Within the heart of the giver compassion and charity are very good things indeed. Putting others before self is a “God like” quality that we all admire and strive for. We would all agree a society made up of such people is far better than one without. From that perspective the United States is a very strong nation. As a nation we spend a great deal on welfare to protect those less fortunate (see the Safety Net Programs Page). As individuals we give generously to charities and that giving has expanded faster than the U.S. economy over the past 50 years. We have one of the most giving cultures ever on the face of the earth.
But things get a lot more complicated when we look at the mind of the receiver. That is where the Hippocratic Oath is measured – on the patient, not the doctor. Is it possible to do more harm than good to the receiver of our charity and compassion?
“Probably not. … we met other homeless men and women whose only income was from money dropped into a hat or cup. Unfortunately, it’s also true that a significant portion of the men and women we knew on the streets would – within a half hour of receiving a donation – spend it entirely on drugs or alcohol. A nugget of marijuana or crack is only five dollars, and a forty-ounce beer is only two-fifty. So your money is probably providing someone with their fix before you even get home or back to the office. That is why I recommend you give them something other than cash”.
A dollar in a beggar’s cup may violate the Hippocratic Oath, but what about giving to others in poverty? Can we do more harm than good with our charity and welfare programs aimed at those in poverty? I wish the answer to that question was a resounding no. But after working with many charities and studying welfare I’ve come to the conclusion that the answer is too often yes. Too often we enable bad acts and bad decisions. Not always, but enough so that we have to look at what we are doing with great care and thought.
When we introduce the Hippocratic Oath to our giving, it changes things rather dramatically. It creates a standard for effective giving. It turns things upside down. Giving money unconditionally is no longer a selfless act but rather a selfish one; done merely to make the giver feel better, not to advance the condition of the receiver. Compassion is no longer enough, effective compassion is required. That is the difference between love and tough love and tough love is so much harder.
 The American - The Online Magazine of the American Enterprise Institute. A Nation of Givers by Arthur C. Brooks. From the March/April 2008 issue. Retrieved October 26, 2014. Available here.
 Mike Yabkoski, Under the Overpass (Multnomah Books, 2010). Page 165.