Thanks for looking at this Vasco, it’s always great to see others doing this kind of cost-effectiveness analysis.
Your results indicate a substantially higher direct cost-effectiveness for SWP relative to the analysis I did last year. From looking at your methodology, I believe our primary difference comes from a difference in weighting the relative badness of different levels of pain. I used the same numbers as a 2023 RP report which weighted excruciating pain as 33 times worse than hurtful pain, while your weights put excruciating pain at 100000x worse than hurtful pain.
I’ve updated towards thinking 33x is probably at least an order of magnitude too low (and more recent RP reports have used weights in the vicinity of 600x), but I would personally be skeptical of 100000x.
Of course much of SWP’s impact is through creating systemic change, so I don’t want to over-emphasize the importance of these direct impact CEAs, as valuable as they are.
Disabling pain is 100 times as bad as hurtful pain. This means 14.4 min (= 24*60/​1/​100) of disabling pain neutralise 1 day of fully healthy life.
Excruciating pain is 1 k times as bad as disabling pain. This implies 0.864 s (= 14.4*60/​10^3) of excruciating pain neutralise 1 day of fully healthy life.
I think these are my 2 most uncertain assumptions.
I’ve updated towards thinking 33x is probably at least an order of magnitude too low (and more recent RP reports have used weights in the vicinity of 600x), but I would personally be skeptical of 100000x.
Nice that you updated. If excruciating pain was only 33 times as bad as hurtful pain, and this was as intense as fully healthy life (as I assumed), a fully healthy life plus less than 43.6 min (= 24*60/​33) of excruciating pain per day would still be positive. For excruciating pain 600 times as bad as hurtful pain, a fully healthy life plus less than 2.4 min (= 24*60/​600) of excruciating pain per day would still be positive. Excruciating pain is defined as follows by WFP (emphasis mine):
All conditions and events associated with extreme levels of pain that are not normally tolerated even if only for a few seconds. In humans, it would mark the threshold of pain under which many people choose to take their lives rather than endure the pain. This is the case, for example, of scalding and severe burning events. Behavioral patterns associated with experiences in this category may include loud screaming, involuntary shaking, extreme muscle tension, or extreme restlessness. Another criterion is the manifestation of behaviors that individuals would strongly refrain from displaying under normal circumstances, as they threaten body integrity (e.g. running into hazardous areas or exposing oneself to sources of danger, such as predators, as a result of pain or of attempts to alleviate it). The attribution of conditions to this level must therefore be done cautiously. Concealment of pain is not possible.
Do you think adding to a fully healthy 2.4 min/​d of scalding and severe burning would make it neutral (instead of negative)? The global healthy life expectancy in 2021 was 62.2 years, so maybe one can roughly say that a child taking their live due to excruciating pain would loose 50 years of fully healthy life. Under my assumptions, 0.864 s of excruciating pain neutralise 1 day of fully healthy life, so 4.38 h (= 0.864*50*365.25/​60^2) of excruciating pain neutralise 50 years of fully healthy life. However, I guess many people take their lives (if they can) after a few seconds (not hours) of excruciating pain. So, even if people should hold excruciating pain a few orders of magnitude longer to maximise their own welfare, my numbers could still make sense. 4.38 h is 5.26 k (= 4.38*60^2/​3) times as long as 3 s (a few seconds). One complication is that people may be maximising their welfare in taking their lives because excruciating pain quickly decreases their remaining healthy life expectancy, such that there is a decreased opportunity cost of taking their lives.
I think it would be useful to run surveys of the public to figure out conversion rates between fully healthy life and WFP’s various types of pain (annoying pain, hurtful pain, disabling pain, and excruciating pain) and pleasure (satisfaction, joy, euphoria, and bliss).
For reference, based on Rethink Priorities’ conversions rates between fully healthy life and WFP’s various types of pain (using the geometric mean between the lower and upper bound), I conclude the past cost-effectiveness of HSI is 48.8 times the marginal cost-effectiveness of GiveWell’s top charities.
Thanks for looking at this Vasco, it’s always great to see others doing this kind of cost-effectiveness analysis.
Your results indicate a substantially higher direct cost-effectiveness for SWP relative to the analysis I did last year. From looking at your methodology, I believe our primary difference comes from a difference in weighting the relative badness of different levels of pain. I used the same numbers as a 2023 RP report which weighted excruciating pain as 33 times worse than hurtful pain, while your weights put excruciating pain at 100000x worse than hurtful pain.
I’ve updated towards thinking 33x is probably at least an order of magnitude too low (and more recent RP reports have used weights in the vicinity of 600x), but I would personally be skeptical of 100000x.
Of course much of SWP’s impact is through creating systemic change, so I don’t want to over-emphasize the importance of these direct impact CEAs, as valuable as they are.
Thanks for engaging, MHR!
I think these are my 2 most uncertain assumptions.
Nice that you updated. If excruciating pain was only 33 times as bad as hurtful pain, and this was as intense as fully healthy life (as I assumed), a fully healthy life plus less than 43.6 min (= 24*60/​33) of excruciating pain per day would still be positive. For excruciating pain 600 times as bad as hurtful pain, a fully healthy life plus less than 2.4 min (= 24*60/​600) of excruciating pain per day would still be positive. Excruciating pain is defined as follows by WFP (emphasis mine):
Do you think adding to a fully healthy 2.4 min/​d of scalding and severe burning would make it neutral (instead of negative)? The global healthy life expectancy in 2021 was 62.2 years, so maybe one can roughly say that a child taking their live due to excruciating pain would loose 50 years of fully healthy life. Under my assumptions, 0.864 s of excruciating pain neutralise 1 day of fully healthy life, so 4.38 h (= 0.864*50*365.25/​60^2) of excruciating pain neutralise 50 years of fully healthy life. However, I guess many people take their lives (if they can) after a few seconds (not hours) of excruciating pain. So, even if people should hold excruciating pain a few orders of magnitude longer to maximise their own welfare, my numbers could still make sense. 4.38 h is 5.26 k (= 4.38*60^2/​3) times as long as 3 s (a few seconds). One complication is that people may be maximising their welfare in taking their lives because excruciating pain quickly decreases their remaining healthy life expectancy, such that there is a decreased opportunity cost of taking their lives.
I think it would be useful to run surveys of the public to figure out conversion rates between fully healthy life and WFP’s various types of pain (annoying pain, hurtful pain, disabling pain, and excruciating pain) and pleasure (satisfaction, joy, euphoria, and bliss).
For reference, based on Rethink Priorities’ conversions rates between fully healthy life and WFP’s various types of pain (using the geometric mean between the lower and upper bound), I conclude the past cost-effectiveness of HSI is 48.8 times the marginal cost-effectiveness of GiveWell’s top charities.