This post made me rather uncomfortable. I think what got to me was a somewhat flippant expression of what it was like for ‘Sarah’ to be unwantedly pregnant: “She has made plans which are inconsistent with being pregnant, and prefers not to give birth at the current time.”, which is summarised in the table as the idea that bringing the fetus to term would be ‘inconvenient’. This seems dismissive of the suffering which could be entailed by bringing it to term.
While it seems quite likely that people do compartmentalise, in this particular example it’s not at all clear to me that that is a bad rather than good thing. Abortion is a very hot button topic. We’re not likely to get any leverage on it one way or the other, because of the resources already invested pushing both ways. It’s also likely to be emotional to people (as Lila described in her comment). So actually, taking pains to think through what implications effective altruist ideas might have for abortion, and discussing it a bunch, might just have negative consequences. It might be better to start by focusing on areas where we can ‘push the rope sideways’.
It’s probably not a good idea to tackle abortion for the reasons you give, but we can’t know that if we never think through the implications of our beliefs (‘compartmentalisation’).
There should probably be a private place to discuss issues like this and determine if they are worth bringing up more publicly, after taking account of the many downsides (stoking internal division, wasting effort on a mainstream issue, alienating/offending half of the political spectrum whichever position we take etc).
Re use of ‘inconvenient’, I’ve also used that to describe things that are harmful, but fall short of e.g. a serious injury, for lack of a better English term. However, I’ve discovered that the general public thinks of inconveniences exclusively as things that wastes time or effort. So, for example, eating less tasty food is never an ‘inconvenience’, even if it is a modest harm.
Using inconvenience this way is confusing, so I’ve stopped using it as a general term for medium-sized harms, and recommend others do the same.
Instead we can use depending on context: loss, misfortune, modest/mild/serious harm, damage and hurt.
Having experienced (a comparatively smooth and uncomplicated) pregnancy and delivery, ‘discomfort’ feels wildly inadequate.
For example, rates of post partum depression are about 10%, higher in adverse circumstances. Depression is one illness where a person’s QALY’s are plausibly <0
As well as being woefully inadequate to describe what’s involved physically, the analysis here doesn’t address the other harms and distress that would be involved in term pregnancy, delivery and relinquishing of a child. The woman’s family, personal and work-life would all be affected in difficult to predict and probably negative ways. For example, what if you are a casual worker with no maternity allowance? Almost certainly lose shifts as you get more pregnant, probably lose your job.
rates of post partum depression are about 10%, higher in adverse circumstances. Depression is one illness where a person’s QALY’s are plausibly <0
Apparently even “Major depressive disorder: severe episode” only costs 0.655 QALYs.. If we generously assume every instance of post partum depression is ‘major’ and ‘severe’, and generously assume it lasts for 3 years, we get 30.10.655 = 0.1965 QALYs. As we were generous on both multiplicative assumptions, it’s plausible the true number is much much lower. Yet even if it was as high as 0.1965, that’s not enough to justify aborting a fetus if you ascribed even a 1% chance of it having moral value.
So perhaps my wording choice could have been better—but I don’t think it actually makes much difference to the object-level issue.
there are different ways of scoring QALYs—most of the constructs seem pretty dumb on the face of it that advantage people with small issues across the board compared to people with life-cripplingly severe issues along one dimension.
We’re not likely to get any leverage on it one way or the other, because of the resources already invested pushing both ways.
Do you think we should give up on immigration as well? That’s a pretty ‘hot button topic’ as well. At least in the UK it seems much more political than abortion.
I certainly think we should be wary when discussing immigration: we should be aware that discussing it in detail could be destructive (eg alienate people with particular political affiliations entirely), and that it seems intractable. We might want to, for example, wait for the Copenhagen Consensus Centre to do more work on it, and see whether they come up with tractable ways to help the world based on it. On the other hand, the harm I was trying to describe in the case of abortion is far greater than immigration. While I would expect there to be somewhat few readers of the blog sufficiently emotionally attached to one view on immigration that they would experience a somewhat careless discussion of it as distressing, I would expect there to be decidedly more so on abortion. If abortion seemed a more tractable issue, it would likely still be worth having the discussion, but trying to be careful in the language used (just as when comparing the effectiveness of charities, it’s important to be sensitive to the suffering relieved by charities which are comparatively ineffective). But given the current state of things, it doesn’t seem worth it. This is compounded by the fact that effective altruism in general is sometimes seen as somewhat male dominated, and the people likely to be put off by insensitive-seeming discussion of abortion are likely to be disproportionately women. Given that, and the huge space of effective research to be done, and topics which need further analysis, it seems sensible to focus on those others rather than this one.
One relevant difference between abortion and immigration is that rival views about abortion, but not about immigration, correlate well with positions on the left-right continuum. Pulling the rope sideways thus seems easier in the case of immigration, because you can appeal to both the left and the right, and cannot be accused of being partisan to either.
Given the availability of adoption, “inconvenient” seems like a reasonable description for “timing is wrong”.
I agree, however, that sometimes it might cause substantial suffering—hence why I suggested an annualized figure of 0.494 QALYs. That’s a very high number! It suggests pregnant women would be almost indifferent between
pregnancy and then adoption
a 50% chance of going into a coma for the rest of the year
which seems if anything to assign too great a negative weight to pregnancy.
In I think we need to be very careful of availability bias and scope insensitivity. Our individual preferences, and the suffering of already existing, literate people are very cognitively available—the opportunity cost is not. Doing explicit QALY calculations allows us to avoid this, but we have to actually do the calculations.
This post made me rather uncomfortable. I think what got to me was a somewhat flippant expression of what it was like for ‘Sarah’ to be unwantedly pregnant: “She has made plans which are inconsistent with being pregnant, and prefers not to give birth at the current time.”, which is summarised in the table as the idea that bringing the fetus to term would be ‘inconvenient’. This seems dismissive of the suffering which could be entailed by bringing it to term.
While it seems quite likely that people do compartmentalise, in this particular example it’s not at all clear to me that that is a bad rather than good thing. Abortion is a very hot button topic. We’re not likely to get any leverage on it one way or the other, because of the resources already invested pushing both ways. It’s also likely to be emotional to people (as Lila described in her comment). So actually, taking pains to think through what implications effective altruist ideas might have for abortion, and discussing it a bunch, might just have negative consequences. It might be better to start by focusing on areas where we can ‘push the rope sideways’.
It’s probably not a good idea to tackle abortion for the reasons you give, but we can’t know that if we never think through the implications of our beliefs (‘compartmentalisation’).
There should probably be a private place to discuss issues like this and determine if they are worth bringing up more publicly, after taking account of the many downsides (stoking internal division, wasting effort on a mainstream issue, alienating/offending half of the political spectrum whichever position we take etc).
Re use of ‘inconvenient’, I’ve also used that to describe things that are harmful, but fall short of e.g. a serious injury, for lack of a better English term. However, I’ve discovered that the general public thinks of inconveniences exclusively as things that wastes time or effort. So, for example, eating less tasty food is never an ‘inconvenience’, even if it is a modest harm.
Using inconvenience this way is confusing, so I’ve stopped using it as a general term for medium-sized harms, and recommend others do the same.
Instead we can use depending on context: loss, misfortune, modest/mild/serious harm, damage and hurt.
Discomfort, maybe
Good phrase; I’ll use it in future.
Having experienced (a comparatively smooth and uncomplicated) pregnancy and delivery, ‘discomfort’ feels wildly inadequate.
For example, rates of post partum depression are about 10%, higher in adverse circumstances. Depression is one illness where a person’s QALY’s are plausibly <0
As well as being woefully inadequate to describe what’s involved physically, the analysis here doesn’t address the other harms and distress that would be involved in term pregnancy, delivery and relinquishing of a child. The woman’s family, personal and work-life would all be affected in difficult to predict and probably negative ways. For example, what if you are a casual worker with no maternity allowance? Almost certainly lose shifts as you get more pregnant, probably lose your job.
Apparently even “Major depressive disorder: severe episode” only costs 0.655 QALYs.. If we generously assume every instance of post partum depression is ‘major’ and ‘severe’, and generously assume it lasts for 3 years, we get 30.10.655 = 0.1965 QALYs. As we were generous on both multiplicative assumptions, it’s plausible the true number is much much lower. Yet even if it was as high as 0.1965, that’s not enough to justify aborting a fetus if you ascribed even a 1% chance of it having moral value.
So perhaps my wording choice could have been better—but I don’t think it actually makes much difference to the object-level issue.
there are different ways of scoring QALYs—most of the constructs seem pretty dumb on the face of it that advantage people with small issues across the board compared to people with life-cripplingly severe issues along one dimension.
Untrained childbirth scores much higher on pain severity than almost all medical problems—at least on one pain scale http://www.thblack.com/links/RSD/McGill500x700.jpg
Do you think we should give up on immigration as well? That’s a pretty ‘hot button topic’ as well. At least in the UK it seems much more political than abortion.
I certainly think we should be wary when discussing immigration: we should be aware that discussing it in detail could be destructive (eg alienate people with particular political affiliations entirely), and that it seems intractable. We might want to, for example, wait for the Copenhagen Consensus Centre to do more work on it, and see whether they come up with tractable ways to help the world based on it. On the other hand, the harm I was trying to describe in the case of abortion is far greater than immigration. While I would expect there to be somewhat few readers of the blog sufficiently emotionally attached to one view on immigration that they would experience a somewhat careless discussion of it as distressing, I would expect there to be decidedly more so on abortion. If abortion seemed a more tractable issue, it would likely still be worth having the discussion, but trying to be careful in the language used (just as when comparing the effectiveness of charities, it’s important to be sensitive to the suffering relieved by charities which are comparatively ineffective). But given the current state of things, it doesn’t seem worth it. This is compounded by the fact that effective altruism in general is sometimes seen as somewhat male dominated, and the people likely to be put off by insensitive-seeming discussion of abortion are likely to be disproportionately women. Given that, and the huge space of effective research to be done, and topics which need further analysis, it seems sensible to focus on those others rather than this one.
One relevant difference between abortion and immigration is that rival views about abortion, but not about immigration, correlate well with positions on the left-right continuum. Pulling the rope sideways thus seems easier in the case of immigration, because you can appeal to both the left and the right, and cannot be accused of being partisan to either.
My impression was that the left is pro-immigrant (at least more so than the right) and the far right is very xenophobic.
Indeed, you’re right.
The most frequently cited main motivation for aborting a fetus is
“Not ready for a(nother) child†/timing is wrong”
which does not mention suffering at all, and neither do the next two most frequently cited reasons
Can’t afford a baby now
Have completed my childbearing/have other people depending on me/children are grown
source
Given the availability of adoption, “inconvenient” seems like a reasonable description for “timing is wrong”.
I agree, however, that sometimes it might cause substantial suffering—hence why I suggested an annualized figure of 0.494 QALYs. That’s a very high number! It suggests pregnant women would be almost indifferent between
pregnancy and then adoption
a 50% chance of going into a coma for the rest of the year
which seems if anything to assign too great a negative weight to pregnancy.
In I think we need to be very careful of availability bias and scope insensitivity. Our individual preferences, and the suffering of already existing, literate people are very cognitively available—the opportunity cost is not. Doing explicit QALY calculations allows us to avoid this, but we have to actually do the calculations.