Thank you for writing. I had question about this come up a few times when I was community building so it is helpful to see an effective altruism discussion on the topic.
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One area of your post that confuses me, where (intuitively) I disagree with you is on your push back against family planning charities.
My understanding is that the charities you mention, Family Empowerment Media and Maternal Health Initiative, are trying to empower women with knowledge about and access to contraception. This supports women’s autonomy and right to decide on their family, and is good for maternal health and childhood health (due to more spaced out births). Neither charity has that I know of made a stance for or against abortion and they do not work on abortions, but my assumption would be that more deliberate use of contraception would mean less unwanted pregnancies and less abortions. So, if you care about the moral value of embryos then supporting access to contraception could be among the most effective places to donate.
So, I would have expected you to advocate people donate more to these charities not less.
(I can see a case for not donating to such charities out of moral uncertainty reasons but I could also see a case for avoiding working at all on abortion reduction for moral uncertainty reasons so not really sure where to take that line of argument).
Disclaimer: I work for Charity Entrepreneurship, the organisation that incubated both of the above charities. All views are my own and do not represent Charity Entrepreneurship or anyone else.
I think the evidence for this is surprisingly slim. Generally in developing countries contraception promotion has both positive and negative effects on abortions—it reduces the chance of a pregnancy in any given case of sexual intercourse, but a) increases sexual intercourse, disproportionately in ‘risky’ situations; and b) potentially increases the unwantedness of any given pregnancy as well. Moreover, the unmet need for contraception in developing countries is also pretty low, and the proportion of this which is due to lack of access is very small—so the number of women not using contraception because they lack access to it is pretty miniscule.
Do you have a source for the claim that providing contraception disproportionately increases risky sex + the unwantedness of a pregnancy?
the unmet need for contraception in developing countries is also pretty low—so the number of women not using contraception because they lack access to it is pretty miniscule.
Also, can you quantify this? Not sure what your source is, but a brief google search suggests that “sub-Saharan Africa had the lowest use of modern contraceptives (24%) and demand satisfied (52%).”
The same source suggests that ~10% of women globally with a need for contraception do not have it met (for a total of ~160million women with unmet need), and ~half of these women live in sub-Saharan Africa and South Asia. I haven’t checked the methodology personally, but probably not the number I’d consider “pretty miniscule”.
Thanks for asking, Bruce. Yes, regarding contraception increasing risky sex, it’s been a while since I looked at this literature but here are some of the references from my notes on it:
I don’t agree that the conclusions regarding low unmet need for contraception in developing countries, and this being due to access, is correct based on the sources that you have linked (although thanks for providing sources).
I just had a very quick (<5 minute) look at some of the sources regarding the low unmet needs for contraception in developing countries, largely because it goes against what I would expect (lower resource settings having proportionally higher resources in this area than high resource settings). Because I looked very quickly I’ve so far only looked at the abstract/highlights, however I expect that nothing in the main text would contradict this.
The source you gave for ‘low unmet need for contraception in developing countries’: https://pubmed.ncbi.nlm.nih.gov/23489750/
It does say that generally contraceptive prevalence has gone up and unmet needs have gone down (this is a good thing, i.e. progress), unless this was already high or low respectively (not surprising, a low unmet need can only decrease by a lesser degree than a high unmet need).
However: “The absolute number of married women who either use contraception or who have an unmet need for family planning is projected to grow from 900 million (876-922 million) in 2010 to 962 million (927-992 million) in 2015, and will increase in most developing countries.”
This suggests that the unmet need is projected to increase more in developing countries compared to others.
The sources on access: https://www.guttmacher.org/sites/default/files/pdfs/pubs/Contraceptive-Technologies.pdf
It does suggest that 7 in 10 cases access may not be main the issue: “Seven in 10 women with unmet need in the three regions cite reasons for nonuse that could be rectified with appropriate methods: Twenty-three percent are concerned about health risks or method side effects; 21% have sex infrequently; 17% are postpartum or breast-feeding; and 10% face opposition from their partners or others.” But: “In the short term, women and couples need more information about pregnancy risk and contraceptive methods, as well as better access to high-quality contraceptive services and supplies.”
It also says that a quarter of women in developing countries have an unmet need: “In developing countries, one in four sexually active women who want to avoid becoming pregnant have an unmet need for modern contraception.” I would not call that low, and I think this is one of those cases of it being important to put number on it otherwise people may have different definitions of what is/isn’t low.
(A very quick estimate using the first links that come up on Google: 152 developing countries, population approx 6.69 billion total, say therefore around 3.35 billion who are female.
Turns out a quick Google does not bring up the proportion of women who are of childbearing age (15-49), but an interesting 2019 UN source on the need for family planning does come up which breaks down the unmet needs by region and is consistent with saying around 1⁄4 of women in developing countries have unmet needs: https://www.un.org/en/development/desa/population/publications/pdf/popfacts/PopFacts_2019-3.pdf That UN source has a quote: “In 2019, 42 countries, including 23 in sub-Saharan Africa, still had levels of demand satisfied by modern methods below 50 per cent, including three countries of sub-Saharan Africa with levels below 25 per cent ”
Back to that raw numbers estimate I was attempting: 1⁄4 of 3.35 billion is around 840 million for the unmet needs part. Maybe classing 1⁄3 of those women being of childbearing age/benefiting from contraceptives. That’s around 280 million people.)
The second source of access: https://pubmed.ncbi.nlm.nih.gov/24931073/
This has less information than the others as I can by default only see the abstract
“Our findings suggest that access to services that provide a range of methods from which to choose, and information and counseling to help women select and effectively use an appropriate method, can be critical in helping women having unmet need overcome obstacles to contraceptive use. ” Suggesting that access is critical, and might imply that this is at least in part a reason for the unmet needs.
Edit: me reading the sources took about 5 minutes, the above writeup including me looking some stuff up (perhaps unsurprisingly) took a bit longer than that. I see having posted that Matt Sharp has also made a reply which says something very similar to what I am, would recommend reading that as well.
Thank you Lin for your thoughtful comment. I gave some further thoughts to Matt above, and it felt rude to copy and paste that comment again here. But if you have a particular hesitation which I haven’t addressed to Matt above please do let me know and I’ll do my best to come back to you on it.
“In 2010, 146 million (130-166 million) women worldwide aged 15-49 years who were married or in a union had an unmet need for family planning. The absolute number of married women who either use contraception or who have an unmet need for family planning is projected to grow from 900 million (876-922 million) in 2010 to 962 million (927-992 million) in 2015, and will increase in most developing countries.
Interpretation: Trends in contraceptive prevalence and unmet need for family planning, and the projected growth in the number of potential contraceptive users indicate that increased investment is necessary to meet demand for contraceptive methods and improve reproductive health worldwide.”
Seven in 10 women with unmet need in the three regions cite reasons for nonuse that could be rectified with appropriate methods: Twenty-three percent are concerned about health risks or method side effects; 21% have sex infrequently; 17% are postpartum or breast-feeding; and 10% face opposition from their partners or others.
In these three regions, the typical woman with reasons for unmet need that could be addressed with appropriate methods is married, is 25 or older, has at least one child and lives in a rural area.
In the short term, women and couples need more information about pregnancy risk and contraceptive methods, as well as better access to high-quality contraceptive services and supplies.
In the medium term, adaptations of current methods can make these contraceptives more acceptable and easier to use.
Investment in longer-term work is needed to discover and develop new modes of contraceptive action that do not cause systemic side effects, can be used on demand, and do not require partner participation or knowledge.
Overcoming method-related reasons for nonuse of modern contraceptives could reduce unintended pregnancy and its consequences by as much as 59% in these regions.
Our findings suggest that access to services that provide a range of methods from which to choose, and information and counseling to help women select and effectively use an appropriate method, can be critical in helping women having unmet need overcome obstacles to contraceptive use
I’d also note that because demand for contraception tends to increase with better education, we would expect demand to increase over time. If supply does not increase to meet this demand, then unmet need will increase.
Thanks, Matt. Sorry I was heading out earlier so didn’t have time to elaborate as much as I would have liked. When I say unmet need for contraception (UMC) is low, I meant proportionally—by 2010 it was just over 10%, and I would guess is significantly lower still now. Of course, 10% globally is still a lot of people, but these are presumably the hardest people to reach and it is not clear how cost-effective doing so would be—moreover, it seems clear that even if we did manage to reach those 10%, the abortion rate would hardly decline by that much—so it is a pretty limited strategy for reducing abortions, if it is effective at all.
Regarding the second paper, table 5 indicates that only 8% of women with UMC globally lacked access (including because of cost). Table 3 in the third paper shows similar. So it still seems that only a very small proportion of women globally—perhaps 1% in 2010 - have a UMC because of lack of access to contraception.
There probably are interventions which could increase contraceptive uptake—but I don’t think they are by any means simple, and they are not generally solving lack of access per se. The access is there, even if the relevant education or empowerment of women is not. As indicated in the rest of my previous post, even if this were solved, it is still not clear to me that it would reduce abortions, given the counterbalancing effects contraception promotion has on sexual behaviour and desired family size. It seems particularly doubtful that it would reduce abortions by a large amount.
You are right that as education increases, desired family size generally falls, and contraception demand will grow. But I don’t see that there is a significant risk of contraception supply failing anytime soon. Even under the Mexico City Policy, which was widely held to significantly impede access to contraception, contraceptive use in the affected countries (turquoise—unaffected countries in orange) rapidly increased:
This, I suppose, is relevant to the EA discourse on neglectedness—with the emphasis on contraception in international development circles, it seems unlikely that slightly trimmed down support for it is going to significantly impede it or significantly increase abortion rates. But I confess I am only really on the peripheries of EA so I might be outdated with the neglectedness stuff.
Hi, thanks for your comment! You make a fair point that my essay isn’t precise enough about the potential moral caveats of these charities, and I’ll try to elaborate on that here.
It looks like one common source of confusion is what the precise reasons are for why abortion may be wrong. If abortion were wrong only because embryos could have personhood, then you’d be absolutely correct that we should donate more to family planning charities which reduce the number of abortions rather than less.
However, it seems to me that a stronger reason why abortion may be wrong is for the same reason longtermists oppose x-risk: It reduces the expected amount of future people. I briefly sketch the argument in the “Increasing the Amount of Near-Term Future People” section, but I could have done a better job of it, and elaborate some more in this comment. The magnitude of the difference between adding a future person and saving a living person is debated, but it seems that many prominent EAs consider it to be close to as good as saving a living person today. What we Owe the Future’s “Is it Good to Make Happy People?” (Chapter 8) does a great job of making that case, though some disagree.
For an example of where this consideration could be relevant, consider this statement from Family Empowerment Media (FEM)’s founders:
A commitment of $7 million would fund FEM’s scaling plans over the next four years, preventing ∼3100 maternal deaths and ∼340,000 unintended pregnancies.
Let’s assume 10% of those unintended pregnancies would have been carried to term and not counterfactually replaced (to avoid child replaceability concerns). In that case, this intervention would prevent 34,000 lives from being lived, far more than the 3100 maternal lives saved. If we’re sympathetic to the above arguments (as many longtermists are), then this well-meaning intervention could arguably be doing much more harm than good.
It’s critical to note that supporting women’s autonomy, maternal health, and economic outcomes is a deeply important cause, and CE’s family planning charities absolutely contribute to those good outcomes. However, it seems to me that the
case for not donating to such charities out of moral uncertainty reasons
you pointed to could be quite strong, and that there are many other interventions which support women’s empowerment and maternal health without this possible serious negative externality.
I’d also like to note that I’m not saying EAs should never donate to FEM or its related charities. I only believe that the moral considerations are serious enough that we should temporarily suspend our support for these charities until we’ve systematically reviewed the effect of these considerations.
It could be that a systematic review uses randomized controlled trials to verify that FEM’s interventions don’t reduce the expected amount of future people at all and only space out births. The review could also show that replaceability should be accorded much higher credence than many actually accord it, and argue that even with these moral considerations, the absolute effect of FEM’s interventions is good. In that case, the suspension of support for FEM should be reversed.
I think it’s important to also take into account the moral risks of refusing funding for family planning specifically because you want others to have more unintended pregnancies. On broadly Kantian-inspired views, for example, this would plausibly qualify as objectionably treating people as mere means.
FWIW, I favour interventions that give people more control over their lives, including reproductive autonomy, along with making it easier for people to have more kids when they’re ready and they positively want this.
There’s no doubt that the considerations you pointed out are deeply relevant. When considering this issue, women’s autonomy and physical, mental, and economic health are of paramount importance. One way to support these values is through FEM and its related charities. Another way is through charities like the Fistula Foundation and GAIN’s Salt Iodization program. It seems that the second way also achieves the aims we want—women’s health and autonomy—while avoiding the possible serious negative externality.
As an analogy, many Ethiopians suffer from malnutrition. Let’s say well-meaning EAs sponsored an “EA steakhouse” in Ethiopia, as steak can provide crucial nutrients to people in extreme poverty. There seem to be other interventions, including GAIN’s Salt Iodization program, which also target malnutrition, without the possible serious negative externality of animal suffering. In that case, I think we should temporarily suspend our support for the steakhouse while we evaluate the relevant moral considerations. In the meanwhile, Ethiopians can still eat steak at non-EA steakhouses if they’d like (as other well-meaning altruists have sponsored steakhouses of their own), or acquire steak through other means—we wouldn’t be reducing their ability to voluntarily eat steak if they so choose. Our goal—combating malnutrition—remains the same, but we choose the intervention to accomplish that goal without the possible negative externality.
Your disclaimer says this post is specifically about voluntary abortion reduction. But claims such as “the possible serious negative externality” of women not having kids because they get access to information or contraception or family planning, combined with recommendations that “support for these charities should be suspended” make this sound less about voluntary abortion reduction than you might intend, given family planning interventions are usually targeted at women who don’t want to become pregnant in the first place.
It sounds like you go further than recommending people to voluntarily consider not having abortions. For example, you recommend that charities should have their support suspended because of population size / longtermist arguments. This sounds like you are making the case that actions which limits access to contraception / family planning (because doing so results in this “possibl[y] serious negative externality”) are justifiable for purposes of increasing population size. Can you clarify if this is what you mean?
Given the post is specifically about voluntary abortion reduction, it’s not clear to me that interventions focussing on women who have unmet needs (i.e. women who don’t want to be pregnant) for contraception are a relevant consideration? Sorry if I’ve missed something, only briefly skimmed.
Hi Bruce, I think your concern boils down to a semantic disagreement on the definition of “voluntary” in this case. If we are one among many providers of service X, and we decide to stop providing, is that an intervention which involuntarily prevents people’s access to that service?
I think the relevant semantic disagreement is: My view is that if provider of service X is targeted at women who do not want children, then changes to provision of service X is irrelevant to “a case for voluntary abortion reduction”, because by decreasing provision of service X, you haven’t made it so these women are voluntarily wanting more children / less abortions, you’ve just made it so they have less of a choice, whereas it seems like you disagree.
It sounds like I’m misunderstanding you though, so perhaps it’s more useful if you clarify / define what you mean by “voluntary abortion reduction”.
you haven’t made it so these women are voluntarily wanting more children / less abortions, you’ve just made it so they have less of a choice, whereas it seems like you disagree.
That’s a compelling distinction! I’m better understanding what you mean now. We can narrow the set of interventions which affect a service down to three types:
Voluntary: The service remains the same, but users of the service are incentivized to change their behavior.
Voluntary?: Some providers stop offering the service, but the service remains available with other providers.
Involuntary: All providers stop offering the service.
I’m keeping the situation abstract as a service to try to show why I think the “Voluntary?” type is distinct from the involuntary type.
Would advocating for a platform to reduce hate speech impressions be an involuntary imposition on free speech? They can always use a different platform.
Would a doctor personally deciding to not perform abortions be an involuntary imposition on abortion seekers? They can always find another doctor.
Would a wedding planning company deciding to not plan weddings for homophobes be an involuntary imposition on homophobe weddings? They can always find another wedding planner.
What you have convinced me on is that the “Voluntary?” type is more gray area than I thought. However, I still don’t think any of the situations I enumerated should count as involuntary impositions.
The two commonsense relevant definitions of “voluntary” you’ll find in the dictionary are “of one’s own free will” and “in the absence of payment.”
Reducing funding for abortion services may in some cases cause people to choose to carry a pregnancy to term when could have still obtained an abortion, perhaps by exerting more effort or taking on more risk. Since they were not paid to not have an abortion, I suppose it is technically “voluntarily” in the second sense, in the same way that criminalizing homosexuality caused people to “voluntarily” have less homosexual sex.
While I grant you the benefit of the doubt, I tend to see this kind of subtle misuse of language in a native English speaker (as I assume you are?) as a deliberate obfuscating move rather than a slip-up, so you may want to reconsider your linguistic choices in the future to avoid creating that impression.
I think more to your point, there is a difference between “freedom from” and “freedom to,” or positive and negative rights. Many people feel people should have freedom from being legally prevented from seeking an abortion, but not necessarily that we should subsidize their ability to have an abortion. I read your post as about eliminating subsidies for family planning, as well as encouraging voluntary increased child rearing.
I strongly disagree with the comparison between (a) proposals to suspend EA funding for services which reduce the amount of future people and (b) criminalizing homosexuality.
I don’t think there’s any “subtle misuse of language” which causes one to be anywhere near the other. Isn’t the comparison between (a) and any of the analogues I gave in my above comment far more natural? How are any of those anywhere near criminalizing homosexuality? If anything, comparing (a) to criminalizing homosexuality could constitute a “deliberate obfuscating move.”
I think we’re both acting in good faith here, and I’m willing to admit a passion for this cause which can affect the impartiality with which I react to comments. All I can say is that I really don’t see things that way, and I don’t think there’s anything unreasonable about recognizing (a) and (b) as fundamentally different.
Would a doctor personally deciding to not perform abortions be an involuntary imposition on abortion seekers? They can always find another doctor.
It sounds like the crux here is the extent to which these women have many options RE: access to safe abortion services—this could be an involuntary imposition if they’re the only doctor in a 100km radius, for example, or if other doctors are so busy they don’t have time to look after additional patients.
It’s also not all-or-nothing, it could be the case that there are many other doctors, but only one doctor with the skill to perform abortions, or many other doctors accessible by car but not by foot etc, or doctors available but are less affordable.
Unfortunately, the bar is much higher on your end, because if only a minority of women who previously were using service X now no longer have an alternative, this would be an involuntary imposition on this small minority, so if you’re suggesting that “any involuntary intervention is out of scope”, then you’d also have to show that all users of service X have similar access to a functional equivalent. I don’t know if this is the case personally, but it would surprise me if the charity’s nonexistence did not change the number of women with access to family planning / abortion. Presumably if this were the case, these charities would be working in a fairly non-neglected context, and thus not worth funding purely on cost-effectiveness / neglectedness considerations.
It sounds like the crux here is the extent to which these women have many options RE: access to safe abortion services
Yes, I think this is close to the consensus on definition we’re reaching. The only quibble I have with this is that I think the level of “obligation” on the service provider to provide a service is also relevant.
The publishing platform has no obligation to host content it considers hate speech.
The anti-abortion doctor has no obligation to perform abortions.
The homophobe-phobic wedding planning company has no obligation to plan any particular person’s wedding.
Similarly, I don’t think EA can be said to have an “obligation” to provide funding for any particular cause, unless that cause is clearly and unambiguously more important than EA’s erstwhile top priorities. In that regard, I don’t think that a proposal to withdraw EA funding for some service constitutes an involuntary imposition on the service’s recipients, especially given conditional on the option that the recipients can procure the service in other ways.
Thanks for the engagement! There’s a lot going on here. Responding first to:
especially given that the recipients can procure the service in other ways.
I’m just noting that your comment on the recipients being able to procure services elsewhere is prefaced with the word “especially”, and not something like “conditional on”. This implies that the ability of the recipients being able to procure services elsewhere is not a necessary factor of determining whether this constitutes a voluntary or involuntary imposition.
So if you’re saying something like “Because EAs don’t have an obligation to provide funding to any cause, no withdrawal for funding can constitute an involuntary imposition on the service’s recipients, irrespective of whether these women have other options available” then this is something I pretty strongly disagree with. It seems to me that what EA funders’ moral obligations are here are either irrelevant or vastly dominated by the experience of the recipient when deciding whether this action contributes to a voluntary reduction in abortion or an involuntary reduction?
From the perspective of a pregnant woman seeking abortion, they don’t care about what the EA funder’s obligation are. All she knows is that last year her friend had access to affordable abortion services, and this year she doesn’t have the same choice. I don’t really understand how this could be really considered meaningfully voluntary, even if she decides to keep the baby instead of try a dangerous DIY method at home (though clearly, many women will do this).
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In that regard, I don’t think that a proposal to withdraw EA funding for some service constitutes an involuntary imposition on the service’s recipients, especially given that the recipients can procure the service in other ways.
More generally, it might be true that recipients can procure the services in other ways, but I’d like to see this claim actually justified for the charities that you are suggesting should have their funding suspended, or added as a caveat above (“conditional on these recipients being able to access the same quality of care elsewhere at no meaningful cost...etc), alongside the other philosophical caveats you’ve provided.
Otherwise it’s an open Q whether the recipients can in fact procure the services in other ways, what costs they may have to bear in order to do so (also see above RE: the bar being higher on your end in terms of showing that such recommendations for suspensions result in no involuntary impositions), and whether this harm is worth the benefits it brings, especially considering 2nd order considerations such as those raised by a commentor above.
I’m pretty hesitant to update in your direction until I see at least an attempt at quantifying this.
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For what it’s worth, most of this message above and an earlier comment was me going along with your usage of the terms voluntary / involuntary, but I think this is actually quite a misleading use of these terms. (Mainly in response to your comment RE: “consensus on definition”, as I don’t want to give the impression I am endorsing this definition, but just that I am trying to understand it more clearly). That being said—I’m not suggesting you are being intentionally misleading!
Hypothetical analogy: suppose you think higher homelessness rates are better. Suppose you know that there’s a subset of researchers who applied for funding from EA sources because they wanted a way to pay rent. Would you say that because EA funders have no obligation to provide funding for any cause, that such a withdrawal of funding, for the purpose of increasing homelessness rates (and against your best guess for what the researcher would want for themselves), would be appropriately classified as “increasing voluntary homelessness”?
By your usage of voluntary and involuntary, this would depend on whether or not they could find a source of $ elsewhere. But I think my original interpretation is that even if you showed me that these researchers could find $ elsewhere for rent, it would still be inaccurate for this suspension of funding to be classified as “increasing voluntary homelessness”, because the mechanism by which this increases homelessness is decreased access to alternatives, not because it is empowering people to make the choice of becoming homeless because they wish to be for their own reasons. (This doesn’t at all interact with the possibility that suspension of funding is the right call for other reasons, e.g. if their research isn’t adding a lot of value, or if this isn’t neglected because they have many other funding options available).
I hope this illustrates my concern with the “suspending funding” recommendation based on “voluntary abortion reduction” arguments. (i.e. I think the definitions you use are contrary to my best guess of what most people would interpret as “voluntary abortion reduction”, but even by your own definition, you provide pretty limited support for the extent to which other options are available).
I think that the main relevant question in determining whether the abortion reduction is voluntary or not should be: “Are the women in question making a well-informed, uncoerced choice that keeping the baby is preferable to a safe abortion, or are the women in question ‘choosing’ to keep the baby because there are limited alternatives available to them?”
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The anti-abortion doctor has no obligation to perform abortions.
Minor nitpick: I’m not sure if you’re talking about a moral or legal obligation here, and I guess it may vary by jurisdiction, but it’s not as clear cut as written here. When a doctor conscientiously objects to providing a service (i.e. refuse to provide a service that is against their personal values), there’s a clear case to be made that it is the doctor’s professional obligation to let the patients know what options they have available and how they can access this care from other doctors who can provide this service, such that their personal values do not not meaningfully impact their patients’ health outcomes and access to treatment. And if there are no other options available, and conscientious objection will compromise healthcare delivery then this may be unacceptable.
I agree that a charity / EA funding may not be held to the same standard as a medical doctor in terms of moral obligations, but the same thought process is relevant in terms of taking into account how much harm you may be contributing to in expectation. To reiterate though, the extent to which EA funders or doctors are obligated to provide this service is (imo) not particularly relevant to whether or not the women in question are now voluntarily choosing not to have abortions.
(btw the disagree votes on your comments in this thread aren’t coming from me)
On “especially,” yep, that was an incorrect use of words, and I’ve edited my comment accordingly. Thanks for pointing that out!
Based on your considerations, and after thinking about it some more, I retract the “obligation” point, and now agree that the fact that we’re not “obligated” to fund this cause doesn’t make the downstream effects of the funding redirection “voluntary” or “involuntary” for the recipients.
it might be true that recipients can procure the services in other ways, but I’d like to see this claim actually justified for the charities that you are suggesting should have their funding suspended
Of the charities I mentioned, to the best of my knowledge, only PSI actually provides abortions. DMI and FEM run media campaigns encouraging contraception. MHI connects women with contraception access. On DMI, FEM, and MHI, Calum suggests that the unmet need for contraception due to lack of access is quite low, and supports his suggestion pretty well IMO.
I think PSI is where your point is strongest, since it seems very difficult to rule out the possibility that there exists some place where PSI is the only abortion provider. However, PSI is not an EA charity, and it seems very unlikely that removing its recommendation from The Life You Can Save’s website would cause it to stop being able to offer its services where there’s the greatest unredirectable demand.
As for whether or not the intervention’s harm is worth the benefits it brings, I’d like to point out that this concern is orthogonal to the question of whether or not the intervention could be considered “voluntary.” That said, I would say yes, and that’s the reasoning I use to recommend it.
[homelessness analogy]...the definitions you use are misleading and contrary to my best guess to what most people would interpret as “voluntary abortion reduction”
Your homelessness analogy is a good one, and it does accurately show how my use of the term “voluntary” could have been misleading. I have some regrets about the whole structure of my post in that regard. I reply to Julia Wise’s similar concern here, which might help explain much more about my thought process.
(btw the disagree votes aren’t coming from me)
No worries! I used to go on Reddit often, and as you can imagine from our interactions, I was prone to getting heavily downvoted :P To avoid motivated/emotion-driven “reasoning”, I made a personal rule to never downvote anyone on Reddit for any reason. I’m off Reddit now, but I’ve always maintained the rule that I never downvote respectful discourse. I think engagement is better than a disagree-vote, and strive to avoid the latter in favor of the former.
To close (as frankly, there’s only so much brainpower I’m willing to extend on this semantic consideration), I maintain that the interventions I suggest would be the right thing to do. However, there’s a sensible case that there are reasonable definitions of “voluntary” which readers understandably presuppose when reading the post for which the interventions don’t qualify. Though I maintain that there are senses in which they do qualify, I think you’ve made an excellent case that there’s substantial ambiguity there which can blindside readers. I’d appreciate if you read my reply to Julia Wise’s similar concern (which helps to spell my actual intention behind the post), and let me know what you think would be the best way to disambiguate while staying true to the post’s scope.
Thanks! Happy to see real-time updates on the internet.
I did see Calum’s papers—I didn’t reply because I didn’t have time to meaningfully engage with all those sources, and it looked like others replied first. There were some info that surprised me, but on a very brief skim, I don’t know if those sources actually bring me to the conclusion of:
Moreover, the unmet need for contraception in developing countries is also pretty low, and the proportion of this which is due to lack of access is very small—so the number of women not using contraception because they lack access to it is pretty miniscule.
RE: harm vs benefit tradeoff, I agree that this is basically irrelevant in terms of whether this is voluntary or not, though it is relevant in terms of deciding whether or not I should accept the suggestion at face value.
To close (as frankly, there’s only so much brainpower I’m willing to extend on this semantic consideration), I maintain that the interventions I suggest would be the right thing to do.
Makes sense RE: capacity. Yeah, I’m not engaging with whether this is the right thing to do, all things considered—you could make a case for example that money spent on these charities could plausibly be better spent elsewhere, though to be clear, I would personally find it pretty aversive to justify this primarily because we wanted higher rates of unwanted pregnancies to increase population size. I’m mainly suggesting that even if you think this is the right thing to do, it shouldn’t be considered “voluntary abortion reduction” for the reasons I illustrate above.
RE: your response to Julia’s, I’ll add a quick comment in that thread.
Thanks for your response. Just to clarify, part of my concern is with the possible disrespect inherent in regarding the avoidance of unwanted pregnancies as a “possible serious negative externality”. I don’t think that’s a good (or respectful) way to think about it, and accordingly I don’t think the “steakhouse” analogy works (because, to be clear, the moral reasons we have to defer to individual women about the desirability of them personallybecoming pregnant have no analogue in the steak case—individuals do not have the moral authority to determine whether them personally eating meat is morally good or bad).
Of course, you might disagree about whether respect for individual women calls for this kind of deference or granting of moral authority over whether it’s good or bad for them personally to become pregnant. But I think it’s sufficiently credible that you should give it significant weight in moral uncertainty. And that means that there’s a significant moral risk to the kind of argument that you’re putting forward here, which involves depriving them of that moral authority.
(Note that there is no such risk to the alternative many are urging here, of supporting pro-fertility policies in a way that’s fully co-operative with—rather than potentially adversarial towards—the wishes and choices of individual women.)
I don’t think the “steakhouse” analogy works (because, to be clear, the moral reasons we have to defer to individual women about the desirability of them personallybecoming pregnant have no analogue in the steak case—individuals do not have the moral authority to determine whether them personally eating meat is morally good or bad).
The two situations seem pretty analogous to me. In both cases there is some prima facie plausible personal autonomy case on one side (it certainly seems plausible people have the right to choose what food they eat!) and a prima facie harm to third parties on the other (with debate about whether those third parties are morally relevant). In both cases the person has some moral authority (to decide if eating meat is good for them) but not complete (they can’t decide if eating meat is bad for the animals).
There’s no prima facie harm from contraception. There’s a possible foregone benefit, but one it would be arguably illicit to obtain by treating the provider as a mere means.
A better analogy would be to stop supporting medical treatment for car accident victims, because if we let them die we could use their organs to save more others.
You’re not talking about averting negative externalities, but about promoting exploitation of others without their consent. I don’t think EA should countenance such reasoning.
Sorry, I think we may have been talking past each other. I was referring to abortion, which presumably you would agree does have a prima facie harm, and hence is comparable to the steakhouse situation.
Yes, that’s right—thanks for clarifying. (For context, note that upthread Ariel wrote: “If abortion were wrong only because embryos could have personhood, then you’d be absolutely correct that we should donate more to family planning charities which reduce the number of abortions rather than less. However...” So our dispute was about whether preventing unwanted pregnancies should count as a “possible negative externality”.)
(Edited to add: I’m speaking only in a personal capacity here, and not on behalf of my employer.)
If you try to account broadly for indirect effects and externalities, it’s not clear you’ve arrived at the right stance on abortion and population reduction. There are many effects to consider:
Withdrawing support for (or actively opposing) abortion and the reasoning here to do so could have impacts on norms/values around exploitation and treating others like mere means (or allowing them to be treated like mere means), like Richard suggests, so (EDIT) to make explicit, have other negative effects for women and girls (or others) in the near term. Norms more permissive of exploitation and treating others like mere means may make us more prone to conflict and less cooperative in general, and so more prone to catastrophic conflicts and missing opportunities for positive sum trades. Values in general via value lock-in and such effects on conflict and cooperation in particular could even have far-future effects.
Abortion and population reduction (for humans) could go either way for nonhuman animals. I’d guess they’re good for farmed animals by reducing animal farming and because I think farmed animals mostly have bad lives (even on symmetric ethical views, although my views are suffering-focused), and the sign for wild animals (whose populations would plausibly increase) will depend on your expectations about their average welfare. I’d guess this would be limited to impacts on Earth, but humans might colonize space themselves and bring nonhuman animals with them, and more humans colonizing space could mean more nonhuman animals brought with them.
Abortion and population reduction could mitigate climate change, which may have near-term effects on humans and nonhuman animals, as well as far-future effects.
Moral circle expansion towards fetuses could transfer to MCE for other (far future) minds with limited cognitive capacities or agency, or otherwise in situations similar to fetuses.
Economic and technological effects from increased population or reducing costs on children (in time or money), which could possibly even compound into the far future.
There are a few broad practical responses to all of this that I can think of:
Try harder to quantify and compare these effects (EDIT: in some cases, rough bounds can be useful enough), and try to ensure you’re capturing a relatively unbiased subset of indirect effects, and especially the largest ones. Use this information to
come to an overall stance on specific interventions and support them accordingly, and/or
Cluelessness, and look for interventions that are more robustly positive to support and promote instead. This would also mean withdrawing support for human life-saving interventions (except possibly those that reduce existential risk overall, possibly). Possibly promote the withdrawal of support for abortion-affecting and human population-affecting interventions, including family planning interventions, interventions that incentivize people to have more children, life-saving interventions, and abortion reduction interventions.
Also, another possible response is 3. ignoring indirect effects, but this seems pretty unprincipled/unjustified and prone to systematic error to me. Ignoring cross-worldview or cross-cause indirect effects may be okay as an approximation to the portfolio approach if it’s done within a portfolio of interventions across causes/worldviews, because it’s plausible negative indirect effects can be made up for through more targeted/leveraged interventions for those causes/worldviews in the portfolios.
However, when I think of the current total EA portfolio of interventions, I think it’s pretty plausible we aren’t making up for possibly negative wild animal effects because agricultural land use is huge and fishing has huge population effects, and (although I’m much less informed on the issue) I also worry about s-risks being increased.
Yes, that’s absolutely a relevant consideration. I think there are similar considerations regarding the effect of supporting abortion on the permissiveness of bad societal norms:
The dehumanization of those outside one’s moral circle (“it’s just a clump of cells/parasite”, “it’s just a beast”, “they won’t even exist for millions of years”)
The callous treatment of moral patients whose existence is inconvenient (“it’s my body; I’ll do whatever I want with that fetus”, “who cares? meat tastes good”)
The masking of disenfranchisement of unrecognized moral patients as “rights” of recognized moral patients (“reproductive rights”, “the right to eat whatever I want”)
Yes, animal welfare considerations likely weigh in favor of abortion. I’d go even further than your statement and say they plausibly dominate the welfare concerns of both the woman and the fetus. Of course, this consideration plausibly dominates the purpose of many human-centric interventions, and the implications are scary. (That doesn’t mean I won’t think them through, but there’s only so fast I can overturn my worldview!) I know you have strong opinions on this, and would love to get any recommendations on reads you think would be enlightening on the subject.
Yep! That should also weigh in favor of abortion, though I personally think other concerns substantially dominate it.
100%
Yes. I could be persuaded either way on the sign of this consideration, because abortion does increase economic output per capita, but having more people should increase gross economic output on the margin.
On your responses:
Very cool! I wasn’t aware of research on this, and it makes perfect sense, including avoiding “sector risk” (e.g. a portfolio of human-centered interventions could be totally dominated by farmed animal welfare considerations).
I’m still making up my mind on the implications of cluelessness, but I agree that it updates towards not taking much concrete action on abortion as an EA cause area.
I think the human impacts on wild animals are primarily through agricultural land use, fishing and climate change, and most of these are largely affected by human diets (although climate change possibly dominated by fossil fuel use). Maybe also environmental pollutants/contaminants/toxins and forestry (I haven’t really looked into these). I’d guess the effects from the land humans take up in cities, towns, villages, etc., is not significant compared to these, based on Our World in Data.
For moral weights across animals (including humans):
I don’t know if the above covers all the strongest arguments for humans mattering substantially more than nonhuman animals, and I’d guess it doesn’t cover many such arguments in much detail. I don’t know off the top of my head what to recommend.
If you think the moral concerns about abortion is more about the prevention of future people instead of the value of the lives of the embryos, you should probably try to optimise for women having more children in the near term. It is not clear to me why you think preventing abortions is the best way to do so.
Hi Denise! I agree that optimizing for increasing the amount of children that families want and are able to happily have is probably better than voluntary abortion reduction as a means of increasing the amount of near-term future people. I apologize if I wrote anything which could give the implication that I “think preventing abortions is the best way to do so” (emphasis mine), as that is not my opinion.
As for why I decided to write a whole post on abortion reduction, here are some of my reasons.
It could be that a systematic review uses randomized controlled trials to verify that FEM’s interventions don’t reduce the expected amount of future people at all and only space out births.
Joey Savoi (CEO of Ambitious Impact, which was formerly Charity Entrepreneurship) said:
I am far less convinced that life saving interventions are net population creating than I am that family planning decreases it.
I agree with you it is unclear whether family planning interventions decreasing population are beneficial/harmful.
Part of the problem, I think, will be that this is such a highly politicised area that vague terms are often used so that it is not clear whether a charity is promoting abortion or not. I have seen a lot of this in developing countries in particular—family planning is promoted and contraception is the only element of this publicised—but abortion is promoted behind the scenes as well (because it is less glamorous and often illegal). All sorts of charities support abortion (in a variety of different ways) without many people realising—MSF, Oxfam, Water Aid, plausibly even groups like Christian Aid when you dig deep enough.
Of course none of this is specific evidence that FEM and MHI do so—but in general there is a pretty high prior probability that any given family planning organisation supports abortion in some way, and probably the presumption for anyone who opposes abortion is that family planning organisations have the burden of proving otherwise, given the prior probabilities. This may be unfair on those family planning organisations which genuinely don’t in any way support abortion—but unfortunately given the way the world is sometimes people have unfair burdens of proof.
I am not the best person to answer this question, but will do my best:
My understanding is that FEM only works through large public radio information raising campaigns. There is no behind the scenes where they would / could promote abortion that I know of. So I think it highly unlikely that they have done any work on abortion.
Maternal Health Initiative is a few months old. They are still at the scoping and research stage so I cannot comment on their plans.
Neither charity has that I know of made a stance for or against abortion and they do not work on abortions
Have they explicitly said they do not work on abortion? My assumption is that many places which did would not advertise the fact, precisely because they know many people would be concerned.
I am not the best person to answer this question, but will do my best:
My understanding is that FEM only works through large public radio information raising campaigns. There is no behind the scenes where they would / could promote abortion that I know of. So I think it highly unlikely that they have done any work on abortion.
Maternal Health Initiative is a few months old. They are still at the scoping and research stage so I cannot comment on their plans.
Thank you for writing. I had question about this come up a few times when I was community building so it is helpful to see an effective altruism discussion on the topic.
– –
One area of your post that confuses me, where (intuitively) I disagree with you is on your push back against family planning charities.
My understanding is that the charities you mention, Family Empowerment Media and Maternal Health Initiative, are trying to empower women with knowledge about and access to contraception. This supports women’s autonomy and right to decide on their family, and is good for maternal health and childhood health (due to more spaced out births). Neither charity has that I know of made a stance for or against abortion and they do not work on abortions, but my assumption would be that more deliberate use of contraception would mean less unwanted pregnancies and less abortions. So, if you care about the moral value of embryos then supporting access to contraception could be among the most effective places to donate.
So, I would have expected you to advocate people donate more to these charities not less.
(I can see a case for not donating to such charities out of moral uncertainty reasons but I could also see a case for avoiding working at all on abortion reduction for moral uncertainty reasons so not really sure where to take that line of argument).
Disclaimer: I work for Charity Entrepreneurship, the organisation that incubated both of the above charities. All views are my own and do not represent Charity Entrepreneurship or anyone else.
My understanding was as well that improved contraceptive access in poor countries is one of the best things we can do to lower abortions.
I think the evidence for this is surprisingly slim. Generally in developing countries contraception promotion has both positive and negative effects on abortions—it reduces the chance of a pregnancy in any given case of sexual intercourse, but a) increases sexual intercourse, disproportionately in ‘risky’ situations; and b) potentially increases the unwantedness of any given pregnancy as well. Moreover, the unmet need for contraception in developing countries is also pretty low, and the proportion of this which is due to lack of access is very small—so the number of women not using contraception because they lack access to it is pretty miniscule.
Do you have a source for the claim that providing contraception disproportionately increases risky sex + the unwantedness of a pregnancy?
Also, can you quantify this? Not sure what your source is, but a brief google search suggests that “sub-Saharan Africa had the lowest use of modern contraceptives (24%) and demand satisfied (52%).”
The same source suggests that ~10% of women globally with a need for contraception do not have it met (for a total of ~160million women with unmet need), and ~half of these women live in sub-Saharan Africa and South Asia. I haven’t checked the methodology personally, but probably not the number I’d consider “pretty miniscule”.
Thanks for asking, Bruce. Yes, regarding contraception increasing risky sex, it’s been a while since I looked at this literature but here are some of the references from my notes on it:
https://www.tandfonline.com/doi/abs/10.1080/07350015.2011.652052
https://onlinelibrary.wiley.com/doi/full/10.1111/ecin.12757
https://www.amazon.co.uk/AIDS-Behavior-Culture-Questions-Anthropology/dp/1598744798
https://pubmed.ncbi.nlm.nih.gov/11939239/
https://www.thelancet.com/journals/lancet/article/PIIS0140673606697870/fulltext
On unwantedness of pregnancy: https://pubmed.ncbi.nlm.nih.gov/31196674/ and Relationships Between Contraception and Abortion: A Review of the Evidence (guttmacher.org)
For low unmet need for contraception in developing countries: https://pubmed.ncbi.nlm.nih.gov/23489750/
And for low proportion of unmet need attributable to lack of access: https://www.guttmacher.org/sites/default/files/pdfs/pubs/Contraceptive-Technologies.pdf and https://pubmed.ncbi.nlm.nih.gov/24931073/
I don’t agree that the conclusions regarding low unmet need for contraception in developing countries, and this being due to access, is correct based on the sources that you have linked (although thanks for providing sources).
I just had a very quick (<5 minute) look at some of the sources regarding the low unmet needs for contraception in developing countries, largely because it goes against what I would expect (lower resource settings having proportionally higher resources in this area than high resource settings). Because I looked very quickly I’ve so far only looked at the abstract/highlights, however I expect that nothing in the main text would contradict this.
The source you gave for ‘low unmet need for contraception in developing countries’: https://pubmed.ncbi.nlm.nih.gov/23489750/ It does say that generally contraceptive prevalence has gone up and unmet needs have gone down (this is a good thing, i.e. progress), unless this was already high or low respectively (not surprising, a low unmet need can only decrease by a lesser degree than a high unmet need).
However: “The absolute number of married women who either use contraception or who have an unmet need for family planning is projected to grow from 900 million (876-922 million) in 2010 to 962 million (927-992 million) in 2015, and will increase in most developing countries.” This suggests that the unmet need is projected to increase more in developing countries compared to others.
The sources on access: https://www.guttmacher.org/sites/default/files/pdfs/pubs/Contraceptive-Technologies.pdf It does suggest that 7 in 10 cases access may not be main the issue: “Seven in 10 women with unmet need in the three regions cite reasons for nonuse that could be rectified with appropriate methods: Twenty-three percent are concerned about health risks or method side effects; 21% have sex infrequently; 17% are postpartum or breast-feeding; and 10% face opposition from their partners or others.” But: “In the short term, women and couples need more information about pregnancy risk and contraceptive methods, as well as better access to high-quality contraceptive services and supplies.” It also says that a quarter of women in developing countries have an unmet need: “In developing countries, one in four sexually active women who want to avoid becoming pregnant have an unmet need for modern contraception.” I would not call that low, and I think this is one of those cases of it being important to put number on it otherwise people may have different definitions of what is/isn’t low.
(A very quick estimate using the first links that come up on Google: 152 developing countries, population approx 6.69 billion total, say therefore around 3.35 billion who are female.
Turns out a quick Google does not bring up the proportion of women who are of childbearing age (15-49), but an interesting 2019 UN source on the need for family planning does come up which breaks down the unmet needs by region and is consistent with saying around 1⁄4 of women in developing countries have unmet needs: https://www.un.org/en/development/desa/population/publications/pdf/popfacts/PopFacts_2019-3.pdf That UN source has a quote: “In 2019, 42 countries, including 23 in sub-Saharan Africa, still had levels of demand satisfied by modern methods below 50 per cent, including three countries of sub-Saharan Africa with levels below 25 per cent ”
Back to that raw numbers estimate I was attempting: 1⁄4 of 3.35 billion is around 840 million for the unmet needs part. Maybe classing 1⁄3 of those women being of childbearing age/benefiting from contraceptives. That’s around 280 million people.)
The second source of access: https://pubmed.ncbi.nlm.nih.gov/24931073/ This has less information than the others as I can by default only see the abstract “Our findings suggest that access to services that provide a range of methods from which to choose, and information and counseling to help women select and effectively use an appropriate method, can be critical in helping women having unmet need overcome obstacles to contraceptive use. ” Suggesting that access is critical, and might imply that this is at least in part a reason for the unmet needs.
Edit: me reading the sources took about 5 minutes, the above writeup including me looking some stuff up (perhaps unsurprisingly) took a bit longer than that. I see having posted that Matt Sharp has also made a reply which says something very similar to what I am, would recommend reading that as well.
Thank you Lin for your thoughtful comment. I gave some further thoughts to Matt above, and it felt rude to copy and paste that comment again here. But if you have a particular hesitation which I haven’t addressed to Matt above please do let me know and I’ll do my best to come back to you on it.
The final 3 links seem to suggest the opposite of what you’re claiming (though I guess it depends what you mean by ‘low’):
Firstly, “for low unmet need for contraception in developing countries: https://pubmed.ncbi.nlm.nih.gov/23489750/″
From the abstract of that paper:
2. Secondly “And for low proportion of unmet need attributable to lack of access: https://www.guttmacher.org/sites/default/files/pdfs/pubs/Contraceptive-Technologies.pdf″
From the Highlights section of that paper:
3. Thirdly: https://pubmed.ncbi.nlm.nih.gov/24931073/
I’d also note that because demand for contraception tends to increase with better education, we would expect demand to increase over time. If supply does not increase to meet this demand, then unmet need will increase.
Thanks, Matt. Sorry I was heading out earlier so didn’t have time to elaborate as much as I would have liked. When I say unmet need for contraception (UMC) is low, I meant proportionally—by 2010 it was just over 10%, and I would guess is significantly lower still now. Of course, 10% globally is still a lot of people, but these are presumably the hardest people to reach and it is not clear how cost-effective doing so would be—moreover, it seems clear that even if we did manage to reach those 10%, the abortion rate would hardly decline by that much—so it is a pretty limited strategy for reducing abortions, if it is effective at all.
Regarding the second paper, table 5 indicates that only 8% of women with UMC globally lacked access (including because of cost). Table 3 in the third paper shows similar. So it still seems that only a very small proportion of women globally—perhaps 1% in 2010 - have a UMC because of lack of access to contraception.
There probably are interventions which could increase contraceptive uptake—but I don’t think they are by any means simple, and they are not generally solving lack of access per se. The access is there, even if the relevant education or empowerment of women is not. As indicated in the rest of my previous post, even if this were solved, it is still not clear to me that it would reduce abortions, given the counterbalancing effects contraception promotion has on sexual behaviour and desired family size. It seems particularly doubtful that it would reduce abortions by a large amount.
You are right that as education increases, desired family size generally falls, and contraception demand will grow. But I don’t see that there is a significant risk of contraception supply failing anytime soon. Even under the Mexico City Policy, which was widely held to significantly impede access to contraception, contraceptive use in the affected countries (turquoise—unaffected countries in orange) rapidly increased:
This, I suppose, is relevant to the EA discourse on neglectedness—with the emphasis on contraception in international development circles, it seems unlikely that slightly trimmed down support for it is going to significantly impede it or significantly increase abortion rates. But I confess I am only really on the peripheries of EA so I might be outdated with the neglectedness stuff.
Interesting points! Thanks for taking the time to respond and clarify.
Hi, thanks for your comment! You make a fair point that my essay isn’t precise enough about the potential moral caveats of these charities, and I’ll try to elaborate on that here.
It looks like one common source of confusion is what the precise reasons are for why abortion may be wrong. If abortion were wrong only because embryos could have personhood, then you’d be absolutely correct that we should donate more to family planning charities which reduce the number of abortions rather than less.
However, it seems to me that a stronger reason why abortion may be wrong is for the same reason longtermists oppose x-risk: It reduces the expected amount of future people. I briefly sketch the argument in the “Increasing the Amount of Near-Term Future People” section, but I could have done a better job of it, and elaborate some more in this comment. The magnitude of the difference between adding a future person and saving a living person is debated, but it seems that many prominent EAs consider it to be close to as good as saving a living person today. What we Owe the Future’s “Is it Good to Make Happy People?” (Chapter 8) does a great job of making that case, though some disagree.
For an example of where this consideration could be relevant, consider this statement from Family Empowerment Media (FEM)’s founders:
Let’s assume 10% of those unintended pregnancies would have been carried to term and not counterfactually replaced (to avoid child replaceability concerns). In that case, this intervention would prevent 34,000 lives from being lived, far more than the 3100 maternal lives saved. If we’re sympathetic to the above arguments (as many longtermists are), then this well-meaning intervention could arguably be doing much more harm than good.
It’s critical to note that supporting women’s autonomy, maternal health, and economic outcomes is a deeply important cause, and CE’s family planning charities absolutely contribute to those good outcomes. However, it seems to me that the
you pointed to could be quite strong, and that there are many other interventions which support women’s empowerment and maternal health without this possible serious negative externality.
I’d also like to note that I’m not saying EAs should never donate to FEM or its related charities. I only believe that the moral considerations are serious enough that we should temporarily suspend our support for these charities until we’ve systematically reviewed the effect of these considerations.
It could be that a systematic review uses randomized controlled trials to verify that FEM’s interventions don’t reduce the expected amount of future people at all and only space out births. The review could also show that replaceability should be accorded much higher credence than many actually accord it, and argue that even with these moral considerations, the absolute effect of FEM’s interventions is good. In that case, the suspension of support for FEM should be reversed.
I think it’s important to also take into account the moral risks of refusing funding for family planning specifically because you want others to have more unintended pregnancies. On broadly Kantian-inspired views, for example, this would plausibly qualify as objectionably treating people as mere means.
FWIW, I favour interventions that give people more control over their lives, including reproductive autonomy, along with making it easier for people to have more kids when they’re ready and they positively want this.
There’s no doubt that the considerations you pointed out are deeply relevant. When considering this issue, women’s autonomy and physical, mental, and economic health are of paramount importance. One way to support these values is through FEM and its related charities. Another way is through charities like the Fistula Foundation and GAIN’s Salt Iodization program. It seems that the second way also achieves the aims we want—women’s health and autonomy—while avoiding the possible serious negative externality.
As an analogy, many Ethiopians suffer from malnutrition. Let’s say well-meaning EAs sponsored an “EA steakhouse” in Ethiopia, as steak can provide crucial nutrients to people in extreme poverty. There seem to be other interventions, including GAIN’s Salt Iodization program, which also target malnutrition, without the possible serious negative externality of animal suffering. In that case, I think we should temporarily suspend our support for the steakhouse while we evaluate the relevant moral considerations. In the meanwhile, Ethiopians can still eat steak at non-EA steakhouses if they’d like (as other well-meaning altruists have sponsored steakhouses of their own), or acquire steak through other means—we wouldn’t be reducing their ability to voluntarily eat steak if they so choose. Our goal—combating malnutrition—remains the same, but we choose the intervention to accomplish that goal without the possible negative externality.
Your disclaimer says this post is specifically about voluntary abortion reduction. But claims such as “the possible serious negative externality” of women not having kids because they get access to information or contraception or family planning, combined with recommendations that “support for these charities should be suspended” make this sound less about voluntary abortion reduction than you might intend, given family planning interventions are usually targeted at women who don’t want to become pregnant in the first place.
It sounds like you go further than recommending people to voluntarily consider not having abortions. For example, you recommend that charities should have their support suspended because of population size / longtermist arguments. This sounds like you are making the case that actions which limits access to contraception / family planning (because doing so results in this “possibl[y] serious negative externality”) are justifiable for purposes of increasing population size. Can you clarify if this is what you mean?
Given the post is specifically about voluntary abortion reduction, it’s not clear to me that interventions focussing on women who have unmet needs (i.e. women who don’t want to be pregnant) for contraception are a relevant consideration? Sorry if I’ve missed something, only briefly skimmed.
Hi Bruce, I think your concern boils down to a semantic disagreement on the definition of “voluntary” in this case. If we are one among many providers of service X, and we decide to stop providing, is that an intervention which involuntarily prevents people’s access to that service?
I think the relevant semantic disagreement is:
My view is that if provider of service X is targeted at women who do not want children, then changes to provision of service X is irrelevant to “a case for voluntary abortion reduction”, because by decreasing provision of service X, you haven’t made it so these women are voluntarily wanting more children / less abortions, you’ve just made it so they have less of a choice, whereas it seems like you disagree.
It sounds like I’m misunderstanding you though, so perhaps it’s more useful if you clarify / define what you mean by “voluntary abortion reduction”.
That’s a compelling distinction! I’m better understanding what you mean now. We can narrow the set of interventions which affect a service down to three types:
Voluntary: The service remains the same, but users of the service are incentivized to change their behavior.
Voluntary?: Some providers stop offering the service, but the service remains available with other providers.
Involuntary: All providers stop offering the service.
I’m keeping the situation abstract as a service to try to show why I think the “Voluntary?” type is distinct from the involuntary type.
Would advocating for a platform to reduce hate speech impressions be an involuntary imposition on free speech? They can always use a different platform.
Would a doctor personally deciding to not perform abortions be an involuntary imposition on abortion seekers? They can always find another doctor.
Would a wedding planning company deciding to not plan weddings for homophobes be an involuntary imposition on homophobe weddings? They can always find another wedding planner.
What you have convinced me on is that the “Voluntary?” type is more gray area than I thought. However, I still don’t think any of the situations I enumerated should count as involuntary impositions.
The two commonsense relevant definitions of “voluntary” you’ll find in the dictionary are “of one’s own free will” and “in the absence of payment.”
Reducing funding for abortion services may in some cases cause people to choose to carry a pregnancy to term when could have still obtained an abortion, perhaps by exerting more effort or taking on more risk. Since they were not paid to not have an abortion, I suppose it is technically “voluntarily” in the second sense, in the same way that criminalizing homosexuality caused people to “voluntarily” have less homosexual sex.
While I grant you the benefit of the doubt, I tend to see this kind of subtle misuse of language in a native English speaker (as I assume you are?) as a deliberate obfuscating move rather than a slip-up, so you may want to reconsider your linguistic choices in the future to avoid creating that impression.
I think more to your point, there is a difference between “freedom from” and “freedom to,” or positive and negative rights. Many people feel people should have freedom from being legally prevented from seeking an abortion, but not necessarily that we should subsidize their ability to have an abortion. I read your post as about eliminating subsidies for family planning, as well as encouraging voluntary increased child rearing.
I strongly disagree with the comparison between (a) proposals to suspend EA funding for services which reduce the amount of future people and (b) criminalizing homosexuality.
I don’t think there’s any “subtle misuse of language” which causes one to be anywhere near the other. Isn’t the comparison between (a) and any of the analogues I gave in my above comment far more natural? How are any of those anywhere near criminalizing homosexuality? If anything, comparing (a) to criminalizing homosexuality could constitute a “deliberate obfuscating move.”
I think we’re both acting in good faith here, and I’m willing to admit a passion for this cause which can affect the impartiality with which I react to comments. All I can say is that I really don’t see things that way, and I don’t think there’s anything unreasonable about recognizing (a) and (b) as fundamentally different.
I think this is a useful clarification, thanks.
It sounds like the crux here is the extent to which these women have many options RE: access to safe abortion services—this could be an involuntary imposition if they’re the only doctor in a 100km radius, for example, or if other doctors are so busy they don’t have time to look after additional patients.
It’s also not all-or-nothing, it could be the case that there are many other doctors, but only one doctor with the skill to perform abortions, or many other doctors accessible by car but not by foot etc, or doctors available but are less affordable.
Unfortunately, the bar is much higher on your end, because if only a minority of women who previously were using service X now no longer have an alternative, this would be an involuntary imposition on this small minority, so if you’re suggesting that “any involuntary intervention is out of scope”, then you’d also have to show that all users of service X have similar access to a functional equivalent. I don’t know if this is the case personally, but it would surprise me if the charity’s nonexistence did not change the number of women with access to family planning / abortion. Presumably if this were the case, these charities would be working in a fairly non-neglected context, and thus not worth funding purely on cost-effectiveness / neglectedness considerations.
Yes, I think this is close to the consensus on definition we’re reaching. The only quibble I have with this is that I think the level of “obligation” on the service provider to provide a service is also relevant.
The publishing platform has no obligation to host content it considers hate speech.
The anti-abortion doctor has no obligation to perform abortions.
The homophobe-phobic wedding planning company has no obligation to plan any particular person’s wedding.
Similarly, I don’t think EA can be said to have an “obligation” to provide funding for any particular cause, unless that cause is clearly and unambiguously more important than EA’s erstwhile top priorities. In that regard, I don’t think that a proposal to withdraw EA funding for some service constitutes an involuntary imposition on the service’s recipients,
especially givenconditional on the option that the recipients can procure the service in other ways.Edit: Altered incorrect language
Thanks for the engagement! There’s a lot going on here. Responding first to:
I’m just noting that your comment on the recipients being able to procure services elsewhere is prefaced with the word “especially”, and not something like “conditional on”. This implies that the ability of the recipients being able to procure services elsewhere is not a necessary factor of determining whether this constitutes a voluntary or involuntary imposition.
So if you’re saying something like “Because EAs don’t have an obligation to provide funding to any cause, no withdrawal for funding can constitute an involuntary imposition on the service’s recipients, irrespective of whether these women have other options available” then this is something I pretty strongly disagree with. It seems to me that what EA funders’ moral obligations are here are either irrelevant or vastly dominated by the experience of the recipient when deciding whether this action contributes to a voluntary reduction in abortion or an involuntary reduction?
From the perspective of a pregnant woman seeking abortion, they don’t care about what the EA funder’s obligation are. All she knows is that last year her friend had access to affordable abortion services, and this year she doesn’t have the same choice. I don’t really understand how this could be really considered meaningfully voluntary, even if she decides to keep the baby instead of try a dangerous DIY method at home (though clearly, many women will do this).
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More generally, it might be true that recipients can procure the services in other ways, but I’d like to see this claim actually justified for the charities that you are suggesting should have their funding suspended, or added as a caveat above (“conditional on these recipients being able to access the same quality of care elsewhere at no meaningful cost...etc), alongside the other philosophical caveats you’ve provided.
Otherwise it’s an open Q whether the recipients can in fact procure the services in other ways, what costs they may have to bear in order to do so (also see above RE: the bar being higher on your end in terms of showing that such recommendations for suspensions result in no involuntary impositions), and whether this harm is worth the benefits it brings, especially considering 2nd order considerations such as those raised by a commentor above.
I’m pretty hesitant to update in your direction until I see at least an attempt at quantifying this.
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For what it’s worth, most of this message above and an earlier comment was me going along with your usage of the terms voluntary / involuntary, but I think this is actually quite a misleading use of these terms. (Mainly in response to your comment RE: “consensus on definition”, as I don’t want to give the impression I am endorsing this definition, but just that I am trying to understand it more clearly). That being said—I’m not suggesting you are being intentionally misleading!
Hypothetical analogy: suppose you think higher homelessness rates are better. Suppose you know that there’s a subset of researchers who applied for funding from EA sources because they wanted a way to pay rent. Would you say that because EA funders have no obligation to provide funding for any cause, that such a withdrawal of funding, for the purpose of increasing homelessness rates (and against your best guess for what the researcher would want for themselves), would be appropriately classified as “increasing voluntary homelessness”?
By your usage of voluntary and involuntary, this would depend on whether or not they could find a source of $ elsewhere. But I think my original interpretation is that even if you showed me that these researchers could find $ elsewhere for rent, it would still be inaccurate for this suspension of funding to be classified as “increasing voluntary homelessness”, because the mechanism by which this increases homelessness is decreased access to alternatives, not because it is empowering people to make the choice of becoming homeless because they wish to be for their own reasons. (This doesn’t at all interact with the possibility that suspension of funding is the right call for other reasons, e.g. if their research isn’t adding a lot of value, or if this isn’t neglected because they have many other funding options available).
I hope this illustrates my concern with the “suspending funding” recommendation based on “voluntary abortion reduction” arguments. (i.e. I think the definitions you use are contrary to my best guess of what most people would interpret as “voluntary abortion reduction”, but even by your own definition, you provide pretty limited support for the extent to which other options are available).
I think that the main relevant question in determining whether the abortion reduction is voluntary or not should be: “Are the women in question making a well-informed, uncoerced choice that keeping the baby is preferable to a safe abortion, or are the women in question ‘choosing’ to keep the baby because there are limited alternatives available to them?”
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Minor nitpick: I’m not sure if you’re talking about a moral or legal obligation here, and I guess it may vary by jurisdiction, but it’s not as clear cut as written here. When a doctor conscientiously objects to providing a service (i.e. refuse to provide a service that is against their personal values), there’s a clear case to be made that it is the doctor’s professional obligation to let the patients know what options they have available and how they can access this care from other doctors who can provide this service, such that their personal values do not not meaningfully impact their patients’ health outcomes and access to treatment. And if there are no other options available, and conscientious objection will compromise healthcare delivery then this may be unacceptable.
I agree that a charity / EA funding may not be held to the same standard as a medical doctor in terms of moral obligations, but the same thought process is relevant in terms of taking into account how much harm you may be contributing to in expectation. To reiterate though, the extent to which EA funders or doctors are obligated to provide this service is (imo) not particularly relevant to whether or not the women in question are now voluntarily choosing not to have abortions.
(btw the disagree votes on your comments in this thread aren’t coming from me)
On “especially,” yep, that was an incorrect use of words, and I’ve edited my comment accordingly. Thanks for pointing that out!
Based on your considerations, and after thinking about it some more, I retract the “obligation” point, and now agree that the fact that we’re not “obligated” to fund this cause doesn’t make the downstream effects of the funding redirection “voluntary” or “involuntary” for the recipients.
Of the charities I mentioned, to the best of my knowledge, only PSI actually provides abortions. DMI and FEM run media campaigns encouraging contraception. MHI connects women with contraception access. On DMI, FEM, and MHI, Calum suggests that the unmet need for contraception due to lack of access is quite low, and supports his suggestion pretty well IMO.
I think PSI is where your point is strongest, since it seems very difficult to rule out the possibility that there exists some place where PSI is the only abortion provider. However, PSI is not an EA charity, and it seems very unlikely that removing its recommendation from The Life You Can Save’s website would cause it to stop being able to offer its services where there’s the greatest unredirectable demand.
As for whether or not the intervention’s harm is worth the benefits it brings, I’d like to point out that this concern is orthogonal to the question of whether or not the intervention could be considered “voluntary.” That said, I would say yes, and that’s the reasoning I use to recommend it.
Your homelessness analogy is a good one, and it does accurately show how my use of the term “voluntary” could have been misleading. I have some regrets about the whole structure of my post in that regard. I reply to Julia Wise’s similar concern here, which might help explain much more about my thought process.
No worries! I used to go on Reddit often, and as you can imagine from our interactions, I was prone to getting heavily downvoted :P To avoid motivated/emotion-driven “reasoning”, I made a personal rule to never downvote anyone on Reddit for any reason. I’m off Reddit now, but I’ve always maintained the rule that I never downvote respectful discourse. I think engagement is better than a disagree-vote, and strive to avoid the latter in favor of the former.
To close (as frankly, there’s only so much brainpower I’m willing to extend on this semantic consideration), I maintain that the interventions I suggest would be the right thing to do. However, there’s a sensible case that there are reasonable definitions of “voluntary” which readers understandably presuppose when reading the post for which the interventions don’t qualify. Though I maintain that there are senses in which they do qualify, I think you’ve made an excellent case that there’s substantial ambiguity there which can blindside readers. I’d appreciate if you read my reply to Julia Wise’s similar concern (which helps to spell my actual intention behind the post), and let me know what you think would be the best way to disambiguate while staying true to the post’s scope.
Thanks! Happy to see real-time updates on the internet.
I did see Calum’s papers—I didn’t reply because I didn’t have time to meaningfully engage with all those sources, and it looked like others replied first. There were some info that surprised me, but on a very brief skim, I don’t know if those sources actually bring me to the conclusion of:
RE: harm vs benefit tradeoff, I agree that this is basically irrelevant in terms of whether this is voluntary or not, though it is relevant in terms of deciding whether or not I should accept the suggestion at face value.
Makes sense RE: capacity. Yeah, I’m not engaging with whether this is the right thing to do, all things considered—you could make a case for example that money spent on these charities could plausibly be better spent elsewhere, though to be clear, I would personally find it pretty aversive to justify this primarily because we wanted higher rates of unwanted pregnancies to increase population size. I’m mainly suggesting that even if you think this is the right thing to do, it shouldn’t be considered “voluntary abortion reduction” for the reasons I illustrate above.
RE: your response to Julia’s, I’ll add a quick comment in that thread.
Thanks for your response. Just to clarify, part of my concern is with the possible disrespect inherent in regarding the avoidance of unwanted pregnancies as a “possible serious negative externality”. I don’t think that’s a good (or respectful) way to think about it, and accordingly I don’t think the “steakhouse” analogy works (because, to be clear, the moral reasons we have to defer to individual women about the desirability of them personally becoming pregnant have no analogue in the steak case—individuals do not have the moral authority to determine whether them personally eating meat is morally good or bad).
Of course, you might disagree about whether respect for individual women calls for this kind of deference or granting of moral authority over whether it’s good or bad for them personally to become pregnant. But I think it’s sufficiently credible that you should give it significant weight in moral uncertainty. And that means that there’s a significant moral risk to the kind of argument that you’re putting forward here, which involves depriving them of that moral authority.
(Note that there is no such risk to the alternative many are urging here, of supporting pro-fertility policies in a way that’s fully co-operative with—rather than potentially adversarial towards—the wishes and choices of individual women.)
The two situations seem pretty analogous to me. In both cases there is some prima facie plausible personal autonomy case on one side (it certainly seems plausible people have the right to choose what food they eat!) and a prima facie harm to third parties on the other (with debate about whether those third parties are morally relevant). In both cases the person has some moral authority (to decide if eating meat is good for them) but not complete (they can’t decide if eating meat is bad for the animals).
There’s no prima facie harm from contraception. There’s a possible foregone benefit, but one it would be arguably illicit to obtain by treating the provider as a mere means.
A better analogy would be to stop supporting medical treatment for car accident victims, because if we let them die we could use their organs to save more others.
You’re not talking about averting negative externalities, but about promoting exploitation of others without their consent. I don’t think EA should countenance such reasoning.
Sorry, I think we may have been talking past each other. I was referring to abortion, which presumably you would agree does have a prima facie harm, and hence is comparable to the steakhouse situation.
Yes, that’s right—thanks for clarifying. (For context, note that upthread Ariel wrote: “If abortion were wrong only because embryos could have personhood, then you’d be absolutely correct that we should donate more to family planning charities which reduce the number of abortions rather than less. However...” So our dispute was about whether preventing unwanted pregnancies should count as a “possible negative externality”.)
(Edited to add: I’m speaking only in a personal capacity here, and not on behalf of my employer.)
If you try to account broadly for indirect effects and externalities, it’s not clear you’ve arrived at the right stance on abortion and population reduction. There are many effects to consider:
Withdrawing support for (or actively opposing) abortion and the reasoning here to do so could have impacts on norms/values around exploitation and treating others like mere means (or allowing them to be treated like mere means), like Richard suggests, so (EDIT) to make explicit, have other negative effects for women and girls (or others) in the near term. Norms more permissive of exploitation and treating others like mere means may make us more prone to conflict and less cooperative in general, and so more prone to catastrophic conflicts and missing opportunities for positive sum trades. Values in general via value lock-in and such effects on conflict and cooperation in particular could even have far-future effects.
Abortion and population reduction (for humans) could go either way for nonhuman animals. I’d guess they’re good for farmed animals by reducing animal farming and because I think farmed animals mostly have bad lives (even on symmetric ethical views, although my views are suffering-focused), and the sign for wild animals (whose populations would plausibly increase) will depend on your expectations about their average welfare. I’d guess this would be limited to impacts on Earth, but humans might colonize space themselves and bring nonhuman animals with them, and more humans colonizing space could mean more nonhuman animals brought with them.
Abortion and population reduction could mitigate climate change, which may have near-term effects on humans and nonhuman animals, as well as far-future effects.
Moral circle expansion towards fetuses could transfer to MCE for other (far future) minds with limited cognitive capacities or agency, or otherwise in situations similar to fetuses.
Economic and technological effects from increased population or reducing costs on children (in time or money), which could possibly even compound into the far future.
There are a few broad practical responses to all of this that I can think of:
Try harder to quantify and compare these effects (EDIT: in some cases, rough bounds can be useful enough), and try to ensure you’re capturing a relatively unbiased subset of indirect effects, and especially the largest ones. Use this information to
come to an overall stance on specific interventions and support them accordingly, and/or
hedge with a portfolio of interventions or do some other kind of worldview diversification/portfolio approach.
Cluelessness, and look for interventions that are more robustly positive to support and promote instead. This would also mean withdrawing support for human life-saving interventions (except possibly those that reduce existential risk overall, possibly). Possibly promote the withdrawal of support for abortion-affecting and human population-affecting interventions, including family planning interventions, interventions that incentivize people to have more children, life-saving interventions, and abortion reduction interventions.
Also, another possible response is 3. ignoring indirect effects, but this seems pretty unprincipled/unjustified and prone to systematic error to me. Ignoring cross-worldview or cross-cause indirect effects may be okay as an approximation to the portfolio approach if it’s done within a portfolio of interventions across causes/worldviews, because it’s plausible negative indirect effects can be made up for through more targeted/leveraged interventions for those causes/worldviews in the portfolios.
However, when I think of the current total EA portfolio of interventions, I think it’s pretty plausible we aren’t making up for possibly negative wild animal effects because agricultural land use is huge and fishing has huge population effects, and (although I’m much less informed on the issue) I also worry about s-risks being increased.
Hi Michael, great to hear from you!
Yes, that’s absolutely a relevant consideration. I think there are similar considerations regarding the effect of supporting abortion on the permissiveness of bad societal norms:
The dehumanization of those outside one’s moral circle (“it’s just a clump of cells/parasite”, “it’s just a beast”, “they won’t even exist for millions of years”)
The callous treatment of moral patients whose existence is inconvenient (“it’s my body; I’ll do whatever I want with that fetus”, “who cares? meat tastes good”)
The masking of disenfranchisement of unrecognized moral patients as “rights” of recognized moral patients (“reproductive rights”, “the right to eat whatever I want”)
Yes, animal welfare considerations likely weigh in favor of abortion. I’d go even further than your statement and say they plausibly dominate the welfare concerns of both the woman and the fetus. Of course, this consideration plausibly dominates the purpose of many human-centric interventions, and the implications are scary. (That doesn’t mean I won’t think them through, but there’s only so fast I can overturn my worldview!) I know you have strong opinions on this, and would love to get any recommendations on reads you think would be enlightening on the subject.
Yep! That should also weigh in favor of abortion, though I personally think other concerns substantially dominate it.
100%
Yes. I could be persuaded either way on the sign of this consideration, because abortion does increase economic output per capita, but having more people should increase gross economic output on the margin.
On your responses:
Very cool! I wasn’t aware of research on this, and it makes perfect sense, including avoiding “sector risk” (e.g. a portfolio of human-centered interventions could be totally dominated by farmed animal welfare considerations).
I’m still making up my mind on the implications of cluelessness, but I agree that it updates towards not taking much concrete action on abortion as an EA cause area.
On animal effects, I would recommend:
For farmed animal and wild animal effects and population sizes, with some emphasis on those related to human diets:
Many essays in https://reducing-suffering.org/#animals (although note that these are primarily from a suffering-focused and basically negative utilitarian perspective)
Maybe especially https://reducing-suffering.org/#humanitys_impact , https://reducing-suffering.org/vegetarianism-and-wild-animals/, https://reducing-suffering.org/trophic-cascades-caused-fishing/ (and others in https://reducing-suffering.org/#fishing ) and https://reducing-suffering.org/how-many-wild-animals-are-there/
http://reflectivedisequilibrium.blogspot.com/2013/07/vegan-advocacy-and-pessimism-about-wild.html
https://docs.google.com/document/d/1wMIa6bAn4rfCAzBAsKlHBH9X3gmo8pjn/edit from https://www.invinciblewellbeing.com/research
Various posts at https://forum.effectivealtruism.org/topics/meat-eater-problem
https://forum.effectivealtruism.org/posts/SvbZtETGenTkZni8C/where-does-most-of-the-suffering-from-eating-meat-come-from
I think the human impacts on wild animals are primarily through agricultural land use, fishing and climate change, and most of these are largely affected by human diets (although climate change possibly dominated by fossil fuel use). Maybe also environmental pollutants/contaminants/toxins and forestry (I haven’t really looked into these). I’d guess the effects from the land humans take up in cities, towns, villages, etc., is not significant compared to these, based on Our World in Data.
For moral weights across animals (including humans):
https://reducing-suffering.org/two-envelopes-problem-for-brain-size-and-moral-uncertainty/
https://forum.effectivealtruism.org/posts/848SgRAKpjbuBWkW7/why-might-one-value-animals-far-less-than-humans
RP’s moral weight sequence (disclaimer: I work at RP, but am not speaking for them here), some posts are still coming out.
https://reducing-suffering.org/is-brain-size-morally-relevant/
https://www.lesswrong.com/posts/2jTQTxYNwo6zb3Kyp/preliminary-thoughts-on-moral-weight
I don’t know if the above covers all the strongest arguments for humans mattering substantially more than nonhuman animals, and I’d guess it doesn’t cover many such arguments in much detail. I don’t know off the top of my head what to recommend.
If you think the moral concerns about abortion is more about the prevention of future people instead of the value of the lives of the embryos, you should probably try to optimise for women having more children in the near term. It is not clear to me why you think preventing abortions is the best way to do so.
Hi Denise! I agree that optimizing for increasing the amount of children that families want and are able to happily have is probably better than voluntary abortion reduction as a means of increasing the amount of near-term future people. I apologize if I wrote anything which could give the implication that I “think preventing abortions is the best way to do so” (emphasis mine), as that is not my opinion.
As for why I decided to write a whole post on abortion reduction, here are some of my reasons.
Nice points, Ariel.
Joey Savoi (CEO of Ambitious Impact, which was formerly Charity Entrepreneurship) said:
I agree with you it is unclear whether family planning interventions decreasing population are beneficial/harmful.
Part of the problem, I think, will be that this is such a highly politicised area that vague terms are often used so that it is not clear whether a charity is promoting abortion or not. I have seen a lot of this in developing countries in particular—family planning is promoted and contraception is the only element of this publicised—but abortion is promoted behind the scenes as well (because it is less glamorous and often illegal). All sorts of charities support abortion (in a variety of different ways) without many people realising—MSF, Oxfam, Water Aid, plausibly even groups like Christian Aid when you dig deep enough.
Of course none of this is specific evidence that FEM and MHI do so—but in general there is a pretty high prior probability that any given family planning organisation supports abortion in some way, and probably the presumption for anyone who opposes abortion is that family planning organisations have the burden of proving otherwise, given the prior probabilities. This may be unfair on those family planning organisations which genuinely don’t in any way support abortion—but unfortunately given the way the world is sometimes people have unfair burdens of proof.
In case helpful note I comment below here:
Have they explicitly said they do not work on abortion? My assumption is that many places which did would not advertise the fact, precisely because they know many people would be concerned.
I am not the best person to answer this question, but will do my best:
My understanding is that FEM only works through large public radio information raising campaigns. There is no behind the scenes where they would / could promote abortion that I know of. So I think it highly unlikely that they have done any work on abortion.
Maternal Health Initiative is a few months old. They are still at the scoping and research stage so I cannot comment on their plans.
I hope that helps