dures that will not benefit them. Whenn”futile care” first appeared, many of us whonare interested in medical ethics tliought itnmerely a convenient way to state an oldntruth: Useless care is not required andnshould not be given. But in the interval betweennthen and now, as Smith shows, fiitilencare has taken on a dramatic new significance.nThe term has superseded thenolder word “mercy” as the slogan that increasinglynjustifies what we might call anutilitarian and cost-effective coup de gracenwhere hard cases are concerned.nIn other words, futile care gives healthcarenpersonnel power, first, to designatenfurther treatment of a hard case as “futile,”nthen to terminate it, thereby savingnthe Rmds that could have been expendednon the patient (and perhaps pocketingnsome of the. cash in the process). Smithnargues persuasively that futile-care theorynmay be the tool that will finish off the Hippocraticnethic. Indeed, when medicinenreplaces the “Primum non nocere” of Hippocratesnwith Emperor Vespasian’s “Pecuniannon olet” (“Money doesn’t stink”),nthen it will have replaced what Dr. Liechtenthalerncalled “ethical fixed stars” withnthe all-important bottom line.nTo the concept of futile care is addednthat of “life not worth living.” Germanneuthanasia pioneers Karl Binding and AlfrednHoche introduced the term lehensunwertesnLehen in their groundbreaking littlenbook on euthanasia in 1920. For decades,nit was regarded with revulsion in Americanncircles as a rationalizafion for what thenNazi doctors did, first to ill and infirm Germans,nthen to Jews en masse in the gasnchambers. In the 1930’s, euthanasia wasnpaired with eugenics as poor racial specimensnwere prevented from reproducing—orneven from living. In the contextnof Nazism and World War II, both termsnwere considered abhorrent. Now, euthanasianis already socially acceptable, andneugenics is certainly likely to follow.nSmith devotes some attention to thengrowing power of the animal-rightsnmovement, led by the newly installednPrinceton University ethics professor PeternSinger and Ingrid Newkirk of PETAn(People for the Ethical Treatment of Animals).nThis movement, broadly speaking,nwants to grant animals rights resemblingnthose that belong to humans. Thenact of preferring humans to other senfientnbeings is branded “speciesism” (a newnword coined to facilitate the acceptancenof animal rights). If the principle of animalnrights is adopted, then the longstandingnpolicy of performing experi­nments on laboratory animals before tryingnthem on humans will be reversed.n(To some extent, it already has been.) Ofncourse, it is self-evident that, if animalsnare the same as humans, then humansnare the same as animals and should bentreated as animals (cared for and nurturednas long as they are useful, and quietlyndone away with when they are nonlonger productive). As an added advantage,nthe animal-rights movement maynretard advances in medicine, thus makingn”futile care” ever more relevant.nThe rejecfion of one key belief ties euthanasia,nfutile care for human beings, animalnrights, survival of the fittest, and, ultimately,neugenics together: the biblicalndoctrine that man, male and female, isncreated in the image of God. AlthoughnHippocrates was neither a Jew nor anChristian, this conviction grounded hisnethic. And it is the rejection of the samenconviction that ultimately will mean that,nas Smith’s book implies, “An)’thing goes.”nHarold O.j. Brown is religion editor fornChronicles, a professor of theology andnphilosophy at Reformed Theological Seminarynin Charlotte, North Carolina, andneditor of the Religion & Society Report.nTes, Ma’am. AndnWill There BenAnything Else,nMa’am?”nhy Paul GottfriednGuess Wlio’s Coming to Dinner Now?nMulticultural Conservativesnin Americanby Angela D. DillardnNew York: New York Universit)’ Press;n'”^pp., $26.95nAccording to Angela D. Dillard,n”women and minorit)’ conser’ativesnhave begun to alter irrevocably tiie tonenand complexion of contemporary conservatism.”nDespite the leftist affinity ofnmost gays, blacks, Hispanics, and selfdescribednfeminists, “pariah minorities”—whomnDillard views as belongingnto larger “outcast” groups—have come tonnnidentif)’ with the American right. Consistingnof independent (though misguided)nspirits who have braved opposition (asnin the case of Clarence Thomas) fromnboth the media and minority organizations,nmulticultural conservatives are redefiningnwhat had been a white. Christian,nand predominantly male enclave.nDillard’s categories are so expansiventhat, in the end, they explain very little.nEven among blacks, it is hard to findnmuch common ground between longtimenJohn Bircher George Schuyler andnmoderate Republican J.C. Watts. Hernmethods are no more precise than herncategories. Neoconservatives like BrucenBauer, who became a gay advocate afterncoming out of the closet, are lumped togethernwith staunch conservatives likenElizabeth Wright, Jay Parker, and WalternWilliams —who happen to be black —nand the homosexual neoliberal AndrewnSullivan is praised for his “Burkean conservatism”nin prescribing homosexualnmarriage as a stabilizing structure for demoralizedngays. Any conservative whonmight raise his eyebrows at the homosexualnlobby is given the usual treatment (accusednof “gay-bashing” and religious fanaticism),nwhile Peter Brimelow, despitenthe measured, courteous language ofnAlien Nation, expresses “venom” in maliciouslynreconsidering pro-immigrationnrhetoric and legislation. (Brimelow,nsupposedly, is throwing red meat “tonsegments of the Right that remain inordinatelynfixated on race.”) Inherentnin American conservatism, Dillard explains,nis a “desire to silence irreduciblencollectivities in the name of a constrictivenand artificially singular American identity.”nAny attempt by blacks and othern”pariah” groups to assume this identitynrenders them inauthentic and turnsnthem into gate-crashing “parvenus.” Dillardnshares Toni Morrison’s opinion thatnthe pursuit by American blacks of thenAmerican “egalitarian dream” damagesnthe “irreducible collectivity” of blacknidentity. Of course, if that identity weren”irreducible,” it would make no differencenwhat American dream blacks pursuednfor their collective advantage: Anconsciousness that cannot be taken apartnremains always intact. Wliat Dillard andnMorrison really want is to create and nurturenblack solidarit}’ in the face of a declarednwhite majoritarian enemy —annenemy they totally dehumanize, accordingnwith a strateg)’ Carl Schmitt associatednwith modern ideological conflict. It isnone thing to view your group as antago-nlUNE 2001/31n