As you mention, the scale seems small here relative to the huge political lift necessary to get something like MAID passed in the USA. I don’t know much about MAID or how it was passed in Canada, but I’m picturing that in the USA this would become a significant culture-war issue at least 10% as big as the pro-life-vs-pro-choice wars over abortion rights. If EA decided to spearhead this movement, I fear it would risk permanently politicizing the entire EA movement, ruining a lot of great work that is getting done in other cause areas. (Maybe in some European countries this kind of law would be an easier sell?)
If I was a negative utilitarian, besides focusing on longtermist S-risks, I would probably be most attracted to campaigns like this one to try and cure the suffering of cluster-headaches patients. This seems like a much more robustly-positive intervention (ie, regular utilitarians would like it too), much less politically dangerous, for a potentially similar-ish (???) reduction in suffering (idk how many people suffer cluster headaches versus how many people would use MAID who wouldn’t otherwise kill themselves, and idk how to compare the suffering of cluster headaches to that of depression).
In terms of addressing depression specifically, I’d think that you could get more QALYs per dollar (even from a fully negative-utilitarian perspective) by doing stuff like:
funding Strongminds-style mental health charities in LMIC (and other semi-boring public-health-policy stuff that reduces depression on a population level, including interventions like “get people to exercise more”, or “put lithium in the drinking water”, or whatever)
using AI to try and discover amazing new classes of antidepressants (actually, big pharma is probably already on the case, so EA doesn’t have to take this on)
trying to find various ways to lower the birthrate, and especially of disproportionately lowering the birthrate of people likely to have miserable lives (ie children likely to grow up impovershed / mentally ill / etc), or perhaps improving future people’s mental health via IVF polygenic selection for low neuroticism and low depression.
Finally, I would have a lot of questions about the exact theory of impact here and the exact pros/cons of enacting a MAID-style law in more places. From afar (I don’t know much about suicide methods), it seems like there are plenty of reasonably accessible ways that a determined person could end their life. So, for the most part, a MAID law wouldn’t be enabling the option of suicide for people who previously couldn’t possibly commit suicide in any way—it’s more like it would be doing some combination of 1. making suicide logistically easier / more convenient, and 2. making suicide more societally acceptable. This seems dicier to me, since I’d be worried about causing a lot of collateral damage / getting a lot of adverse selection—who exactly are the kinds of people who would suicide if it was marginally more societally acceptable, but wouldn’t suicide otherwise?
If EA decided to spearhead this movement, I fear it would risk permanently politicizing the entire EA movement, ruining a lot of great work that is getting done in other cause areas.
I agree with this strongly—I initially put at the end of this post that I think most of this work should be done outside of EA spaces for the sake of the movement’s reputation but deleted that part for reasons I can’t fully remember.
I’m picturing that in the USA this would become a significant culture-war issue at least 10% as big as the pro-life-vs-pro-choice wars over abortion rights. [...] (Maybe in some European countries this kind of law would be an easier sell?)
I also agree with this—I think if I were to pursue this as a project it would be a matter of going after low(er)-hanging fruits in the more liberal countries of Europe to normalize it a bit and then bringing it to bigger/more difficult countries. Similar to the approach that is currently being taken for approval voting, drug legalization, etc. I’m not sure if it would ever pass in the US, at least not in my lifetime, though if it were available to non-citizens elsewhere (also a big lift) that could be a way around that.
Finally, I would have a lot of questions about the exact theory of impact here and the exact pros/cons of enacting a MAID-style law in more places. From afar (I don’t know much about suicide methods), it seems like there are plenty of reasonably accessible ways that a determined person could end their life. So, for the most part, a MAID law wouldn’t be enabling the option of suicide for people who previously couldn’t possibly commit suicide in any way—it’s more like it would be doing some combination of 1. making suicide logistically easier / more convenient, and 2. making suicide more societally acceptable. This seems dicier to me, since I’d be worried about causing a lot of collateral damage / getting a lot of adverse selection—who exactly are the kinds of people who would suicide if it was marginally more societally acceptable, but wouldn’t suicide otherwise?
I think more research is needed on this, absolutely. One thing I also didn’t mention is that we discussed this in an ethics class I took for my master’s degree and I believe some author had speculated that the added bureaucracy of going through this sort of approval process might actually force people to reflect on their life in a way that they wouldn’t if they resorted to more accessible means. And there may be other psychological impacts of it that we don’t fully understand, e.g. it could also be opening up the conversation/gateway to more intensive treatment methods that people might otherwise be afraid to access for fear of being locked up in a psych ward.
As you mention, the scale seems small here relative to the huge political lift necessary to get something like MAID passed in the USA. I don’t know much about MAID or how it was passed in Canada, but I’m picturing that in the USA this would become a significant culture-war issue at least 10% as big as the pro-life-vs-pro-choice wars over abortion rights. If EA decided to spearhead this movement, I fear it would risk permanently politicizing the entire EA movement, ruining a lot of great work that is getting done in other cause areas. (Maybe in some European countries this kind of law would be an easier sell?)
If I was a negative utilitarian, besides focusing on longtermist S-risks, I would probably be most attracted to campaigns like this one to try and cure the suffering of cluster-headaches patients. This seems like a much more robustly-positive intervention (ie, regular utilitarians would like it too), much less politically dangerous, for a potentially similar-ish (???) reduction in suffering (idk how many people suffer cluster headaches versus how many people would use MAID who wouldn’t otherwise kill themselves, and idk how to compare the suffering of cluster headaches to that of depression).
In terms of addressing depression specifically, I’d think that you could get more QALYs per dollar (even from a fully negative-utilitarian perspective) by doing stuff like:
funding Strongminds-style mental health charities in LMIC (and other semi-boring public-health-policy stuff that reduces depression on a population level, including interventions like “get people to exercise more”, or “put lithium in the drinking water”, or whatever)
literally just trying to use genetic engineering to end all suffering
using AI to try and discover amazing new classes of antidepressants (actually, big pharma is probably already on the case, so EA doesn’t have to take this on)
trying to find various ways to lower the birthrate, and especially of disproportionately lowering the birthrate of people likely to have miserable lives (ie children likely to grow up impovershed / mentally ill / etc), or perhaps improving future people’s mental health via IVF polygenic selection for low neuroticism and low depression.
Finally, I would have a lot of questions about the exact theory of impact here and the exact pros/cons of enacting a MAID-style law in more places. From afar (I don’t know much about suicide methods), it seems like there are plenty of reasonably accessible ways that a determined person could end their life. So, for the most part, a MAID law wouldn’t be enabling the option of suicide for people who previously couldn’t possibly commit suicide in any way—it’s more like it would be doing some combination of 1. making suicide logistically easier / more convenient, and 2. making suicide more societally acceptable. This seems dicier to me, since I’d be worried about causing a lot of collateral damage / getting a lot of adverse selection—who exactly are the kinds of people who would suicide if it was marginally more societally acceptable, but wouldn’t suicide otherwise?
Thanks for the comment!
I agree with this strongly—I initially put at the end of this post that I think most of this work should be done outside of EA spaces for the sake of the movement’s reputation but deleted that part for reasons I can’t fully remember.
I also agree with this—I think if I were to pursue this as a project it would be a matter of going after low(er)-hanging fruits in the more liberal countries of Europe to normalize it a bit and then bringing it to bigger/more difficult countries. Similar to the approach that is currently being taken for approval voting, drug legalization, etc. I’m not sure if it would ever pass in the US, at least not in my lifetime, though if it were available to non-citizens elsewhere (also a big lift) that could be a way around that.
I think more research is needed on this, absolutely. One thing I also didn’t mention is that we discussed this in an ethics class I took for my master’s degree and I believe some author had speculated that the added bureaucracy of going through this sort of approval process might actually force people to reflect on their life in a way that they wouldn’t if they resorted to more accessible means. And there may be other psychological impacts of it that we don’t fully understand, e.g. it could also be opening up the conversation/gateway to more intensive treatment methods that people might otherwise be afraid to access for fear of being locked up in a psych ward.