Careers in Medicine and Social Work

Question: I have read many texts on Objectivism and have gathered it is a view that holding an occupation in which helping others, for example a social worker, is not a valid form of self-achievement and also that all persons should be independently sufficient. I was questioning then, even though medical doctors are essential to acquire good health in times of needing advice and needing medication given, the one thing doctors do is cater to others’ needs. Is this a valid occupation in which you have self-achievement?

Or even, is this an occupation for an Objectivist?

Answer: Objectivism holds that productive work is, as Ayn Rand put it, man’s “noblest activity.” Whether one is a janitor or a philosopher, he should pursue his work passionately, with the full focus of his mind and the knowledge that he is contributing to his own life. As you indicated, Objectivism also demands self-sufficiency. This does not mean that you must personally produce all the goods and services that you use. Rather, self-sufficiency means living by the recognition that the most consistent, reliable way to acquire values is to produce and trade for them yourself.

The trader principle is another key tenet of Objectivism . According to this principle, one should exchange value for value with other people, and neither demand nor grant the unearned. This principle provides guidance as to when it is appropriate to give goods or services to another, viz., when doing so contributes to one’s own rational interests. This defines a critical difference—between helping others as part of a selfish pursuit, and self-denying altruism.

Trade is essential not only as an abstract ethical mandate, but also as part of the daily functioning of a complex capitalist economy. In a division-of-labor society such as ours, most individuals specialize in producing a very narrow range of goods or services that they could never use themselves but instead exchange in the open market for the outputs of other specialized producers. This does not mean they are not self-sufficient; so long as each interacts by trade, he is, in effect, supporting himself. And this division of labor allows workers to produce incomparably greater value than they could have by devoting small portions of their time to a wider range of productive pursuits.

Human beings regularly trade for such things as housing, food, transportation, and health care because these are of value to them. It’s no more altruistic to be a doctor than to be a construction worker, a grocer, or a truck driver. In each of these cases, a producer creates something of value and trades it for the values others offer him. Life is certainly a value for Objectivists, and physicians provide some of the most direct and critical protection of life. This need not be a career of self-sacrifice, and indeed, most doctors receive ample compensation for their work.

Things get a bit more complicated when it comes to social workers. Where doctors must often fight an entrenched and stifling bureaucracy, social workers are usually the employees and instruments of bureaucracy. Thanks to the steady progression and expansion of the welfare state ever since Roosevelt’s New Deal, the greater part of social work today consists of distributing stolen loot (i.e., tax revenues) to recipients. Such a career is both illegitimate and immoral.

I suspect that there would still be a (greatly diminished) need for social workers in a free society. Charities, orphanages, or other privately funded assistance organizations require employees with certain skills to run their day-to-day operations. Such careers would be in concert with Objectivist principles, as long as those who pursued them did so by a selfish choice, and did not give aid to the unworthy or undeserving. One can certainly derive satisfaction and enjoyment from improving society and helping people to lead successful lives. This is productive work and a perfectly valid basis for a career.

Work is one’s means of sustaining life. The choice of a career is critical to an individual’s well-being and happiness. He must never base such a choice on altruism or deference to others’ wishes; to do so is to court long-term melancholy, misery, and ruin. Instead he must weigh the pros and cons of each profession against his own skills, interests, and life goals, and choose the career he finds most satisfying and rewarding to himself. This goes for a career in medicine or social work as much as any other.

‍