Executive summary: This exploratory post argues that extreme suffering—such as a “Day Lived in Extreme Suffering” (DLES), encompassing intense physical or psychological pain—is vastly undervalued by existing metrics like QALYs and DALYs, and calls for dedicated research into how we might better quantify and prioritize the alleviation of such suffering in policy and philanthropy.
Key points:
Existing metrics inadequately capture extreme suffering: Tools like QALYs, DALYs, and WELLBYs often overlook short-term but intense suffering (e.g. torture, cluster headaches), as they emphasize duration and average impact over extremity.
Proposed new metric—DLES: The author introduces the concept of a “Day Lived in Extreme Suffering” as a more appropriate unit for evaluating acute, excruciating pain, whether physical or psychological, and outlines ways to conceptualize and communicate its severity.
Current burden may be substantial: For instance, cluster headaches alone may cause millions of DLES annually, with each attack likened to enduring surgery without anesthesia—underscoring an underappreciated public health burden.
Adapting evaluation frameworks: The post explores how DLES-based assessments could fit into existing cost-effectiveness paradigms (e.g. willingness-to-pay, precedent spending, multi-criteria decision analysis), and how both governments and philanthropists might integrate such metrics.
Major uncertainties and research needs: Key gaps include how people would trade a DLES against QALYs/WELLBYs, what interventions most cost-effectively avert DLES, and how to rigorously define and measure extreme suffering.
Call to action for the EA community: Given its focus on neglected and tractable problems, the author suggests effective altruists are particularly well-suited to develop tools, metrics, and priorities around extreme suffering and should treat this as a top research and advocacy frontier.
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Executive summary: This exploratory post argues that extreme suffering—such as a “Day Lived in Extreme Suffering” (DLES), encompassing intense physical or psychological pain—is vastly undervalued by existing metrics like QALYs and DALYs, and calls for dedicated research into how we might better quantify and prioritize the alleviation of such suffering in policy and philanthropy.
Key points:
Existing metrics inadequately capture extreme suffering: Tools like QALYs, DALYs, and WELLBYs often overlook short-term but intense suffering (e.g. torture, cluster headaches), as they emphasize duration and average impact over extremity.
Proposed new metric—DLES: The author introduces the concept of a “Day Lived in Extreme Suffering” as a more appropriate unit for evaluating acute, excruciating pain, whether physical or psychological, and outlines ways to conceptualize and communicate its severity.
Current burden may be substantial: For instance, cluster headaches alone may cause millions of DLES annually, with each attack likened to enduring surgery without anesthesia—underscoring an underappreciated public health burden.
Adapting evaluation frameworks: The post explores how DLES-based assessments could fit into existing cost-effectiveness paradigms (e.g. willingness-to-pay, precedent spending, multi-criteria decision analysis), and how both governments and philanthropists might integrate such metrics.
Major uncertainties and research needs: Key gaps include how people would trade a DLES against QALYs/WELLBYs, what interventions most cost-effectively avert DLES, and how to rigorously define and measure extreme suffering.
Call to action for the EA community: Given its focus on neglected and tractable problems, the author suggests effective altruists are particularly well-suited to develop tools, metrics, and priorities around extreme suffering and should treat this as a top research and advocacy frontier.
This comment was auto-generated by the EA Forum Team. Feel free to point out issues with this summary by replying to the comment, and contact us if you have feedback.