Fair warning to the reader: Culture of Death: The Assault on Medical Ethics in America, by Wesley J. Smith, is hard for me to review. I work at Rush–Presbyterian–St. Luke's Medical Center, where in April 1989, Rudy Linares removed his son, Sammy, from a ventilator at gunpoint. I took the criticism hard and was critical of others who were in the outcry. In fact, some of the people Smith criticizes are people with whom I had differences. Yet, Smith's views are so harsh and alien to my understanding of the culture and practice of healthcare that I find them off-putting. Further, he and I participate in the same listserv, where I often disagree with his postings.