You misunderstand me. I don’t think the person is down voting because they disagree, but the fact they are down voting without commenting is an indication they disagree that a down vote requires a comment. That’s not ironic.
Bernadette_Young
Karma: 488
Not really ironic—just clearly someone who disagrees.
There are indeed great questions there with extensive responses, many of which point to information that was already publicly available.
I think it’s awesome for people to ask questions: in the GWWC fundraising post there’s been a really productive discussion. But here, as on a previous occasion, you seem to be suggesting there is some deception going on. You’ve suggested in another post that you see these responses as ‘punching up’, but by keeping it vague it also looks a lot like mud-slinging (as opposed to an airing of your concerns, which I hope everybody would be keen to have happen).
Hopefully you’ll have time to elaborate on your concerns soon.
I’d find it weird if people who chose their careers based on what they thought was of the greatest benefit didn’t advocate for that work to other people with similar priorities.
And in response to the suggestion of self-serving behaviour or even corruption raised by this post, it should be made absolutely clear that the trustees of CEA are legally barred from being employed by or financially profiting from its operations.
The GWWC fundraising prospectus sets out in quite extensive detail the observations and assumptions that underlie the figures, as well as providing the spreadsheets to let you explore how your own probability estimates would change them.
What further information do you think should be included?
This is fantastic work! Awesome!
Your statement here suggests we have nothing to learn from other movements, which seems an unhelpful position to take.
Sorry for being slow to reply James.
The methods of EBM do absolutely favour formal approaches and concrete results. However—and partly because of some of the pitfalls you describe—it’s relatively common to find you have no high quality evidence that specifically applies to inform your decision. It is also relatively common to find poor quality evidence (such as a badly constructed trial, or very confounded cohort studies). If those constitute the best-available evidence, a strict reading of the phrase ‘to greatest extent possible, decisions and policies should be based on evidence’ would imply that decisions should be founded on that dubious evidence. However in practice I think most doctors who are committed to EBM would not change their practice on the basis of a bad trial.
Regarding tradeoffs between maximising expected good and certainty of results (which I guess is maximising the minimum you achieve), I agree that’s a point where people come down on different sides. I don’t think it strictly divides causes (because as you say, one can lean to maximising expected utility within the global poverty), though the overlap between those who favour maximising expectation and those think existential risk is the best cause to focus on is probably high. I think this is actually going to be a topic of panel discussion at EA Global Oxford if you’re going?
Yes, but a very specific one. After our experience I would generally recommend getting a solicitor to write your will.
I think anybody wanting to raise a potentially divisive or negative discussion should think carefully about how likely a given discussion is to be self-defeating, or to yield negative results that outweigh the benefits.
The setting matters a lot to this: if you post on Facebook, the discussion gets published in lots of people’s feeds in a manner that posters don’t control (I find ‘likes’ on comments I make in the EA FB group from friends I know are not members of that group). Also, the FB policy of only allowing ‘upvoting’ means that the degree to which people’s statements are well or badly received is not well reflected. Finally the listing of threads by order of most recent comment keeps pile-ons in the current discussion.
(This also creates an important asymmetry: those who don’t care about the discussion being damaging are more likely to continue it, while those who disagree might avoid voicing their disagreement in the hopes that the thread will die away.)
This forum doesn’t suffer any of those drawbacks, so I believe it is a better arena for raising these issues for discussion if you reasonably believe there is something important at stake.
When writing a will last year (through quite a basic legal-and- will-writing service), I encountered a potential serious pitfall for people writing unusual wills. One of the legacies I wanted to leave was larger than they expected. They had a maximum £ value for specific legacies, and wen I said I wanted to leave a bigger amount they cautioned me that it was likely to be overturned if legally challenged because ‘nobody would expect you meant that’. I’ve heard similar stories from solicitors (eg a will written in the UK was overturned because the court ruled the parents would not have meant to leave the majority of their estate to the child who was better off. They did: they asked him to use the monety help the other child who was not good at handling finances, but the court reversed their legacies). One of the reasons to have a solicitor look over your will is that they challenge and confirm unusual clauses, which makes them harder to challenge when you die.
All of which is to say: if you are seeking to raise funds via wills, or intended to leave a legacy that would count as unusual in normal practice, than the less formal legal input you have had the more vulnerable it will be to challenge. It cost us £99 for a joint will writing package, which is a reasonable insurance policy to ensure our estates are donated as we wish.
I think your distinction rests on an overly simplistic description of ‘evidence based medicine’, and that to divide effective altruism into camps is likewise a false dichotomy.
(TLDR: EBM doesn’t equal total reliance on meta-analyses. Evidence based medicine still requires reason. EBM without reason is just as dangerous as reason without evidence)
As most people here known, in EBM, the highest standard of evidence is a meta-anaysis of well conducted randomised, controlled, double blind trials. Unfortunately decisions that can be supported by evidence of such quality are relatively few. There are many reasons for this: trials are difficult to design and run in such a way they actually answer the question correctly; when designed well they are expensive to run; not all trial data are reported; there is a long lag time between identifying a question, conceiving and conducting the trials, analysing and reporting the data, and considering how this changes the weight of available evidence.
In general trials are most often run for investigations or interventions that can make somebody money or where regulation demands it for something novel. Drugs and devices need trials to be licensed, but once licensed they can be sold and used ‘off license’ for other conditions without further RCTs. It is considered unethical to withdraw what is currently considered standard best practice and replace it with a placebo in a trial. For these and other reasons there remains a huge amount of medical decision making is not supported by highest quality evidence.
However we still need to act. We can’t put off our patients and ask them to come back with their perforated bowel once somebody has done a controlled trial of operating on a burst colon vs placebo. In the absence of highest quality evidence medical professionals still practice in a way that is considering and respectful of evidence. We consider lesser forms of evidence, we weigh the likelihoods based on biological theories, and we update our beliefs as new evidence comes to light. It all sounds a bit Bayesian, doesn’t it?
In fact, the physicians I know who are most committed to guiding their practice with evidence and reason are prepared to act against the results of randomised clinical trials. As a recent example: a US based RCT showed that EGDT—targeting treatment of septic (ie very sick from infection) at particular numbers—was superior to usual care (ie being guided by the treating doctor). In fact they demonstrated a massive 16% absolute decrease in 30 day mortality. UK, European and US centres set about trying to replicate it, but given what was at stake this required huge and co-ordinated efforts. It took over a decade and all 3 multicentre studies showed… absolutely no benefit.
http://blogs.nejm.org/now/index.php/the-final-nail-in-early-goal-directed-therapys-coffin/2015/03/24/In the meantime, what should the evidence-based practitioner have done? A shallow answer would be to do what the evidence said: immediately change practice to EGDT, and only update when a further RCT countered the result. But that would have been a costly mistake that subjected patients to unnecessary invasive monitoring. The results of the first trial were counterintuitive to many experts, especially those who have seen fashions for ‘treating the numbers’ (rather than the patient) arise and be discredited over many years. Most senior ED/ITU doctors did not follow EGDT in the decade between results because the trial data was not enough to cause them to update their practice.
It later came out that in the original trial there were several systematic ways that the intervention group differed from the usual care group, but this was not fully captured in the study report. Further, the mortality in the first trial was much higher than we see in the NHS. The overall ‘story’ is probably that treatment by numbers is not better than getting the basics right, which we overall do.
Reason and evidence aren’t separate camps. They are both fundamentally important when you act in the real world.
DOI—studying evidence based medicine on and off since 1999.
I agree—we live our lives in communities, and we are often better placed to help people we know. (That’s an excellent reason to make sure that any interventions acting far away are well backed up by data that measures what is important to the recipients, not to the donors or those intervening).
Thank you. For myself at least I don’t see it as reason over empathy, but a reasoned response to what empathy prompts.
Thanks for the kind thoughts.
I’m Not sure what if any discussion I was looking to prompt, but it does strike me that emphasis on things that can be codified and argued over probably means that fora like this don’t encompass important aspects of EA, such as the forces that motivate many of us.
On everyday altruism and the local circle
When you say asap do you mean to imply the prior applications will get priority?
This is an interesting read, thank you!
Your analysis is even more widely relevant if we consider the costs in two parts: the cost of spending time as an unwaged intern (rent, food, local travel), and the costs of travel to the hub (flight, visa, passport). The former would apply equally to anyone living outside the hub, the second is considerably higher if you are as far away as Australia.
(I make the Oxford—Australia journey about once a year from my personal budget, spending about $AU 1800 each time to do so)
I believe the updated pledging form asks people to specify the broad cause(s) they will donate to (eg poverty, animal suffering, existential risk), so that information would be readily available to the GWWC team.
Ravi Patel is a medical student in Cambridge who independently led the enormously successful campaign to get new pledges as a New Years resolution. It was hosted in a Facebook group, and you can see here the people posting as they joined. https://www.facebook.com/events/1581545938749145/ This coincides with the Dec/jan spike on the chart above.
But by the same token everybody in this movement has competing priorities and calls on their time. Their feedback might be helpful to you, but why should they be obliged to give it as the price of participating?