James Snowden🔸

Should char­ity pri­ori­tise the worst off?

• James Snowden🔸Sep 30, 2015, 11:22 AM

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  on: Why effec­tive al­tru­ism used to be like ev­i­dence-based medicine. But isn’t anymore

  Thank you all for some great responses and apologies for my VERY late reply. This post was intended to ‘test an idea/​provoke a response’ and there’s some really good discussion here.

• James Snowden🔸Aug 17, 2015, 9:23 AM

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  in reply to: Bernadette_Young’s comment on: Why effec­tive al­tru­ism used to be like ev­i­dence-based medicine. But isn’t anymore

  Bernadette,

  Thank you for your very informative response. I must admit that my knowledge of EBM is much more limited than yours and is primarily Wikipedia-based.

  The lines which particularly led me to believe that EBM favoured formal approaches rather than doctors’ intuitions were:

  “Although all medicine based on science has some degree of empirical support, EBM goes further, classifying evidence by its epistemologic strength and requiring that only the strongest types (coming from meta-analyses, systematic reviews, and randomized controlled trials) can yield strong recommendations; weaker types (such as from case-control studies) can yield only weak recommendations”

  “Whether applied to medical education, decisions about individuals, guidelines and policies applied to populations, or administration of health services in general, evidence-based medicine advocates that to the greatest extent possible, decisions and policies should be based on evidence, not just the beliefs of practitioners, experts, or administrators.”

  Criticism of EBM: “Research tends to focus on populations, but individual persons can vary substantially from population norms, meaning that extrapolation of lessons learned may founder. Thus EBM applies to groups of people, but this should not preclude clinicians from using their personal experience in deciding how to treat each patient.”

  Perhaps the disagreement comes from my unintentional implication that the two camps were diametrically opposed to each other.

  I agree that they are “both fundamentally important when you act in the real world” and that evidence based giving /​ evidence based medicine are not the last word on the matter and need to be supplemented by reason. At the same time though, I think there is an important distinction between maximising expected utility and being averse to ambiguity.

  For example, to the best of my knowledge, the tradeoff between donating to SCI ($1.23 per treatment) and Deworm the World Initiative ($0.50 per treatment), is that DWI has demonstrated higher cost effectiveness but with a wider confidence interval (less of a track record). Interestingly, this actually sounds similar to your EGDT example. I therefore donate to SCI because I prefer to be confident in the effect. I think this distinction also applies to XRisk vs. development.

• James Snowden🔸Aug 12, 2015, 6:41 PM

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  on: Why effec­tive al­tru­ism used to be like ev­i­dence-based medicine. But isn’t anymore

  Thanks both for thoughtful replies and links.

  I agree that it may be counterproductive to divide people who are answering the same questions into different camps and, on re-reading, that is how my post may come across. My more limited intention was to provide a (crude) framework through which we might be able to understand the disagreement.

  I guess I had always interpreted (perhaps falsely) EA as making a stronger claim than ‘we should be more reasonable when deciding how to do good’. In particular I feel that there used to be more of a focus on ‘hard’ rather than ‘soft’ evidence. This helps explain why EA used to advocate charitable giving over advocacy work /​ systemic change, for which hard evidence is necessarily more limited. It seems EA is now a broader church and this is probably for the better but in departing from a preference for hard evidence/​RCTs it has lost its claim to being like evidence-based medicine.

  The strength of this evolution is that EA seems to have absorbed thoughtful critiques such as that of Acemoglu http://​​bostonreview.net/​​forum/​​logic-effective-altruism/​​daron-acemoglu-response-effective-altruism although I imagine it must have been quite annoying to be told that “if X offers some prospect of doing good, then EAs will do it” when we weren’t at the time. Perhaps EA is growing so broad that the only real opponents they have left are the anti-rationalists like John Gray (although the more opponents he has the better)

Why effec­tive al­tru­ism used to be like ev­i­dence-based medicine. But isn’t anymore