Given the fairly recent and dramatic increase in the number of "engineering to help" (ETH) programs in the developed world, we seem to be observing a theme that resonates with engineering students and faculty. Within this context, this article has two goals: first, it positions ETH programs within a history of the U.S. engineering profession generally. We argue that the emergence of ETH programs represents a shift in how some engineers and engineering educators are re-imagining and re-framing their profession and engineering education from a constraining concept of "service" to include a broader notion of "helping." Second, we want to question the notion of "helping" as a defining framework for ETH initiatives. Engineering students and faculty, though well-intentioned and motivated by altruism, should be aware of significant critiques from fields such as development studies, feminist critical theory, and cultural studies. These critiques may both challenge and enrich theoretical frameworks used by ETH practitioners, and guide future practice. We provide only a broad introduction to these frameworks here, but we hope that this work will serve as a springboard for further inquiry, reflection, and reform.