A friend of mine is an amateur painter. She has a degree from one of the best colleges in the country (where she earned top grades), and she is able-bodied and healthy. After college, she decided to pursue painting, which is her passion. While she hopes to work professionally as an artist, she is currently working a part-time teaching job. She comes from an upper-middle-class household, and I know she has received some monetary support from her parents in the past. She does not live lavishly by any means, but she lives in a comfortable apartment with roommates and rents a separate art studio. I admire her for pursuing her art and have no problem with her receiving support from her parents as she works on her painting.
Recently, my friend told me that she uses the federally funded Supplemental Nutrition Assistance Program (SNAP) to purchase food for herself. I feel that this is dishonest and using the welfare system in a way that hurts those who need it most. When I expressed my concern, she told me that she is not taking a ‘‘spot’’ from someone else. Even though there is not a limit to the number of those who use SNAP via an Electronic Benefits Transfer card (the contemporary equivalent of food stamps), I feel that my friend is taking away from people who need it.
People from all backgrounds can struggle with finances and can (and should) benefit from the small amount of social support that the United States offers. But I feel that by not trying to work or applying to work full-time, and by accepting her parents’ money and using it to support her painting, my friend disqualifies herself from being a SNAP candidate. At the same time, I think artists are a necessary part of our country’s ecosystem, and I certainly do not think that using an E.B.T. card precludes a person from spending money on anything that isn’t a life-or-death necessity. But something about my friend’s situation rubs me the wrong way. Is what she’s doing ethical? — Name Withheld
From the Ethicist:
To begin with, there’s the question of whether she’s officially eligible for SNAP benefits. Though each state determines the eligibility of its residents, there are federal guidelines they must follow. Some pertain to income limits; to qualify for benefits for an extended period, there are also work requirements if you’re able-bodied and don’t have dependents (or other complicating circumstances). Approved volunteer activities can contribute toward the work requirement; the program isn’t designed to make you take the highest paying job you can get. So let’s assume she has accurately represented her situation, parental loans included, and does indeed meet the program’s criteria.
But then there’s the question of how to think about this. When you say you feel your friend is taking benefits from the needy, you don’t mean this literally. SNAP helps tens of millions of people, and there isn’t a cap on the number of recipients. Nobody is going without because of her enrollment. But you know this. Instead, I suspect your thought is that we shouldn’t rely on payments that come from other people’s work unless we have to.
You’re thinking of society, then, as a system in which each of us should use our talents to make whatever reasonable contribution we can. From this perspective, accepting public assistance when we could avoid doing so could look like taking advantage of our fellow citizens who are earning enough to support themselves — some of them by doing jobs they don’t much enjoy.
There’s a long history to this way of thinking about work. Some relates to talk of the ‘‘deserving poor,’’ but another influential formulation is found in the socialist tradition. The Soviet Constitution of 1936 declared, ‘‘In the U.S.S.R., the principle applied is that of socialism: ‘From each according to his ability, to each according to his work.’ ’’ (The allusion was to a slogan favored by certain French socialist thinkers of the first half of the 19th century, in a version not to be confused with the one that was introduced by other French socialists of the time and that ends ‘‘to each according to his needs.’’) Here, the thought was that, in a decent society, those who have the capacity to work should be rewarded commensurately with the value of what they produced. Socialists, of course, have tended to doubt that the true value of your work is adequately captured by your wage in a capitalist labor market.
I confess to finding this maxim unattractive, both on the ‘‘ability’’ side and on the ‘‘work’’ side. First, I don’t think society has a right to ask us to do a job just because we’re able to do it. Second, there’s no sensible system of valuing what a person contributes in such a way as to guarantee that it is matched by what they receive.
Still, there’s something to be said for the idea that we all should do our fair share to make our social arrangements work for everyone. My fair share may well depend on my abilities, but people should have broad latitude in deciding how to make their contribution. Part of your friend’s contribution is being made — as you imply in referring to our cultural ecosystem — by doing her work as an artist. She’s also making herself useful through her work as a teacher. If those activities aren’t earning her enough money to feed herself adequately, I don’t see why she shouldn’t take the help our society has decided to offer.
Readers Respond
The previous question was from a reader who was pondering the ethics of self-diagnosis. She wrote: “I’m in my 30s and have multiple motor and vocal tics that started in my early teens and have never gone away. As far as I can tell, I fit the diagnostic criteria for Tourette’s syndrome. … Can I say I have Tourette’s without being formally diagnosed? I’m wary of doing so, given that self-diagnosis is looked down upon for medical issues generally and specifically in the case of Tourette’s; there has been a recent rash of people on social media falsely claiming to have it. But I feel that telling people that I have Tourette’s, which is a label many people recognize, would allow me to talk about my tics more freely and in so doing help counter the mild shame I have around them. It might even educate others on the range of severity with which Tourette’s can present, i.e., that it’s not always so noticeable. But I’m very concerned about seeming to co-opt a group’s struggles, and I don’t know if I need a formal diagnosis to be welcomed into groups for people with Tourette’s, either. What is your view?”
In his response, the Ethicist noted: “Some diagnoses have depth. … But a Tourette’s diagnosis doesn’t have depth like that; it just says that someone has certain symptoms (like those you’ve mentioned) and that they started before the person was 18. Diagnosis isn’t a matter of scans or blood tests, save when other explanations must be ruled out; it’s a matter of the behavioral history you report. So why not bring it up with a health care practitioner? Despite your fears about time and expense, a diagnosis needn’t be a drawn-out process. Though you don’t mention any other complaints, many people with Tourette’s syndrome have co-occurring conditions, which clinicians might be able to help with. And on the off chance there’s some medical reason to think it isn’t Tourette’s syndrome, it’s best to know that, too.” (Reread the full question and answer here.)
⬥
I wholeheartedly agree with the Ethicist that the letter writer should discuss her symptoms with a health care professional to assess a diagnosis of Tourette’s syndrome. — Renee
⬥
When I was 55, I realized that I had autism spectrum disorder. I’d always been clumsy and had difficulties with social interactions. I took some online tests and decided that was that. Seven years later I was under an excellent health plan and decided to seek treatment for it. Not only did this formal process confirm my self-diagnosis, it also gave me additional perspective as well as suggestions to deal with A.S.D. characteristics. (For example, I work out three times a week with a focus on balance exercises.) By seeking professional advice, I learned that A.S.D. is not a handicap, but a variation. — Jeffrey
⬥
I am also a person in my 30s who had undiagnosed tics from a young age. I finally sought out a formal diagnosis a year ago and found that it was a huge relief to put a name to the tics and to have a way to discuss my symptoms with others. It has made a big difference in my life. I don’t think the letter writer needs a formal diagnosis to categorize herself as having Tourette’s, but I do think the diagnostic process would help her to own it. — Pamela
⬥
It’s not necessary to have a formal diagnosis in order to describe a condition. I don’t know if I have A.D.H.D., but I have many of the symptoms associated with it. If the topic comes up, I say, “Often I have difficulties focusing, so I use tools helpful for people with A.D.H.D.” Likewise, someone with tics can say, “I have tics similar to Tourette’s.” Anyone who pushes further is being rude. — Lee
⬥
I’m a physician. I agree with the Ethicist here, and if I were the letter writer, I’d try to think about how different it is to say “I have Tourette’s syndrome,” as opposed to “I have involuntary tics” or “I have tics that seem consistent with Tourette’s, but I haven’t seen a doctor.” The letter writer is appropriately thoughtful about the impact of claiming diagnoses as identities, which can complicate actual medical evaluations and potentially detract from people’s lived experiences with a disorder (which may be different than the average person imagines). I also want to echo the Ethicist’s point that Tourette’s is a diagnosis of exclusion. While the average person would benefit from having a primary care doctor address potential health issues, a person with an unknown cause of involuntary tics would likely benefit, even more than the average person, from exploring the possibility of an alternate or concomitant problem. — J