The Samaritan's Dilemma: Should Government Help Your Neighbor?

Stone argues that democracy depends on altruism, not self-interest, and rejects the 'new conventional wisdom' that help is harmful . She challenges the Reagan-era 'perversity argument' that government assistance makes people lazy and dependent, contending that this view has 'privatized' Americans' natural caring impulses . Her central claim is that everyday altruism is the premier school for citizenship, and that if government helps neighbors, citizens will once again want to help govern .

Stone repurposes economist James Buchanan's 'Samaritan's dilemma,' a game theory model that divides players into 'Samaritans' and 'parasites' and argues that helping others weakens society by diverting resources to the unmotivated . Buchanan's framework treats altruism as a vulnerability to be overcome through 'strategic courage'—the refusal to help despite the cost . Stone inverts this: she treats the dilemma not as a reason to withhold help but as evidence that the real moral hazard is walking away from those in need .

Stone explicitly targets Rand's idea that 'the only rational ethical principle for human relationships is free-market trade' . Where Rand treats self-interest as the foundation of ethics and altruism as a destructive weakness, Stone argues that altruism is a robust and pervasive human motive—one so strong that people 'commonly lie, cheat, steal, and break laws to do right by others' . She uses stories of home health aides and volunteers to show that caring for others is not self-sacrifice but a source of meaning and civic identity.

Stone draws extensively on 'everyday altruism' in practice: home health aides who risk their jobs to care for patients beyond their official duties, Meals on Wheels volunteers, family caregivers, and community organizations . She also cites surveys and anecdotes showing that most average Americans are not innately greedy but willing partners in community action . The book's reportage includes the story of an aide who said 'After 3:30, you're a private citizen'—explaining why she continued caring for a man the government wanted to cut off from Medicare .

Reception was mixed. Francine Prose in O Magazine praised it as 'calm, logical, and immensely reassuring,' saying it dismantles standard arguments against a caring society . Publishers Weekly noted Stone's aim to 'reunite politics with doing good' and found her argument persuasive . The American Prospect's review was more critical, finding the book 'overly anecdotal and vague,' with altruism 'loosely defined,' and noting that Stone writes as if the attack on social programs 'had no basis whatever in reality' . Library Journal called the writing 'brisk and entertaining' but said the book 'cries for more background' .

The title's reference to a 'dilemma' can suggest Stone believes altruism is inherently problematic or self-defeating. In fact, she treats the alleged dilemma as a myth propagated by self-interest ideology. Her point is not that helping others is difficult or dangerous, but that Americans have been wrongly taught to distrust their own caring impulses in public life . She argues the suppression of altruism is itself the problem, not the altruism. The book is a defense of compassion as a political virtue, not a warning against it.