My Patients Need Me. Can I Quit?

The magazine’s Ethicist columnist on placing family above work despite the pandemic and becoming a volunteer in order to get the Covid-19 vaccine sooner.

I’ve worked in the mental-health field for more than a decade. I have prided myself on pursuing a vocation that centers on helping others. In the context of the pandemic and its ongoing traumatic fallout, however, I have found myself pulling away from the world and instead turning my focus inward to myself and my family.

I would like to take a leave from my profession and become a stay-at-home parent. I am fortunate to be in a position to do so. I feel immense guilt, however, about shifting to a life that will be turned inward rather than outward. This feels particularly egregious after this year, in which stress and mental illness are raging, bigotry is more salient than ever and so many are suffering from poverty.

Furthermore, the mental illness in which I specialize has skyrocketed during the pandemic, and there is a dearth of providers who treat it. I have typically felt judgmental of and saddened by people who just live their lives focused on themselves and their own families, but now I feel a strong pull to do just that.

During particularly turbulent periods like this in the world, is it ever OK to stick my head in the sand? Is it ethical to leave a helping profession at a time when people need that help most if I do so out of choice, not necessity? K., San Francisco

If morality concerns what we owe to others, ethics — in a tradition reaching back to the ancients — encompasses a broader terrain: It concerns how a life should be lived. And a central idea in modern ethics is that each of us has the primary responsibility for making a well-lived life. With the exception of moral saints like Nelson Mandela and Mother Teresa, we pretty much all could have lived a life in which we made a significantly larger contribution to the welfare of others. Every moment spent making a meal for my family is time I might have devoted to a soup kitchen.

Some people — proponents of utilitarianism — have thought that your task as a human being is simply to aim at doing the most you can for the collective welfare. I doubt that this is right. It seems to me that ethics permits you to give special weight to you and yours; indeed, it requires you to give special weight to those with whom you have the sorts of connections we have with family, friends, colleagues, fellow citizens and a whole host of people to whom we have what philosophers call “special obligations” by virtue of our relationships. Giving particular weight to you and yours doesn’t mean you can ignore the moral demands of others, especially when it comes to their rights. But it does mean that people with whom you have no special relationship are not entitled to your special care.

How is the moral calculus affected by the fact that you have training in an area of unmet need, and have the opportunity to render a service that most people cannot? It would certainly be admirable to take this into consideration in deciding how to live your life. Your turning entirely away from using your highly developed skills would represent a loss; I’d be saddened to see it. But I hope I wouldn’t be judgmental, as you put it, as well. Not least because focusing on our own families can also be admirable, especially in these difficult times. Raising children into happy, decent adults is one of the most important things we can do.

I would urge you to consider, though, whether there are ways of balancing these calls, rather than choosing between them — perhaps there’s a way to do some professional work part time? But if making a good life is a responsibility that each of us has to manage ourselves, balancing the demands of the many worthwhile things we could do is a central part of that task, and one not to be delegated to anyone else.


I live in a city that offers Covid vaccines to volunteers who have worked 15 hours at a vaccination site. Not surprisingly, the demand for volunteer slots far exceeds supply. I got my first shot last week. I have more volunteer shifts scheduled for the next few weeks. Should I relinquish those shifts to others, so they can be vaccinated? Does the answer change if I am assured that my shifts will go to friends who I know are also hard-working volunteers? I feel an obligation to continue volunteering because a) I don’t want to disappear now that I have the vaccine; and b) even after just one shot, it is probably safer for me to interact with patients (who are old or otherwise vulnerable) than someone who has not been vaccinated at all. However, I also feel a duty to let someone else be vaccinated. Elaine, Dallas

Your vaccination was done early not in order to get you to volunteer but in order to make your shifts safer for you and for those you serve. Stopping now undermines that purpose. You’re considering stopping so that someone else can be vaccinated. But someone will get that dose whatever you do. You’ve framed the question to yourself in terms of a “duty to let someone else be vaccinated.” But suppose you asked whether it’s OK to game the system in order to favor one or two of your friends. I’m sure that prospect wouldn’t sit well with you.

Giving particular weight to you and yours doesn’t mean you can ignore the moral demands of others.

By the logic of this “duty” you invoke, each of your diligent friends should spend the minimum amount of time working at the site in order to be vaccinated and then pass the opportunity along to another. Your duty is, in fact, to do your job and recognize that the vaccination program doesn’t exist for the benefit of those who work there. Volunteering was a gift; but if you treat the work as means for vaccinating friends who don’t otherwise qualify, it’s in danger of becoming a grift. You’d only be diverting vaccine doses away from people who have been declared eligible by a system of vaccine distribution that seeks to achieve a variety of aims. Allowing people who work at a vaccination site to get special treatment for their friends isn’t one of those aims.


In my state and possibly elsewhere, food-bank volunteers get priority access to coronavirus vaccines. Is it ethical to start volunteering at a food bank in order to be vaccinated sooner? Name Withheld, Somerville, Mass.

The best kind of people do what is right for the best reasons. The moral saint would volunteer unselfishly at the food bank because it’s a way of serving the disadvantaged in her community. You’re admitting you’re not that perfect person. But volunteering for the food bank, even if for less-than-admirable reasons, is still a good thing to do. Once again, the vaccination isn’t a reward for that good act; it’s necessary to reduce the chances of people (including you) becoming infected at the food bank. Still, it can also be an incentive to sign up, as people in your community obviously know, and in these circumstances, it’s not terribly likely that you’ll get loads of unmerited kudos for showing up. Were you then to contrive for the job to carousel among your otherwise vaccine-ineligible friends, though, you’d be abusing the arrangement. If your motives are self-serving, make sure that your actions are above board.


Kwame Anthony Appiah teaches philosophy at N.Y.U. His books include “Cosmopolitanism,” “The Honor Code” and “The Lies That Bind: Rethinking Identity.” To submit a query: Send an email to ethicist@nytimes.com; or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, N.Y. 10018. (Include a daytime phone number.)

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