in which I was personally engaged came just after Callahan had left the Hastings Center but which perfectly captured the Hastings Center’s deeply utilitarian ethos that he helped breed into its DNA.

It was the notion that since babies with anencephaly were “going to die anyway,” why not harvest their organs? In 1998, the late Dr. John Willke, then NRLC President, and I wrote a counter which, to the credit of the Hastings Center Report, they had solicited from us. 

But we were figuratively and literally voices crying in the wilderness.

This was one of the earliest examples of an idea that is incalculably dangerous. And that is, if ones “quality of life” doesn’t measure up to what the elites of the Bioethical Establishment consider minimal, they won’t “waste” resources on you. But they will reassure you that your life can have “meaning,” provided they can cull your organs before you are pronounced dead (the fresher, the better).

Callahan on rationing of medical resources

Besides being “pro-choice,” Daniel Callahan preached (and that is the correct word) the secular gospel of rationing. Emily Langer writes obituaries for the Washington Post and no matter what they are paying her, it’s not enough. She is that good.

In the obituary that is dated July 23, 2019,  Langer wrote

At the center of Dr. Callahan’s worldview was what he considered society’s moral imperative to provide the greatest care for the greatest number of people.

Society spends “too much on health in comparison with other social needs, too much on the old in comparison with the young,” he observed, “too much on the acutely ill in comparison with the chronically ill, too much on curing in comparison with caring.”

He argued — often provocatively — against the provision of unlimited medical care to patients unlikely to live long or good lives, among them extremely premature babies and the very elderly. The financial cost was too high, he argued, and came at the expense of pressing needs such as education.

“Provocatively” is putting the nicest possible construction on what the agnostic Callahan favored and promoted, in season and out. If you were “too old” or a “too premature” baby, heaven help you because Callahan sure wouldn’t.

In reviewing a second edition of a book by pro-life bioethicist Wesley J. Smith, I wrote (under the headline “Culture of Death: a mother lode of insight and wisdom”) the following that began with a quote from Callahan that appeared in the November/ December 1993 Hastings Center Report Special Supplement: 

“There is one view of bioethics which says that it should somehow work to bring social harmony and peace. To that my response is, Who says so? It seems to me that bioethics, to be serious, has to ask hard, even nasty questions. If that leads to peace, fine. If it doesn’t, that is also fine.”

To which I responded…

In that essay, Callahan wrote about “Why America Accepted Bioethics.” For our purposes, what is most revealing is how Callahan believed that bioethics took a “middle course” between Joseph Fletcher (whose world view Smith aptly describes as “paradoxically anarchic and totalitarian”) and religion.

In a keen moment of semi-candor, Callahan tells us, “The first thing that…bioethics had to do– though I don’t believe anyone set this as a conscious agenda– was to push religion aside.”

And while there are surely bioethicists who are believers, when it comes to public policy, to invoke “God-talk” is bad manners, akin to chewing your nails at the dinner table.

Like so many bioethicists, Callahan coined some jaw-dropping phrases which led to the most brutal conclusions. For example, the “biologically tenacious”– those people the bioethical priesthood had decided ought to die but wouldn’t. 

What to do?

In a 1983 essay in the Hastings Center Report, Callahan opined as how “a denial of nutrition, may, in the long run, become the only effective way to make certain that a large number of biologically tenacious patients actually die.” He added, “Given the increasingly large pool of superannuated, chronically ill, physically marginal elderly, it could well become the nontreatment of choice.”

Just so we’re clear. Not content with starving (and dehydrating) PVS patients to death, or even the so-called “pleasantly senile,” Callahan had now set his sights on a much, much larger pool of candidates for death. The logic has since been extended to include those who are mentally ill and those who are judged (using very flexible criteria) incompetent.

There are many other examples, but the point is made. I can think of no better way to end these reflections than to again quote Fr. Richard John Neuhaus’ prophetic observation:

Thousands of medical ethicists and bioethicists, as they are called, professionally guide the unthinkable on its passage through the debatable on its way to becoming the justifiable until it is finally established as the unexceptionable.