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In my work as a transplant ethicist I have always been interested in the topic of altruism. Thus, when a book appeared with the title, Pathological Altruism, I was very intrigued to read it. An exceedingly heavy book, however, arrived in my mailbox, and I admit I was taken aback. But upon reading Pathological Altruism, edited by Barbara Oakley, Ariel Knafo, Guruprasad Madhavan, and David Sloan Wilson, I was not disappointed. In fact, chapter 1 baited me with the line, “Altruism can be the back door to hell.”
The authors of this book place many people in the category of the pathological altruist: workaholics, victims of domestic abuse who remain with their abusers, codependent persons (“displaced mutual aid endeavors”), anorexics, animal hoarders. As clinical psychologist Rachel Bachner-Melman describes (chapter 7), pathological altruism happens when there is the “absence of an internal compass of what is beneficial for self” and others’ needs are given preference over one’s own....