Concerning the Moral Obligations of the Wealthy

by Joshua Michtom

I have come under some criticism of late for being uncharitable toward the rich. To be more precise, I offhandedly wrote, alluding to Ester’s piece on trust fund kids, that my policy concerning people born rich is to distrust them. Commenters took me to task for that, and rightly so: it is foolish and wrong to suppose that affluence, in and of itself, defines character. As one commenter noted, mine was “exactly the kind of ignorance several writers on the Billfold would preach against if it were any other kind of discrimination.”

I think that commenter was right, and I said so in comments and a note appended to the post in question. I also said, “We could have a separate discussion about whether there is any moral imperative on the inheritors of wealth to do something selfless and worthwhile with their money, or about the attitudes that may or may not prevail among them about whether they deserve their good fortune.” Several commenters later suggested that yes, that is a discussion worth having. This came to mind over the weekend, when I was engaged in that most proletarian of leisure activities, camping and reading the New Yorker. So let’s start our discussion about the moral obligations of the wealthy with a focus on how they help people with acute need.

I suppose I should not expect a worldview untouched by a certain elitism when I read the New Yorker, but more and more, I notice that there is an archetypal story about rare diseases and how progress is made in their cures. It goes like this:

1. An upper-middle-class couple notices something unusual about their infant child.
2. Doctors are either flummoxed and unhelpful or convinced that it is a terminal illness.
3. The parents refuse to accept the doctors’ assessment and devote large sums of money to (a) organizing and lobbying for more research on the illness; and (b) making all kinds of costly changes to their home, lives, and routines to accommodate their ill child and make the child’s life more enriching.
4. Progress in treatment results from the parents’ tireless efforts.

This sequence became clear to me while reading Seth Mnookin’s piece, “One of a Kind” in the July 21, 2014, issue. The article focuses on a couple, a college professor and an M.B.A., whose son has an extraordinarily rare genetic disease, and their ultimately successful quest to push the medical establishment toward more data-sharing and collaboration to develop treatments. (Spoiler: the disease isn’t quite as rare as previously believed.) The article is great and fascinating: in addition to following a family with the surname Might and involving a glycobiologist who is actually named Hudson Freeze, it illustrates how more base human motivations (researchers’ desire for sole credit on publications; institutions’ need to compete for scarce funding) can impede medical progress. It also has a happy-ish ending: the Mights’ son is showing surprising progress as he gets older; research is progressing.

But all that progress is predicated on the fact that this terrible disease befell not just Matt and Cristina Might’s child, but the child of Matt and Kristen Wilsey as well. The Wilseys, we learn, “are one of the most prominent families in San Francisco.”

It helps that both the Mights and the Wilseys have family money. (Matt Might’s father is the president and C.E.O. of Cable One, the cable-television division of the former Washington Post Company.) Since 2012, the Mights have devoted more than a hundred thousand dollars a year to NGLY1-related research in Hudson Freeze’s lab, while the Wilseys have spent two million dollars funding researchers around the world.

When I read this, I vaguely remembered (and then found, thanks to the New Yorker’s momentarily open archives), a story that casually mentioned a couple who built wheelchair ramps and elevators in their house for their terminally ill sons:

Tom, as a physician, tended to accept the prevailing medical view that nothing could be done. He began to prepare for when Christopher and Patrick could no longer walk, building a wheelchair-accessible addition to their house and installing a small elevator.

And a little more searching brought me to an article, in 2008, that would seem to frame the question of whether the affluence of disease sufferers influences research agendas too much, titled, “Buying a Cure.” The article mentions several instances of wealthy people pursuing cures near and dear to their hearts: the piece focuses principally on a Harvard MBA and rising pharmaceutical executive who gave up her career to found a research foundation on myeloma after being diagnosed with that disease; we also learn that Steve Case, the founder of AOL, created a foundation to research brain cancer, which killed his brother. The myeloma patient declares unabashedly, “We try to get academics to work like businesspeople… Money gives you power to drive people’s behavior.” But the focus of the piece is more on whether her business model is too much of a break from established medical research practices, not on the morality of wealthy people founding charities to cure diseases from which they suffer.

In all of these stories and others, particularly in (surprise!) New York Times magazine, it is the understandable drive of people to cure their own or their loved ones’ rare illnesses, coupled with their happy access to money and influence, that ultimately prods the medical establishment forward. (Of course, sometimes the drive alone suffices.) There is surely nothing wrong with this. As my girlfriend noted when we were discussing the phenomenon, “Maybe that’s just how progress happens.” And it isn’t the only way: governments are pretty good at channeling research money toward the most common afflictions.

What interests me is the morality of this sort of personal crusade, and of rich people’s giving in general. Certainly, it is not immoral for affluent people to use their wealth to cure (or try to cure) the diseases affecting their loved ones. As many of the articles documenting these crusades point out, their drive and resources end up benefiting lots of people, many of them, presumably, of more modest means. But there is an element of systemic immorality in the reality that these cases imply: before the Mights and the Wilseys, there were surely many unnamed poor families whose children just suffered or died of the same genetic disease, and others who were removed by child protective services. In many states, there is a special subset of neglect and abuse cases — in Connecticut, where I practice law, it is called “Uncared For/Specialized Needs” — that allows the state to remove children who have been neither abused nor neglected but whose problems, either medical or psychological, are simply too much for their parents to handle. In my experience, the state does not file Uncared For cases against wealthy families.

I also have to wonder: if the Mights and the Wilseys had only healthy children, would the millions they collectively spent on NGLY1 mutation research have been devoted to other worthy causes, or simply set aside for their heirs’ benefit in some other way? I don’t mean to single out those families, who might, for all I know, be very charitable. But statistically, the rich do give a smaller percentage of their incomes to charity than the poor.

Let us take a step back from the difficult immediacy of ailing children. I won’t fault rich folks for spending like crazy to help their very ill kids, in the same way that I don’t fault the parents of murder victims for supporting the death penalty for their children’s killers, even though I oppose the death penalty. The overwhelming emotional toll of an injured, ailing, or dead child defies reason. (If I thought someone killed one of my kids, I would support the death penalty because I would want to impose it personally.) So instead of asking whether it’s moral to spend a million bucks on curing a disease that affects, say, 1000 people (or even just one!), let’s ask this: is it moral to spend $480,000 on one child for twelve years of prep school at $40,000/year, when that money could buy tutoring, SAT prep, extracurricular activities, and even improved nutrition for, well, a lot of poor kids?

This is not a new line of argument: the Australian philosopher Peter Singer likes drawing direct moral equivalencies that suggest, taken to their logical extremes, that most everyone should give an awful lot to charity just to achieve baseline morality. He articulates his theory well in this 1999 article. Since a family earning $50,000 a year spends $30,000 on necessities, Singer reasons, that family should endeavor to give as close as possible to $20,000 to charity every year.

I can actually remember reading Singer’s article in 1999, but I do not remember wondering how it could be the case that a family earning $50,000 a year spends only $30,000 on necessities. Now, that’s all I can think about. (That is the difference between 22 and single and 37 and divorced with two kids.) Does “necessities” include saving for retirement and calamitous illness? It’s hard to imagine that it does, or that a family earning the national median today — around $60K — could spare $24K every year. But Singer recognizes that his argument is at least partly aspirational:

If that makes living a morally decent life extremely arduous, well, then that is the way things are. If we don’t do it, then we should at least know that we are failing to live a morally decent life — not because it is good to wallow in guilt but because knowing where we should be going is the first step toward heading in that direction.

So let’s agree that imposing strict moral-economic imperatives on the rather hard-hit middle class is difficult. I don’t think the same can be said for the rich. Ultimately, since we are all human beings, the cost of being alive, and even of enjoying life, is essentially the same for all of us. Can we then say that there is some income threshold above which, barring special circumstances, it is immoral not to devote additional earnings to good works?

Understand, dear readers, that I am not inviting a discussion about effective tax rates. I am not disputing the fundamental principle that people can do whatever they please with their money, whether earned or inherited. I am not even saying that very rich people who don’t tithe adequately are bad people. Here’s what I’m submitting, for your honest consideration: let’s take the income level that, according to recent research, is what you need to maximize happiness (i.e., the point at which more money stops translating into more happiness): $75,000 a year. Adjusted for cost of living, that means that in Hawaii, you need $122,175 for optimal happiness. In Mississippi, it’s $65,850. So let’s take whatever that number is for a given area and double it (because why not?). Let’s adjust for number of dependents and other economic variables. And then let’s say that there is a moral imperative to devote all income beyond that number to helping others, and that anyone who doesn’t (excluding those with some legitimate extenuating circumstances) is doing something fundamentally immoral and worthy of condemnation. Agree or disagree?

Now, you may say that the parameters are too debatable, too subjective. What counts as “helping others”? What counts as “extenuating circumstances”? Why should we adjust for number of dependents when having children is a choice? To all of that, I say only that we are talking philosophy here, not real policy. You may pick the particulars and make them the rules for the sake of this exercise, as long as you apply them rigidly. The question is, can we agree that at some point, people can be too rich, and immorally so? If you say yes, but think my formula is inadequate, propose your own — and no Potter Stewart definitions, please! How rich is too rich?

Josh Michtom is a public defender in Hartford, Connecticut. He spends way too much of his spare time decorating his children’s school lunch bags.

Photo by the author