What is good for the world is not necessarily good for our self-image as heroic do-gooders. It would be good for the world if there was lots of money already being directed to the most important things. It would be good for the world if there were enough folks with money and good intentions to ‘fill up’ any funding gaps promptly after they arise. It would be good for the world that things that really matter already attract the intellectual and creative energies of large numbers of extremely talented people.
Yet, as you say, the closer this is to how the world really is squeezes out opportunities for individual acts of heroism. Things have gone badly wrong if vast stakes hang in the balance of my behaviour or my bank account—the margin of ‘vitally important things for thousands of lives/​the human species/​everything that matters’ should be really well populated, and my impact should be fairly marginal.
(Doctors sometimes pompously remark that medicine is the only profession that works towards its own obsolescence. And there definitely is a common medical Bildungsroman of how a JD-like idealist wanting to save the world gets marinated in blood sweat and tears into a grizzled-but-heart-in-the-right-place Perry Cox figure. Doctors I know dislike medical heroism not only because it can twist judgement, and not only because it can be an exercise in demeaning vaingloriousness, but also because good medicine should make heroism unnecessary—the system for medics to ‘save the day’ shouldn’t be extraordinarily demanding, else saving the day would be extraordinarily rare.)
Speaking for me, insofar as optimism about the state of the world is in tension with optimism about the likely impact I could make, I find the former much more psychologically comforting than the latter. It is damning indictment on the human condition I really am one of the best candidates to save the world.
I would also much prefer if altruism was obsolete. You could watch your hero stories on TV and be done with it. :)
Doctors sometimes pompously remark that medicine is the only profession that works towards its own obsolescence.
I see doctors more as organized rentseekers who peddle artificial scarcity. Not only don’t they invent the drugs they prescribe, they earn money because we need their permission before we can buy a prescription drug from the pharma industry. We can’t even sign a legal waiver to reject this paternalism.
Many times have I brought money into a doctor’s practice only to fetch the piece of paper that I needed to buy what I wanted to buy from other people.
Off topic: As a member of the aforementioned rent-seeking organisation, I might be biased, but I’m fairly pro- regulating access to medical substances via prescriptions or similar. The value a doctor (hopefully) provides when prescribing is that they will select the right medication, and I’d back them to get this right significantly more often than (even well informed) laypeople. Maybe a libertarian would be happy with legal waivers etc. to get access to medical substances (let an individual decide the risks that are tolerable, and let the market set the price on how much value expert prescribing adds!), but most folks might be happy for some paternalism to protect people from the dangers—even it means savvy educated laypeople suffer some costs. Besides, even if you could waiver away your own damages, most countries have some degree of socialized medicine which are obliged to treat you, and the costs to health services of medication errors are already significant. I’d guess letting amateurs have a go would increase this still further.
Yeah, it could make sense to move lots of medications down a notch on the restriction scale based on practical libertarian arguments but doing away with prescriptions altogether seems very net harmful.
Surely anyone save an absolutist non-EA (non-consequentialist) libertarian would grant that; but equally, surely it does make sense to move lots of medications down a notch on the restriction scale. See Slate Star Codex on the FDA, 23 and me, meds with tiny chances of huge harms compared to antidepressants with high chances of libido reduction, etc.
What is good for the world is not necessarily good for our self-image as heroic do-gooders. It would be good for the world if there was lots of money already being directed to the most important things. It would be good for the world if there were enough folks with money and good intentions to ‘fill up’ any funding gaps promptly after they arise. It would be good for the world that things that really matter already attract the intellectual and creative energies of large numbers of extremely talented people.
Yet, as you say, the closer this is to how the world really is squeezes out opportunities for individual acts of heroism. Things have gone badly wrong if vast stakes hang in the balance of my behaviour or my bank account—the margin of ‘vitally important things for thousands of lives/​the human species/​everything that matters’ should be really well populated, and my impact should be fairly marginal.
(Doctors sometimes pompously remark that medicine is the only profession that works towards its own obsolescence. And there definitely is a common medical Bildungsroman of how a JD-like idealist wanting to save the world gets marinated in blood sweat and tears into a grizzled-but-heart-in-the-right-place Perry Cox figure. Doctors I know dislike medical heroism not only because it can twist judgement, and not only because it can be an exercise in demeaning vaingloriousness, but also because good medicine should make heroism unnecessary—the system for medics to ‘save the day’ shouldn’t be extraordinarily demanding, else saving the day would be extraordinarily rare.)
Speaking for me, insofar as optimism about the state of the world is in tension with optimism about the likely impact I could make, I find the former much more psychologically comforting than the latter. It is damning indictment on the human condition I really am one of the best candidates to save the world.
I would also much prefer if altruism was obsolete. You could watch your hero stories on TV and be done with it. :)
I see doctors more as organized rentseekers who peddle artificial scarcity. Not only don’t they invent the drugs they prescribe, they earn money because we need their permission before we can buy a prescription drug from the pharma industry. We can’t even sign a legal waiver to reject this paternalism.
Many times have I brought money into a doctor’s practice only to fetch the piece of paper that I needed to buy what I wanted to buy from other people.
Off topic: As a member of the aforementioned rent-seeking organisation, I might be biased, but I’m fairly pro- regulating access to medical substances via prescriptions or similar. The value a doctor (hopefully) provides when prescribing is that they will select the right medication, and I’d back them to get this right significantly more often than (even well informed) laypeople. Maybe a libertarian would be happy with legal waivers etc. to get access to medical substances (let an individual decide the risks that are tolerable, and let the market set the price on how much value expert prescribing adds!), but most folks might be happy for some paternalism to protect people from the dangers—even it means savvy educated laypeople suffer some costs. Besides, even if you could waiver away your own damages, most countries have some degree of socialized medicine which are obliged to treat you, and the costs to health services of medication errors are already significant. I’d guess letting amateurs have a go would increase this still further.
Yeah, it could make sense to move lots of medications down a notch on the restriction scale based on practical libertarian arguments but doing away with prescriptions altogether seems very net harmful.
Surely anyone save an absolutist non-EA (non-consequentialist) libertarian would grant that; but equally, surely it does make sense to move lots of medications down a notch on the restriction scale. See Slate Star Codex on the FDA, 23 and me, meds with tiny chances of huge harms compared to antidepressants with high chances of libido reduction, etc.