Altruism Discussions in the Time of Pandemic: May We Ask, May They Tell?

Pandemic can prompt a variety of human motives, ranging from a desire for security to altruism. In our current perilous times, some patients have voiced a desire to help others. Such action can result in self-peril, and, as a result, their motives may be questioned. One health system now has a pandemic-based advance directive that queries patients about their value preferences regarding care that is directed toward others. Some object to this action because it may evoke patients to altruism. We examine both remote and recent examples of altruism, in which coercion could have played a major role. We next consider concerns based on aspects of the process of "inquiry versus evocation," slippery-slope claims, and inherent manipulation, and conclude that patients should be allowed to be asked about their preferences and values regarding altruism.