Bollocks to panhandlers!
I detest panhandlers.
"Help me buy a cup of coffee?"
"I'm so hungry."
"I just need enough for a bus ticket."
Lies. As a student, I could afford little. I never carried any cash around so that I would never be tempted to spend it. But when a man plaintively tells you he hasn't eaten for three days and piteously petitions you for money to buy food, a stone would be moved to pity.
I had an apple. I had been saving it for the long ride home, but his need seemed so great. I gladly gave it to the man, who thanked me as I boarded the bus. As I sat down, I glanced up and through the window, watched as he disgustedly threw my shiny-sweet apple in the garbage.
When I volunteered at the hospital, I would get free bus tickets to help me get there and back. Since I had to purchase a monthly bus pass to get to the university anyway, I would save these bus tickets for the holiday months when I didn't have to travel as often. When people asked me for money to buy bus tickets, I would hand them mine, only to hear them opportuning other strangers on the street for money to buy bus tickets that had already been secured.
I've since learned to donate my money directly to shelters and other agencies that help the homeless. For a number of reasons, it is difficult to measure the prevalence of mental illness and substance abuse among the homeless. Nevertheless, a 2001 study from the Canadian Psychiatric Association found that as many as 2/3 of homeless people using urban shelters have some sort of mental illness. Even if you look at more conservative studies citing a prevalence of 40%, the numbers remain impressive. That same year, the Canadian Medical Association Journal published a literature review by Stephen W. Hwang on homelessness and health in Canada. According to his research, mental illness and alcohol use disorders were widespread among the homeless.
So what does this tell me? This tells me that homeless people are less likely to be able to make well-informed decisions. As a surgeon, I cannot legally secure consent for a procedure from anyone who is mentally ill or under the influence of exogenous substances, as both of these compromise informed decision-making and, therefore, autonomy.
By simply and naïvely giving money to vagrants, there exists no guarantee that they will get the help they so desperately need. All it does is reinforce to the panhandler that this is a viable way to attain an income and therefore maintain the status quo. However, if I donate money to the agencies who provide food, clothing, shelter, and job training to the homeless, I can better ensure that those funds aren't spent on cigarettes or alcohol or crack.
Please think before you part with your spare change. Are you just trying to momentarily assuage your Christian middle/upper-class guilt by occasionally tossing a few coins the way of the homeless? If you truly wish to effect change in their lives, help them gain access to what they truly need.




