Under the standard person-affecting view, this creates the same paradox as our previous thought experiment. But even Roberts’s resolution does not work here for the GiveWell view. Roberts’s resolution entails that C = D and therefore B < C. But GiveWell’s cost-effectiveness calculations for AMF implicitly endorse B = C. When we donate to AMF and save an Afiya, standard cost-effectiveness estimates for AMF don’t give any regard to whether a Brian exists, even though under Roberts’s view we should prefer Brian not to exist. If donating to AMF looks like act B, then saving a life is worth 35 QALYs; but if it looks like act C, then saving a life is worth 70 QALYs. Similarly, acts C and D count for the same under Roberts’s resolution, even though GiveWell would count act D as twice as good as act C.
In other words, the cost-effectiveness analysis assumes that B, C, and D are all exactly 35 DALYs better than A, which means B = C = D. It also makes some other assumptions that contradict this assumption. Basically no matter what your view of population ethics, you have to look at population effects to determine how good it is to save a life, and GiveWell’s cost-effectiveness analysis doesn’t do that.
Okay, I can see why this was unclear. In act B and D, you’re doing the same thing—preventing Afiya from getting malaria. In act B, you cause Afiya not to get malaria, and Brian is born and dies of malaria. In act D, Brian does not get malaria. According to the GiveWell view, it doesn’t matter which of these things happens when you $3000 donate to AMF—either way it’s 35 DALYs “better” than act A. But the GiveWell view also claims that B < D, so it contradicts itself.
Which is it: Brian doesn’t get malaria (for reasons that have nothing to do with AMF), or Brian is prevented from getting malaria by AMF? Those are pretty different. The cost-effectiveness analysis is indifferent to the first option, but is affected by the second option.
You should edit the post then. Right now it says “you prevent them both from getting malaria”, which is the exact opposite of what you said just now. In this case I agree that the GiveWell view is indifferent between B, C, and D. Births that may result from or be prevented by AMF (which I would argue is pretty negligible) simply aren’t considered in the cost-effectiveness analysis. There’s nothing contradictory about this.
No, I don’t understand. Why does AMF cost-effectiveness require indifference between B, C, and D?
In other words, the cost-effectiveness analysis assumes that B, C, and D are all exactly 35 DALYs better than A, which means B = C = D. It also makes some other assumptions that contradict this assumption. Basically no matter what your view of population ethics, you have to look at population effects to determine how good it is to save a life, and GiveWell’s cost-effectiveness analysis doesn’t do that.
No, if you were to just count lives saved, D is twice as good as B.
Okay, I can see why this was unclear. In act B and D, you’re doing the same thing—preventing Afiya from getting malaria. In act B, you cause Afiya not to get malaria, and Brian is born and dies of malaria. In act D, Brian does not get malaria. According to the GiveWell view, it doesn’t matter which of these things happens when you $3000 donate to AMF—either way it’s 35 DALYs “better” than act A. But the GiveWell view also claims that B < D, so it contradicts itself.
Which is it: Brian doesn’t get malaria (for reasons that have nothing to do with AMF), or Brian is prevented from getting malaria by AMF? Those are pretty different. The cost-effectiveness analysis is indifferent to the first option, but is affected by the second option.
I also didn’t understand this part. Switching from A to D adds 70 years to what would have been lives that would have existed under option A.
It’s the former. In the second scenario, the only thing donating to AMF does directly is causes Afiya not to get malaria.
You should edit the post then. Right now it says “you prevent them both from getting malaria”, which is the exact opposite of what you said just now. In this case I agree that the GiveWell view is indifferent between B, C, and D. Births that may result from or be prevented by AMF (which I would argue is pretty negligible) simply aren’t considered in the cost-effectiveness analysis. There’s nothing contradictory about this.