I am an undergraduate student who is interested in attending medical school. My primary reason for wanting to work in the medical field is to improve access to medical care in underserved further along my career path. However, attending medical school costs quite a bit. While I am fortunate enough to likely be able to pay for med school without crippling debt, I can't help but think that the money going towards my education could go towards better causes, such as improving infrastructure in rural, underserved communities and improving vaccination rates. Would the most moral option here be to donate money going towards my education to these causes or to go to medical school and use my education to improve access to healthcare in underserved populations?

This is a beautiful question--unanswerable, of course, in any substantive/concrete/objective way. One of the many reasons why it is unanswerable is that even if you are implicitly using some rubric (such as utilitarianism--what will maximize happiness, goodness, etc.), you have no solid way of quantifying the terms. How to weigh donating $100K (say) toward cancer research v. toward your medical education? What if the $100K of research fails to produce anything useful? What if (God forbid) you die on the day you received your MD, thus can't put the education to use? How much good, exactly, is done, by building some infrastructure in rural places? But I think hinted at in your question is perhaps some concern that in spending the money on your education you are somehow wrongly being "selfish." To that I would offer just a couple of thoughts. (1) Being concerned about your own interests and welfare is not automatically a moral wrong. (2) Given how you describe the scenario, it's clear that your own education isn't merely for yourself but something you plan to apply toward, use to help, others. So investing in yourself with those aims in mind is hardly selfish. (3) You always have to weigh probabilities, likelihoods, and while no certainty is ever possible, and you may well evolve over time in unpredictable ways for both internal/external reasons, nevertheless, you probably know your own intentions/goals/character with greater certainty than you know about any of the other competing goods. That is, from where you stand now, you can estimate with reasonable certainty that you will pursue your medical education and apply it to things you judge definitely to be goods ... compared to, what? the possibility that some cash directed toward some research or toward some infrastructure, might pay off in some hard to specify goods? (4) Finally, don't ignore the good you could do by influencing others -- if you are pursuing medicine for the noble reasons you sketch, you may well influence others in the medical field to be moved by your own goals ..... So putting all this together, my money (so to speak) is on educating yourself! .....

oh ... and you will definitely want to read Peter Singer's "The Life You Save" -- you'll find it fascinating and relevant

hope that's useful ...

Some people hold the view that if we're doing what we really ought to, we'll give up to the point where giving more would decrease the overall good that our giving produces. The most obvious arguments for that sort of view come from utilitarianism, according to which the right thing to do is the action that maximizes overall utility (good). If I could give more and overall utility would rise on that account, giving more is what I should do.

Other views are less demanding. A Kantian would say that our most important duty is avoid acting in ways that treat others as mere means to our own ends. Kantians also think we have a duty to do some positive good, but how much and in what way is left open. I'm not aware of any Kantians who think we're obliged to give up to the point where it would begin to hurt.

Who's right? I do think there's real wisdom in the idea that a system of morality won't work well if it's so demanding that few people will be able to follow it, and so I'm not persuaded by the point of view that goes with the first paragraph above. (That's entirely consistent with agreeing that most of us do less positive than we should.) But there's another point: it might be that if you, in isolation, were to take the large sum of money that medical school would cost and give it to Doctors Without Borders, then that would produce more good than if you were to go to medical school. But even if this were true in each individual case, taken one by one, the net effect of having everyone act this way would be that there would be no doctors. And that would be a very bad thing. At the least, it's not clear that you're under any special obligation to make this sacrifice.

Add to that the uncertainties of real life. Do you (or anyone else) actually know that more good would come from having you give your tuition money to charity? Doctors, after all, can do a lot of good.

It's not clear that the demanding view sketched in the first paragraph is actually the right one. And even if it is, it's not clear that acting accordingly calls for you to give up your plans for medical school. I'm not convinced that there's anything wrong with you simply making up your mind based on your own inclinations. After all, it's not as though either choice is ignoble. But I'd go further. If you pass up the chance to become a doctor based on a dubious abstract argument, there's a real chance that you'll eventually end up regretting your decision. A moral outlook according to which people are routinely required to set their own goals and desires aside on the basis of abstract calculation about imponderable outcomes strikes me as a recipe for moral anomie.

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