Is It OK to Use Money Raised for a Child’s Cancer Care on a Car?

The magazine’s Ethicist columnist on the limits of GoFundMe, whether to identify as L.G.B.T.Q. and unequal inheritances.,

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My grandchild is being treated for leukemia. A friend of the child’s parents set up a GoFundMe page for them. They’re both well loved and have siblings who know a ton of people. So the goal was surpassed in three hours, and donations totaled more than double that amount. They plan to donate anything over and above direct hospital-related expenses to leukemia research organizations.

This couple have some needs that aren’t strictly related to the child’s care, like a new car. Am I rationalizing by saying they need to drive the child to the hospital and should use some of this money for a dependable car? Is there a strict line you would not cross? And is it germane that they’re not extravagant and extremely honest? Name Withheld

The United States is either the richest country in the world (going by G.D.P.) or among the richest (going by G.D.P. per capita). It is immoral that anyone here has to borrow large sums of money for essential medical treatment, especially for a child. We should be able to deliver to our people the readily available and affordable health care that nations like Thailand and Costa Rica, which have a fraction of our per-capita G.D.P. but comparable life expectancies, deliver to theirs. That GoFundMe pages like these are now common is a national disgrace.

The requirements of the child’s care are, needless to say, completely independent of whether the parents are able to connect with a network of people who can afford to pay for them. (Research suggests that nonwhite people don’t fare as well with medical fund-raising.) To be sure, people typically resort to such medical-cost campaigns because they are truly in need; donors respond out of a commendable sense of generosity and compassion. The fact remains that such campaigns favor those who can effectively and affectingly represent themselves or know someone who can; they favor patients who are, in some sense, photogenic. The result is uncomfortably close to Tinder for the tenderhearted.

Your particular question raises the issue of what the donors reasonably expected their contributions to be spent on. (A better version of crowdfunding for medical costs might involve direct payment to health care providers, reducing the opportunity for fraudulence and questionable decisions.) Did they mean to leave it completely up to your family to decide what counts as a medical expense? Would a family vacation at the end of the process, if — as I very much hope — your grandchild recovers fully, qualify as a mode of recuperation? Surely this isn’t what the donors had in mind. They probably thought they’d cover the sorts of costs that a decent health-insurance policy should cover. That’s the test I’d use to draw the line.

We need to expand the pinpoints of empathy to which medical fund-raisers appeal.

Ideally, a national insurance system would make provisions for travel expenses involved in hospital visits. (Medicaid does, though the details vary among states.) The cost of a car, I agree, isn’t as far afield from direct treatment expenses as the cost of a much-needed vacation would be. But it’s still too far, and would strike many donors as taking advantage of their generosity. Which is why the parents shouldn’t do it. Directing the extra money to leukemia research, by contrast, does seem the sort of thing that donors would consent to. Though why not refund contributions that arrive after your reasonable medical expenses have been covered?

I’m glad that your grandchild’s parents are thrifty and honest — donors who know their character will feel more confident that their money will help address genuinely urgent needs. But if you think they really require a better car owing to their child’s illness, you can start a GoFundMe page for that. In the meantime, we need to expand the pinpoints of empathy to which medical fund-raisers appeal and light the way toward a country where health care is treated not as a privilege but as a right.

I am a cisgender woman, in a monogamous 30-plus-year marriage with a cisgender straight man. However, I don’t identify as straight. Before marriage, I dated both men and women. If I were single, I would most likely do the same. I consider myself bisexual and am open about that identity with friends and family. And that’s how I fill out official forms, like the census. But I feel weird about doing that at work, a law firm, not because I’m embarrassed about identifying publicly as bisexual but because it feels fraudulent to put myself in that category when I live as a straight woman and don’t face the discrimination my L.G.B.T.Q. colleagues might. On the other hand, I feel that it’s important for leaders in organizations to be “out.” Is it ethical to identify myself as L.G.B.T.Q. on client surveys or state bar forms that inquire as to race, sexual orientation, etc., for diversity-tracking purposes? Terri, New York

The Oxford philosopher Gilbert Ryle had a theory about dispositions. In his view, when we say that a person knows Latin, that a glass pane is brittle or that sugar is soluble, we’re not talking about some deep attribute that’s normally hidden from us. Rather, these dispositional concepts are basically predictions about what would happen in certain situations. That’s consistent with the way you explain your bisexuality by saying that if, contrary to fact, you were single and dating, you’d see both men and women.

Surveys meant for tracking diversity, though, aren’t interested in dispositions, as such; they’re interested in social identities. These things are connected, of course. Catholic priests, who have taken a vow of chastity, can identify as gay while abjuring sexual activity or romantic relationships. That is, they could, while leading lives of abstinence, put it out that they’re gay and be recognized by others as such. (I don’t mean just by their nearest and dearest.) They could inhabit that identity.

Yet it can sometimes be hard to turn a disposition into an identity. Father Bryan Massingale, as a scholar and activist, writes and talks publicly about his sexual, racial and religious identities; but unless your professional practice has an L.G.B.T.Q.+ focus, the issue may simply not arise in your work life. And checking a box on a client or state-bar survey doesn’t necessarily affect how you’re seen in the workplace. If the surveys aim to collect information about people with particular social identities in your profession, the pertinent question is whether your colleagues would identify you as such, not just how you would self-identify. The way you regard yourself in pectore (to use the Catholic phrase) doesn’t settle the matter. If your objective is to destigmatize bisexuality among your co-workers, it’s not the subjective but the social dimension of identity that counts.

Ryle, by the way, seems himself to have lived a celibate life. I’m told that his colleague A.J. Ayer once asked him which sex he would incline toward were he ever to have an intimate relationship. (Ayer, a notorious philanderer, was also keen on gay rights.) Ryle apparently spent a long moment in grave reflection on his dispositions and then replied, simply, “I don’t know.” It wouldn’t have occurred to Ayer that he might have had no sexual inclinations at all.

We have two adult children and have always considered that being fair means we give to them equally. As they enter middle age, though, their circumstances are quite different. One has a spouse with equal earning power who is almost certain to inherit from her family. The second child is single, with our family her only resource. Is it fair to give one one-third and the other two-thirds? We would share our decision with them. Emily, Pittsburgh

You can treat two children as equals and still take account of their different needs. A parental bequest allows some people simply to do things they otherwise wouldn’t; for others, it’s a real help in meeting ordinary needs. The closer your second child is to the second situation, the stronger the case for a larger share. It’s good to talk about these things with your beneficiaries as you’re deciding them, though. Children may have unnecessarily disappointed expectations and even conflicts after you’re gone if you don’t make your plans clear while you can explain them.


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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