In defense of quantifying suffering

Author's note: Hi everyone! This is a cross-post from my blog. It's a short, accessible piece intended for those who find the idea of measuring suffering "icky," uncomfortable, or cold. I've noticed this as a fairly common reaction to effective altruism, and I wanted to write from a place of sincerely empathising with it. My goal here was to explore how quantification can complement our natural empathy rather than replace it. 

Is it more difficult to live with AIDS for a year or to have blindness for a year? There is a kind of person who wrinkles their nose at this question. I know because, I wrinkled my nose at it back in 2019, as I paged through my girlfriend's copy of Will MacAskill's Doing Good Better.

"I mean, ok, I get that you can try to measure which is worse, but, um. Feels really, icky? What would even possess someone to ask that question? It's kind of insufferable, you're not blind and you don't have AIDS, but now you're creating a 'badness' competition between the two?" I rolled my eyes. But I continued reading, because my girlfriend really liked the book and I liked her.

And as I read more, the arguments started making sense to me. The core idea is simple: if we want to help others effectively, we need ways to compare different forms of suffering so we can direct our limited resources where they'll do the most good. I hope you’ll allow me to explain a bit more.

Why we resist quantifying suffering

Why do many of us instinctively hate the idea of measuring and comparing suffering? I think it comes from the typical way that most of us orient towards pain: from a place of empathy and care. When my sister starts crying, my stomach clenches and I reach for her. I don't wonder, "Is this the most important suffering I could address right now? Does she feel worse than someone with malaria? Should I pull out my laptop and donate to a charity instead?" I ask my sister, "What's going on?" and I pull her into my arms.

I think, on some level, people are protective of their protective instincts. We like the very human part of us that jumps to our feet when a friend falls. That sees a hand extended to us when we tear up. We are protective of our pain, because it is ours.

This resistance makes sense. Quantification can feel cold, mechanical, and even dehumanising. It seems to reduce our human experience to numbers. And who are we to say, “hey, you there. This pain that feels so real and deep and consuming within you? It’s a 4. And that dude over there? His real and deep experience is a 6.”

A necessary tool in an overwhelming world

I have no argument against our empathetic impulses. I feel them too. But Doing Good Better was the very first book to ask me a question that truly resonated and changed my thinking for the better: there are a lot of hours in the day, there are a lot of people in a complicated world, and there are limited resources — we all have pain, but some of us have different kinds and many of us have a lot more resources than others — what should we do?

Putting a number on pain is not novel. When you go to the doctor and say your head hurts, you're asked to rate it on a scale from 1–10. This scale, despite its limitations and subjectivity, helps medical professionals determine appropriate treatment. When you join a transplant list, multiple factors including medical urgency, expected benefit, and time waiting are assessed to determine priority. These systems aren't perfect—they can't capture every nuance of human suffering—but they're necessary attempts to allocate scarce resources.

And it is awful, because shouldn't the doctor just take your headache seriously? And shouldn't everyone have the organs that they so desperately need? The act of quantifying suffering is not a commentary on the theoretical worth of someone's life or pain — those things are fundamentally invaluable, in my opinion. The act of quantifying suffering is a forced response to the reality that we can't help everyone.

Quantification as a complement to empathy

When we quantify suffering, we gain the ability to optimise our efforts. Research has shown that preventive malaria treatments can save a life for roughly $3000, while other interventions might cost tens or hundreds of thousands per life saved. This isn't just academic—these comparisons translate to real people whose lives are improved or saved because resources were directed more effectively. The humans themselves are, of course, never numbers — we are all very real and deserving.

And if every life matters equally, then we can and even should try to help as many people as possible.

But you don't need to do so at the cost of your sister, your friend, your care, your feeling. You can always connect with the parts of you that need to hold your loved ones — you can give those parts as much time as they need. But perhaps, you have space for other things too. The parts of you that understand how vastly your birthplace affects access to basic medical care, food, water, protection. The parts of you that understand how unfair everything is. The parts of you that have room to consider different approaches to doing good: to engage in analysis, triage, and exploration when necessary.

Quantification isn't meant to replace our empathy—it's meant to extend it, direct it. It's a tool that helps our compassion reach further and do more good in a world where needs far outstrip our capacity to address them all. By embracing both our intuitive empathy and analytical thinking, we can respond to the suffering right in front of us while also making thoughtful choices about how to help those we cannot see. I think that’s really, really beautiful. And to this day, I still say with certainty that one of the most important things I ever did was finish that book.