Ayn Rand, the author of Atlas Shrugged wrote, “When people need help, the best of them (those who need it through no fault of their own) often prefer to starve rather than accept assistance — while the worst of them (the professional parasites) run riot and cash in on it to the full.”

This is so very true. I encounter people all the time who are genuine victims, yet who refuse to accept help, emotional or financial). At the same time, there is no shortage of people who feed off being victims, and who have no hesitation about exaggerating or even outright lying, if necessary, to gain sympathy and attention (under false pretense) from others.

Speaking as a helping professional, I know there is a certain type of person I want to help. And there is a certain type of person I don’t want to help — a type of person, in fact, I cannot help, because there is no helping the willfully irrational.

Those of you who have tried to talk a determined drinker out of drinking know exactly what I mean. Reason does not work with people who have shut it out, on principle.

Although I am not an altruist, and do not believe that self-sacrifice is a virtue, nor that Mother Theresa represents the moral ideal, I do very much want to help a virtuous person. Yet I make distinctions between the moral status of different individuals, based on what I know about them. I don’t, for example, wish to help a professional victim; a whiner; a cheater; or someone who brings some or all of his problems on himself and refuses to acknowledge this fact.

My goal, in my work as a therapist, is to help lift the spirits of the rational, the benevolent, the high-achieving, and the honest. The others can go to hell, so far as I’m concerned.

This is one of the many reasons I oppose socialized medicine, and the welfare state in general. Under the welfare state principle, a health professional is obliged to help anyone he meets, no matter what the context. I reject this principle completely. I won’t “help” a rapist or a killer by lying to him that he has a disease, when he does not. Nor will I give him aid and comfort he has not earned.

Most of you are not helping professionals, and certainly nobody is obliged to help another solely because they are in need. But you can and should help someone who is a value to you. At the same time, make sure those whom you help deserve to be a value to you. Make sure they are not individuals bringing problems on themselves and refusing to face this fact. If they are bringing problems on themselves and refusing to face this fact, the best help you can give them is to tell them the truth. And then bow out gracefully.

Also, remember not to be presumptuous. If you know someone deserves your help, then make sure they want it. They are not obliged to accept your help, however well-meaning, any more than you are obliged to give it! At least, that’s how a rational approach to ethics should work.