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).
======
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.
======
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?”
======
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.
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).
======
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.
======
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?”
======
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.