Thanks Vasco. After thinking about the numbers myself, I agree that allowing for states worse than death can’t on its own do a lot to make the numbers comparable between GiveWell and SWP. I do actually think it would move the numbers more than you’re accounting for there, both because the deaths prevented by GiveWell top charities might involve more than 7.5 minutes of excruciating pain and because GiveWell top charities prevent a lot of morbidity among people who end up surviving (and I think they’re significantly underweighting the value of this, e.g. clean water interventions prevent about 6 person-years of being sick with waterbone illnesses for everyone person who dies, and I would significantly prefer to be in a dreamless sleep than be conscious with a severe enteric infection.[1] But the DALY weight for severe diarrheal illness is 0.247, implying 3/​4ths the wellbeing[2] of being fully healthy). But this is at most going to change the cost-effectiveness of GiveWell top charities by a factor of 2, not 4 OOMs.
As for the 10000x difference in weights between disabling and excruciating pain, I have to admit I’m pretty confused here. On the one hand, it strikes me as fundamentally implausible that suffocating is 10000x worse than dying of heatstroke. On the other hand, some of my intuitions do lean towards not being willing to endure e.g. burning to death for almost anything else. I’ll need to spend some time reviewing the literature before I try and make further sense of how to best make these tradeoffs.
Thanks again for all your work and engagement here, I think it’s genuinely quite valuable to be having these conversations!
I’ll need to spend some time reviewing the literature before I try and make further sense of how to best make these tradeoffs.
I had a look at the literature a few weeks ago (skimming some of the studies mentioned here), and, as a result, updated to an intensity of disabling pain 10 % as high as my original one (from 100 to 10 times as intense as fully healthy life). It looks like there are no studies informing the intensity of excruciating pain:
We find it unlikely that the most intense pain experienced is of an Excruciating nature as defined in the Welfare Footprint framework, since this category is by definition associated with extreme and unbearable pain, not tolerated even if for a few seconds (a definition which does not coincide with the description of the patients in the studies above).
Thanks again for all your work and engagement here, I think it’s genuinely quite valuable to be having these conversations!
Thanks Vasco. After thinking about the numbers myself, I agree that allowing for states worse than death can’t on its own do a lot to make the numbers comparable between GiveWell and SWP. I do actually think it would move the numbers more than you’re accounting for there, both because the deaths prevented by GiveWell top charities might involve more than 7.5 minutes of excruciating pain and because GiveWell top charities prevent a lot of morbidity among people who end up surviving (and I think they’re significantly underweighting the value of this, e.g. clean water interventions prevent about 6 person-years of being sick with waterbone illnesses for everyone person who dies, and I would significantly prefer to be in a dreamless sleep than be conscious with a severe enteric infection.[1] But the DALY weight for severe diarrheal illness is 0.247, implying 3/​4ths the wellbeing[2] of being fully healthy). But this is at most going to change the cost-effectiveness of GiveWell top charities by a factor of 2, not 4 OOMs.
As for the 10000x difference in weights between disabling and excruciating pain, I have to admit I’m pretty confused here. On the one hand, it strikes me as fundamentally implausible that suffocating is 10000x worse than dying of heatstroke. On the other hand, some of my intuitions do lean towards not being willing to endure e.g. burning to death for almost anything else. I’ll need to spend some time reviewing the literature before I try and make further sense of how to best make these tradeoffs.
Thanks again for all your work and engagement here, I think it’s genuinely quite valuable to be having these conversations!
I took some notes on my willingness to make these tradeoffs when I was recently sick with norovirus and am hoping to write a short post on this soon!
DALY weights are a measure of health status, not wellbeing, but that hasn’t stopped anyone from using them as a unit of wellbeing
I had a look at the literature a few weeks ago (skimming some of the studies mentioned here), and, as a result, updated to an intensity of disabling pain 10 % as high as my original one (from 100 to 10 times as intense as fully healthy life). It looks like there are no studies informing the intensity of excruciating pain:
Likewise. Thanks, Matt!