Comment author: Sanjay 18 December 2016 12:50:44PM *  2 points [-]

My belief that AMF is a good donation opportunity are based on the belief that a malaria-free world is qualitatively better than one with malaria. It is based on beliefs such as the following (no one of which I probably have hugely rigorous proof for, but I broadly believe to be reasonable beliefs)

  • Deaths, especially of children, cause some sadness

  • Where parents have lots of children, there is less capacity to invest in any of them, so those children tend to be less likely to have a basic level of education

  • To the extent that malaria contributes to adult death, it (somewhat) leads to a society with a surfeit of young men, who are especially prone to be under-educated relative to their potential (see previous point) – this leads to a higher probability of violence and war.

  • To the extent that malaria contributes to adult death, it stops people from fulfilling long-term life plans to build things of value for society (e.g. companies, civil society)

  • (Linked to the previous point) Malaria slows economic growth, and economic growth is probably a good thing for the poorest societies

  • I would be worried about an argument against AMF’s work if I thought it would lead to explosive population growth that was too fast for infrastructure development to keep up – to a certain extent I think there is an element of valid worry here, but there is at least a partial self-regulating element (albeit with a lag) – this is what David Roodman’s post told us (or which we might have guessed by reading, e.g., work by Jeffrey Sachs)

I have reviewed GiveWell’s past CEA analyses with interest, but always imagined that measures like lives saved or QALYs were simply a simplification/proxy to get at the things we really care about – namely the sorts of things I’ve listed above. If my perspective on this is a minority view, this would come as a genuine surprise to me.

Unless I’ve misunderstood, the arguments that Michael has presented shouldn’t update my propensity to donate to AMF. More than happy to be educated if I’ve misunderstood

Comment author: MichaelPlant 23 December 2016 02:24:16PM 1 point [-]

Hello Sanjay,

To be clear, I'm not arguing that AMF is a total waste of money every way you look at it. I'm arguing that, whichever view you take about population ethics, you should probably think an alternative is more cost-effective. I reckon this conclusion is still probably true for you, even once you take the things you've mentioned into account. I say 'probably' because I don't know what your exact moral views are, and there's quite a lot of empirical certainty anyway knowing the impact of AMF vs alternatives.

I'd be curious to know how what someone would spend your money as a donor if their goal was economic growth in the developing world. Is there something more effective than Give Directly? It sounds like your goal is less about creating/saving happy lives, and more about economic and civic development. It's not impossible, but I'd find it surprising (see my comment to R. Wiblin earlier) if a health intervention like AMF happened to be the best economic intervention too. To pour some cold water on AMF's economic effectiveness, GiveWell reckons AMF saves an under-5 for $9,000 dollars, so one for every 5,000ish bednets, and an adult (by which I think they mean over-5) for $38,000. My guess is there are better ways to spend $9,000 to boost growth than saving a child's life, if boosting growth is your aim.

Comment author: MichaelPlant 23 December 2016 02:08:18PM 0 points [-]

Just a small comment. Shouldn't we really be calling this worry about 'movement building' rather than 'meta'? Meta to me means things like cause prioritisation.

Comment author: MichaelPlant 16 December 2016 04:06:24PM 2 points [-]

I also down voted this. Is this an undergraduate essay you wanted feedback on or something? If so, you should say so and explain what you want from the forum.

Comment author: KrisMartens 28 November 2016 09:02:07AM 2 points [-]

By the way, I e-mailed this before to CEA after attending the ABCT-conference in New York. ABCT= Association for Behavioral and Cognitive Therapies (US). Maybe interesting for some of you:

*Given the fact I heard a lot of ambitious attempts to reduce human suffering the last couple of days, I realized I haven’t encountered these voices in the EA movement yet. Maybe these suggestions have been made before, but I’ll give it a try anyhow.

I make these suggestions as speakers, because I think none of these CBT-interventions are ready to compete with the most efficient ways of reducing human suffering. But still, I guess evidence-based talks on what human suffering is and how to reduce it, are still interesting for EA conferences.

1/ Steven Hayes Stubborn bigshot in CBT, founder of Relational Frame Theory (RFT) & Acceptance and Commitment Therapy (ACT). Had an enormous impact on how CBT-therapists and researches view human pathology and suffering. He’s a fantastic speaker. And a nerd, I guess he’ll love EA and is able to make a great talk, for example on why human suffering differences from non-human-animals (language!), and what to do about it.

2/ Michelle Craske President of ABCT. Presented this very ambitious project today: “Understanding, preventing and treating the world’s greatest health problem’

3/ Vikram Patel But apparently this link already exists a bit

4/ David Clarke His work on IAPT is great: implementing evidence based care in UK to reach out to a lot of people. And changing the culture into one where data-collection is a great part of it.*

I think IAPT is the best way to go for systemic change on human psychological suffering right now. It probably has the biggest added value. Having those meta-organizations like NICE in the UK, the implementation of more mechanism-focused therapies and intervention for prevention will follow automatically.

Comment author: MichaelPlant 15 December 2016 09:17:36PM 0 points [-]

And yes, I'd love to hear any of all of these people talk at EA events.

Comment author: KrisMartens 28 November 2016 07:08:36AM 2 points [-]

I was in contact with Michael before, and let me first say I'm happy he promotes the focus on IHI vs EHI in the EA community.

However, I disagree on how to think of IHI's. I've been struggling with how to think of human suffering since I learned about EA, and it seems to be caused by different views on human suffering between philosophers and what I've learned from clinical psychology, mainly by more pragmatic contextual behavioral sciences (not as an authority argument, but FYI I'm a clinical psychologist/CBT-therapist/PhD-student).

My argument boils down to these 2 points: 1) The premisse and constructs of the EA movement already causes a bias towards Positive Psychology and 2) there are better potential alternatives out there.

"Classical utilitarianism is understood as having three components. First, hedonism about well-being: what makes someone’s life go well(/badly) is experiencing happiness(/unhappiness) – as opposed to having one’s desires met or achieving items on an objective list – and every moment of experience has the same importance to their well-being. I’ll define ‘happiness’ here as any mental state that feels good to the person feeling it, and unhappiness as the converse."

So I believe this is a false distinction, and there is great added value in using a more pragmatic paradigm that can be considered as a third option. And that is: building contexts wherein people can live value-based lives, and preventing avoidable psychological suffering.

"(I note the distinction between mental illness and ordinary human unhappiness is arbitrary and nothing hangs on its precision: mental illnesses and ordinary human unhappiness are supposed to highlight different points on the happiness spectrum. I could alternatively have called these something like ‘clinical unhappiness’ and ‘non-clinical unhappiness’ instead.)"

Yes it is an arbitrary distinction, and contributes to the bias towards positive psychology. I don't see a reason why to make a distinction: humans are humans, and with the knowledge of how high prevalence rates of psychopathology are, it's more logic to assume that underlying mechanisms are present in each of us. The danger of making this distinction is that you end up with interventions targeting the 'ordinary human unhappiness' and not taking into account what these interventions do with people higher up the continuum of suffering. And that's exactly one of the criticism positive psychology receives.

This bias becomes more explicit in the article when Michael describes branches of psychotherapy.

"Regarding mental health a number of methods which have been shown to work including, but not limited to, Cognitive Behavioural Therapy (‘CBT’), mindfulness-based stress reduction (‘MBSR’) and, to a much lesser extent, Positive Psychotherapy. "

If it is to a much lesser extent, then why acknowledge Positive Psychotherapy? NICE guidelines (UK) and APA guidelines (US) don't regard positive psychology interventions as evidence based. (And by the way, classical CBT and MBCT can be regarded as just being part of the happy family of CBT). Another problem is the word 'methods'. Before we start thinking of methods, we need a theory on human suffering, so that when we think of interventions we don't just start from constructs like happiness. This discussion is very alive in the CBT-family, because of the rise of another branch: Acceptance and Commitment Therapy (ACT).

So EA'ers interested in this topic, please read on ACT and the underlying theory of it (Relational Frame Theory, RFT). Before we use numbers, we need a decent theory on suffering to frame them.

If this topic is still alive, I'll try to write another post on how effective altruism based on contextual behavioral sciences might look like. To say it very briefly, a distinction between two sorts of interventions is needed: - building contexts (by EHI) wherein each human being has the possibility to live towards their values (and that has the side effect of unavoidable suffering, e.i. by having the time to worry and grief about the loss of loved ones). - promoting contexts (by IHI) with the least possible psychological suffering.

Comment author: MichaelPlant 15 December 2016 09:15:58PM 0 points [-]

Hello Kris, good to e-hear from you again. I haven't checked this thread in a couple of months so have only just seen this.

I'm not totally sure what it is you're suggesting we do (instead). You seem to be objecting to positive psych, but I never said it was all about positive psych, just that it was one of a number of tools that might allow us to increase happiness. My main point was that we've neglected internal happiness interventions and we should explore those alongside the external happiness interventions we're already working on.

What sort of theory of suffering might you be referring to? Is that about the nature of suffering, or about what makes suffering bad, or something else?

I'd be happy for you to facebook/email me so we can chat through this if you think that's interesting.

Comment author: MichaelPlant 09 December 2016 03:34:18PM 1 point [-]

Just a quick one - your link doesn't seem to work.

Comment author: Robert_Wiblin 07 December 2016 03:38:52AM *  5 points [-]

Two quick things. Firstly I think many people give to GiveWell recommended charities because they believe, rightly or wrongly, that a healthier population will spur economic growth, or political reform, or whatever else, which will improve the welfare of present and future generations of people in the country. That argument would apply to total utilitarians, though be swamped by arguments relating to existential risks.

Secondly, GiveWell at least does not claim that AMF is the 'most best charity', but rather that it meets their four criteria here (evidence, cost-effectiveness, room for more funding and transparency): . But other people might accidentally start using loose language like 'best charity', and they probably shouldn't.

Comment author: MichaelPlant 07 December 2016 11:31:03AM 3 points [-]

Yo Rob.

yeah, I agree it's possible people support AMF for reasons other than that they think saving lives is important, but I've actually never heard anyone talk about it in those terms maybe other than you and Ben Todd. If that's why people support AMF, that also implicitly concedes the point that they don't do it because it saves lives. I have no idea how to think about AMF vs anything else in terms of economic growth, but I'd be curious to see the argument if someone else has made it. It strikes me there are more direct ways to spur growth or reform than stopping young children dying.

As to your 2nd point, that's not how Givewell sell themselves, given they talk about 'top charities'.

"GiveWell tries to help donors do as much good as possible with each dollar they give"

"We recommend charities according to how much good additional donations can do. We examine charities' overall quality and cost-effectiveness, as well as what more funding would enable them to do. We regularly publish discussions of our top charities' strengths and weaknesses"

If that's what GW say, but what they mean by best, when pushed, is "meets are 4 criteria" that a bit of a motte and bailey. Also, it's hard tot hink about cost-effectiveness is anything but moral terms.

Comment author: Julia_Wise  (EA Profile) 06 December 2016 03:23:24PM *  6 points [-]

You thought you were giving a child 35+ years of life and preventing parental suffering, but now you're just (in effect) doing the former.

Do you mean the latter?

If parental suffering is equivalent to taking away 1 year of happy life away from each parent

I think we have very different intuitions here. I'd instantly give a year of my life to not watch my two-year-old daughter die, because I expect that 50 more years as a bereaved parent is worse than 49 years as the parent of a living child. I expect most parents would say the same (though of course social acceptability bias makes it more likely that parents will say that.) Also we may be getting into preference vs. hedonic utilitarianism here, not sure where I stand on that.

In general, though, this post does change the way I think about saving lives; thank you for writing it up.

Comment author: MichaelPlant 07 December 2016 11:22:50AM 1 point [-]

in response to your first point, yes I did mix those up.

And for the 2nd, I'm thinking hedonically and am leaning on the literature on hedonic adaptation. I'm not sure how to think about re-doing the calculations if I was using preferences util. So I think it's consistent to say "I would give up much more than a year of life to keep my child alive" whilst recognising that few (any?) events have a long term impact on happiness, either positive or negative.

Comment author: MichaelDickens  (EA Profile) 06 December 2016 03:53:22PM 3 points [-]

What is the difference between the deprivationist view and the QALY-equivalent of saving a 5-year old's life?

It sounds like you're slightly misunderstanding me. GiveWell's 2015 estimate said that the value of saving a 5-year old's life was ~36 QALYs, which is a time-discounted estimate of the number of quality-adjusted years of life the 5-year old will now have. In the 2016 estimate, employees explicitly input how valuable they think it is to save a 5-year old in terms of QALYs--on the spreadsheet, look at the "Bed Nets" tab in the row "DALYs averted per death of an under-5 averted — AMF". The median value is 8.25, and estimates range from 3 to 26. The highest estimate, 26, is still lower than last year's estimate of 36, which suggests that none of the employees who filled this out adopt the deprivationist view.

And yeah, I'm was just following you when you said there was a 'GiveWell view'. I know in your post you explain how it's a composition of staff views.

Last year GiveWell's cost-effectiveness estimate used 36 QALYs per life saved, which implies a deprivationist view. That's not a composite of staff views, that's the result implied by GiveWell's reported cost-effectiveness numbers. It now appears that no GiveWell employees (or at least none who contributed to this cost-effectiveness analysis) actually hold a deprivationist view.

Comment author: MichaelPlant 06 December 2016 06:58:16PM 1 point [-]

Okay. I've gone back to GiveWell's estimates, thanks. They look confusing and complicated, and it seems that quite a bit has changed in the past year.

Comment author: MichaelDickens  (EA Profile) 06 December 2016 04:07:20PM *  1 point [-]

Well I discuss related issues here, but I'm not the first person to notice. Population ethicists have raised these issues many times before. I don't have any good references on hand because I learned about these issues from classes and discussions, not from reading papers; but here are some search results to get you started.

Edit: clarification

Comment author: MichaelPlant 06 December 2016 06:54:42PM 1 point [-]

I think this is mixing up two issues issues. The time-relative interest account is really about the value of life at various ages.

It's one way someone with person-affecting intuitions might account for the badness of death. Deprivationist is an alternative.

From wikipedia (

"A person-affecting or person-based view (also called person-affecting restriction[1]) in population ethics captures the intuition that an act can only be bad if it is bad for someone.[2] Similarly something can be good only if it is good for someone. Therefore, according to standard person-affecting views, there is no moral obligation to create people nor moral good in creating people because nonexistence means "there is never a person who could have benefited from being created". "

the points about [1] and [2] are points about person-affecting views, rather than necessarily anything to do with the time-relative interest account.

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