In a tale titled Légende du Beau Pécopin et de la Belle Bauldour, Victor Hugo writes about a meeting between the devil and a group of saints. The devil needs help. But the saints decline to give it, for a variety of reasons. Saint Autremoine has the most peculiar: “I regret that I can’t help you, my friend; I would consider that to be a good action, and since good actions have the inconvenience of pushing the vanity of those who make them, I refrain from doing it to preserve my humility,” the saint says.
The story underlines the complexity of altruism. Do people give to one another because it’s good, or because it makes them feel good? Is altruistic giving ever actually altruistic? Are some forms of generosity morally higher than others? And, does it even matter?
What brings people to give, and what kind of giving is most ethical, are two aspects of generosity that play a big role in understanding why medical crowdfunding is so effective at encouraging people to help others, yet at the same time so incapable of improving equal access to healthcare.