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Sentimentality and hardness of heart are two sides of the same coin. When sentimentality is confined to weepy films or romantic novels it does little harm and perhaps even some good, but when it is institutionalised by being made the basis of policy its denial of reality and its elevation of ersatz feeling over an appreciation of reality leads straight to bureaucratic indifference.

I first realised this a number of years ago when I had a patient with a severe, slowly-progressive, and ultimately fatal disease that was gradually disabling her. The disease was of unknown cause and she had done nothing to provoke it. Certain adaptations to her house would have made her life a lot easier for a time, but her husband, who worked in an ill-paid job, could not afford them. It seemed to me an instance when public assistance would have been justified, not in the name of justice but that of kindness or compassion.

I called a social worker and made a disastrous mistake in my first sentence. “€˜I have a particularly deserving case,”€™ I said, thinking to arouse her interest and forgetting for a moment that desert in any traditional sense was a concept that had long been banned from the lexicon of social work. Far from arousing her interest, let alone compassion, it aroused her hostility. If I thought a case was particularly deserving, it followed that I must have thought that some cases were relatively or even absolutely underserving. In short, I was judgmental, that is to say censorious, cruel and Victorian. I would let the homeless starve and the weak go to the wall.

Need, wherever it came from, not desert, was the touchstone of assistance, she told me, and therefore her special desert (in my opinion) was of no account in the allocation of assistance. Need is objective, whose assessment required no moral judgment, while desert was subjective and dependent on an outlook that not everyone shared and therefore favored the opinions and scale of values of white middle-class males such as myself. The fact that I was trying to obtain assistance for a working-class female did not alter this deadly fault. My patient never did get the assistance that would have improved the quality of her life for a time.

The ideology of assistance allocated by need irrespective of desert is fundamentally a sentimental one that empties life of meaning and is a pretext for hard-heartedness of pharaonic proportions. For if you did not sympathise and wish to help a woman with a crippling and ultimately fatal disease, who would you sympathise with and wish to help?       

The fiction that all people are equally deserving is a sentimental one. People congratulate themselves on their generosity and largeness of spirit for not making distinctions between the deserving and undeserving, for such distinctions imply a scale of values and all scales of values are in effect mere prejudice, usually of the well-placed in society. They “€“ the distinctions “€“ are a manifestation of complacency and imply a lack of sympathetic or empathetic understanding of a suffering person’s situation. Therefore it is best, intellectually and ethically, to abandon the distinctions altogether.

There are several problems with this, however. People can and do wilfully increase their needs by their conduct. The worse or more irresponsibly you behave, the more acute your needs are likely to become. An alcoholic who smashes up his own flat in a drunken rage takes precedence over my patient with her progressive disease because no one these days can live without furniture or certain appurtenances such as a refrigerator, and her need, being not so acute, could be dealt with another day “€“ a day that in practice never comes because acuter needs arise all the time.