Thanks for writing this—I really enjoyed reading through it, and definitely value hearing from someone with clinical experience of treating patients with mental illnesses.
Speaking for myself, I find the DALY framework helpful in thinking about estimating the health burden of diseases, but definitely don’t see it as the be all and end all.
That’s kind of you to say—it’s definitely a sobering perspective working in mental health and you end up feeling very strongly (clearly...) about wishing people struggling with mental illnesses had more support.
Of course that makes me biased, and it’s worth saying I’m still learning—if I presented this to my psychiatry trainee colleagues, I’m sure they would all have different takes, let alone more senior clinicians or doctors in other specialities. Clinical work means, of course, we don’t think about ‘evaluating’ illnesses outside of the patients in front of us and it’s highly individualised as a field.
I think that makes it easy to go with my initial reaction to all of this (“Mental health is too complicated, shouldn’t be simplified to numbers, you all don’t understand,” etc). It makes me uneasy to think about ‘comparing’ suffering—it’s much more comfortable to stay railing against the machine in my position, and it’s historically why I’ve not felt aligned with EA or utilitarianism more broadly.
But obviously CEAs happen all the time in medicine, it’s just at a level way over my head so I don’t have to think about it. Reading some of the work that went into the DALY was pretty fascinating to see how people approached this problem on a global health scale (I also favoured the DALY most out of the frameworks I encountered). I think my overall takeaway is a greater sympathy for what EA is trying to do, and I definitely learned a lot in the process—it’s been humbling trying to think from this perspective (even if massively long forum posts are not the usual behaviour of the humble).
Thanks for writing this—I really enjoyed reading through it, and definitely value hearing from someone with clinical experience of treating patients with mental illnesses.
Speaking for myself, I find the DALY framework helpful in thinking about estimating the health burden of diseases, but definitely don’t see it as the be all and end all.
That’s kind of you to say—it’s definitely a sobering perspective working in mental health and you end up feeling very strongly (clearly...) about wishing people struggling with mental illnesses had more support.
Of course that makes me biased, and it’s worth saying I’m still learning—if I presented this to my psychiatry trainee colleagues, I’m sure they would all have different takes, let alone more senior clinicians or doctors in other specialities. Clinical work means, of course, we don’t think about ‘evaluating’ illnesses outside of the patients in front of us and it’s highly individualised as a field.
I think that makes it easy to go with my initial reaction to all of this (“Mental health is too complicated, shouldn’t be simplified to numbers, you all don’t understand,” etc). It makes me uneasy to think about ‘comparing’ suffering—it’s much more comfortable to stay railing against the machine in my position, and it’s historically why I’ve not felt aligned with EA or utilitarianism more broadly.
But obviously CEAs happen all the time in medicine, it’s just at a level way over my head so I don’t have to think about it. Reading some of the work that went into the DALY was pretty fascinating to see how people approached this problem on a global health scale (I also favoured the DALY most out of the frameworks I encountered). I think my overall takeaway is a greater sympathy for what EA is trying to do, and I definitely learned a lot in the process—it’s been humbling trying to think from this perspective (even if massively long forum posts are not the usual behaviour of the humble).