My impression is that GiveWell is on principle explicitly against treating different lives as having different values, even when the mechanism is as simple as different lives having different expected lengths (e.g. valuing saving someone from malaria less if you think they will have a lower life expectancy as a result of their illness).
From a straightforward, surface-level utilitarian perspective, this does seem like it would be a mistake. But I think there are good rule-utilitarian, systems-change, or co-operation-based reasons to want to take this stance.
Treating different lives as worth different amounts violates many peopleâs fairness and justice intuitions, which is both relevant from a moral-trade perspective (itâs a good co-operative principle to avoid doing things that other people really donât want you to do) and a moral-uncertainty perspective (maybe they are correct to not want you to do those things!)
Itâs also pretty uncomfortable that part of the reason that these people live in such difficult conditions is that previous generations have neglected to help them: a policy that discounts them on this basis will tend to reinforce existing problems.
As you say, the fact that they are the cheapest lives to save and the fact that they have poor state capacity are casually related, but theyâre probably causally related the other way too, in the sense that itâs hard to demand or build good state capacity when youâre sick or barely feeding yourself. I hope that as material conditions improve in (say) the DRC, so too will political conditions; Iâm no historian but that seems to have been the trend in much of the rest of the world.
(I have more to say but I have 2% phone battery so maybe Iâll make another comment later)
Yep. A significant portion of the relevant health economics literature Givewell researchers will be familiar with uses measures which do treat lives as non-equal, typically the âvalue of a statistical lifeâ which represents how much society is willing to pay to save that life which is broadly proportional to GDP per capita. The rationale is basically that survivors in richer societies are capable of generating enough wealth to cover the costs of their treatment, but if youâre valuing lives from an altruistic perspective then you really, really donât want to weight it based on future ability to pay...
That âvalue of a statistical lifeâ obviously factors in differences in opportunities and values positive externalities generated from surviving, but vastly overweights differences in actual quality of lifeâand even on value-of-a-statistical-life grounds malaria nets and vitamin supplementation in Sub Saharan Africa is generally still seen as cost effective.[1] From a pure hedonic utilitarian perspective you might want to use some sort of subjective wellbeing factor instead. Multiply that by the expected future life of the person saved and you get the WELLBY as an alternative metric [2]
But the difference in average self-reported subjective wellbeing on a linear scale is⌠really not very big compared with the differences in costs between countries, and probably isnât going to change their recommendations very much. Taking the example of the Democratic Republic of Congo, and Congoese people polled do indeed value their happiness at lower than many other countries on the World Happiness Pollâs nominally linear scale at only 3.3 out of 10. But India and Bangladesh, highlighted in the post as countries which donât have ongoing conflict and plausibly have better economic opportunities, score only 4.1 and 3.8 respectively so factoring in the weightings of subjective wellbeingâif you believe them to be accurateâwould change very little. (The main reason why comparatively few nets are dispensed in India and Bangladesh is that the local malaria variety is a lot less prevalent and a lot less lethal. The life expectancy difference to Congo shrinks if you factor out malaria too...). And if children survive infancy, their lives are typically lived over spans of 60-70 years. Itâs unlikely the global distribution of happiness will be identical 30 years from now, and entirely possible that the countries with the lowest happiness will see the biggest improvement
So whilst GiveWell may have made the judgement to weight lives equally on ideological grounds, the actual data youâd need to create a robust argument for doing things differently tends to not be there or broadly inclined to what theyâre already doing...
people in richer countries not only face proportionally higher healthcare costs in general, but also diminishing returns since the treatments theyâre at risk of missing out on tend to be expensive and complex surgery and new experimental drugs, rather than vitamins and nets...
using national life expectancy figures which are significantly affected by malaria prevalence in infants as weights which discourage supplying malaria nets is questionable, but in theory life expectancy measures could be adjusted to factor malaria out....
Appreciate the response. Descriptively, Iâm sure youâre right about the rationale behind these decisions. I think failing to factor in even the most obvious drivers of quality of lives might be politically more comfortable but has important implications, perhaps even for these specific populations. For example, making adjustments might justify:
1. Moving dollars towards interventions aimed at human capital development (lead removal, (perhaps) deworming).
2.Saving more lives in countries that have regions that are quite poor but have better future prospects.
Iâm also skeptical of the idea that generally improving public health on the margin will contribute in any meaningful way to improving institutional quality. Iâm not arguing as some libertarians do that doing this hampers the incentive to provide public services. But on the other hand, itâs also far from likely that improving public health will improve instituions in the long term. I agree the causation might run both ways but probably much stronger in one direction. (especially since there are all too many examples of places with much better public health but awful institutional quality (Venezuela, Iraq etc come to mind)
My impression is that GiveWell is on principle explicitly against treating different lives as having different values, even when the mechanism is as simple as different lives having different expected lengths (e.g. valuing saving someone from malaria less if you think they will have a lower life expectancy as a result of their illness).
From a straightforward, surface-level utilitarian perspective, this does seem like it would be a mistake. But I think there are good rule-utilitarian, systems-change, or co-operation-based reasons to want to take this stance.
Treating different lives as worth different amounts violates many peopleâs fairness and justice intuitions, which is both relevant from a moral-trade perspective (itâs a good co-operative principle to avoid doing things that other people really donât want you to do) and a moral-uncertainty perspective (maybe they are correct to not want you to do those things!)
Itâs also pretty uncomfortable that part of the reason that these people live in such difficult conditions is that previous generations have neglected to help them: a policy that discounts them on this basis will tend to reinforce existing problems.
As you say, the fact that they are the cheapest lives to save and the fact that they have poor state capacity are casually related, but theyâre probably causally related the other way too, in the sense that itâs hard to demand or build good state capacity when youâre sick or barely feeding yourself. I hope that as material conditions improve in (say) the DRC, so too will political conditions; Iâm no historian but that seems to have been the trend in much of the rest of the world.
(I have more to say but I have 2% phone battery so maybe Iâll make another comment later)
Yep. A significant portion of the relevant health economics literature Givewell researchers will be familiar with uses measures which do treat lives as non-equal, typically the âvalue of a statistical lifeâ which represents how much society is willing to pay to save that life which is broadly proportional to GDP per capita. The rationale is basically that survivors in richer societies are capable of generating enough wealth to cover the costs of their treatment, but if youâre valuing lives from an altruistic perspective then you really, really donât want to weight it based on future ability to pay...
That âvalue of a statistical lifeâ obviously factors in differences in opportunities and values positive externalities generated from surviving, but vastly overweights differences in actual quality of lifeâand even on value-of-a-statistical-life grounds malaria nets and vitamin supplementation in Sub Saharan Africa is generally still seen as cost effective.[1] From a pure hedonic utilitarian perspective you might want to use some sort of subjective wellbeing factor instead. Multiply that by the expected future life of the person saved and you get the WELLBY as an alternative metric [2]
But the difference in average self-reported subjective wellbeing on a linear scale is⌠really not very big compared with the differences in costs between countries, and probably isnât going to change their recommendations very much. Taking the example of the Democratic Republic of Congo, and Congoese people polled do indeed value their happiness at lower than many other countries on the World Happiness Pollâs nominally linear scale at only 3.3 out of 10. But India and Bangladesh, highlighted in the post as countries which donât have ongoing conflict and plausibly have better economic opportunities, score only 4.1 and 3.8 respectively so factoring in the weightings of subjective wellbeingâif you believe them to be accurateâwould change very little. (The main reason why comparatively few nets are dispensed in India and Bangladesh is that the local malaria variety is a lot less prevalent and a lot less lethal. The life expectancy difference to Congo shrinks if you factor out malaria too...). And if children survive infancy, their lives are typically lived over spans of 60-70 years. Itâs unlikely the global distribution of happiness will be identical 30 years from now, and entirely possible that the countries with the lowest happiness will see the biggest improvement
So whilst GiveWell may have made the judgement to weight lives equally on ideological grounds, the actual data youâd need to create a robust argument for doing things differently tends to not be there or broadly inclined to what theyâre already doing...
people in richer countries not only face proportionally higher healthcare costs in general, but also diminishing returns since the treatments theyâre at risk of missing out on tend to be expensive and complex surgery and new experimental drugs, rather than vitamins and nets...
using national life expectancy figures which are significantly affected by malaria prevalence in infants as weights which discourage supplying malaria nets is questionable, but in theory life expectancy measures could be adjusted to factor malaria out....
Appreciate the response. Descriptively, Iâm sure youâre right about the rationale behind these decisions. I think failing to factor in even the most obvious drivers of quality of lives might be politically more comfortable but has important implications, perhaps even for these specific populations. For example, making adjustments might justify:
1. Moving dollars towards interventions aimed at human capital development (lead removal, (perhaps) deworming).
2.Saving more lives in countries that have regions that are quite poor but have better future prospects.
Iâm also skeptical of the idea that generally improving public health on the margin will contribute in any meaningful way to improving institutional quality. Iâm not arguing as some libertarians do that doing this hampers the incentive to provide public services. But on the other hand, itâs also far from likely that improving public health will improve instituions in the long term. I agree the causation might run both ways but probably much stronger in one direction. (especially since there are all too many examples of places with much better public health but awful institutional quality (Venezuela, Iraq etc come to mind)