My Left Kidney

MathiasKB

This is a linkpost for https://www.astralcodexten.com/p/my-left-kidney

The last Guardian opinion columnist who must be defeated is the Guardian opinion columnist inside your own heart.

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Vasco Grilo6mo7

Thanks for sharing, Mathias! Posts like this motivate me to keep trying to contribute to a better world. On the other hand, and I hope this is not too harsh, I do not think donating one of my kidneys now is a cost-effective way of doing so:

From Scott's post, "the average donation buys the recipient about 5 - 7 extra years of life (beyond the counterfactual of dialysis)". So I will assume here donating a kindey leads to an additional goodness of 6 (= (5 + 7)/2) human-years.
I estimated corporate campaigns for chicken welfare reduce suffering at a cost-effectiveness equivalent to creating 30.1 human-year per $.
So I should only donate a kidney if the monetary plus non-monetary (time) costs are less than 0.199 $ (= 6/30.1).
The above may be an underestimate, but I also expect the cost to be much higher. From Sekercioglu 2020, "the average donation-related costs range from $900 to $19 900 over the period of predonation evaluation to the end of the first postoperative year".
I am also not confident extending human life is good due to the meat eater problem. I estimated the scale of the suffering of all factory-farmed animals is 12.1 times the scale of the happiness of all humans. Net global welfare may be negative and declining. Conclusions like these are not resilient, but imply caution around considering life extension as robustly good. I think interventions focussing on improving quality of life (e.g. human mental health or corporate campaings for chicken welfare) are more robustly positive.

80,000 hours for an hourly rate of 24 $/h would be 1.92 M$ (= 8*10^4*24). Scott talks about a risk of dying from surgery of 0.01 %, which would mean an expected cost of 192 $ (= 1.92*10^6*10^-4). This is 3 orders of magnitude (192/0.199 = 965) more costly than what I should be willing to pay based on the 1st 3 bullets above, even neglecting the moneraty costs of the 4th bullet, and harmful effects of the 5th bullet.

That being said, I think there would be a strong case for donating a kidney if the following is successful:

My [Scott's] kidney donation “mentor”⁸ Ned Brooks is starting a new push - the Coalition To Modify NOTA - which proposes a $100,000 refundable tax credit - $10,000 per year for 10 years - for kidney donors.

100 k$ would be enough to outweight the monetary and non-monetary costs of the kidney donations in many circumstances (namely my own). In addition, donating 100 k$ to corporate campaigns for chicken welfare would easily outweight any negative effects on animals from the additional human life linked to the kidney donation. I wonder how much one has to earn in the US to fully benefit from a refundable tax credit of 10 k$/year. If I managed to get 100 k$ for a kidney donation (I am currently in Portugal), I would hopefully convince myself to do it (and donate roughly all gains, but this feels like the easy part).

MintSnap6mo12

The 1/660 was for the standard CT screening exam; Scott says he was able to get a non-radioactive (MRI) alternative, so presumably that risk of death is ~irrelevant for people that ask the question.

Also, while I have no particular opinion on your monetary analysis, it seems orthogonal to the reasons Scott mentioned donating the kidney (& the reason I think it's tempting for a lot of EAs).

Scott himself calculates that "...it only costs about $5,000 - $10,000 to produce this many QALYs through bog-standard effective altruist interventions, like buying mosquito nets for malarial regions in Africa. In a Philosophy 101 Thought Experiment sense, if you’re going to miss a lot of work recovering from your surgery, you might as well skip the surgery, do the work, and donate the extra money to Against Malaria Foundation instead."

The reasons for a kidney donation are because it feels good to know you're directly helping a specific person in a legible way/amount, significantly more effectively than a lot of charities people donate to [though less effective than The Best EA Charities] while being legibly good to even non-EA people.

A lot of non-EA people have strong negative bias toward the "you could work extra hours and donate the money to slightly decrease factory farming" thinking, but pretty much everyone is in favor of donating organs. And sometimes it's really nice to do good in a way that makes people like you more, not less.

Sorry if I misunderstood the criticism you were making above. Obviously I can't speak for Scott, but I am very sympathetic to the choice to donate a kidney even if it's not maximally cost-effective.

Vasco Grilo6mo3

Thanks for clarifying Scott's position!

The 1/660 was for the standard CT screening exam; Scott says he was able to get a non-radioactive (MRI) alternative, so presumably that risk of death is ~irrelevant for people that ask the question.

I have modified the above calculations using a risk of death from surgery of 0.01 %, although I do not know how costly (in terms of time and money) it would be for me to get one of those exams in Portugal. Having to spend much more than 0.2 $ would make the kidney donation not worth it for me, assuming no monetary benefit from donating a kidney (which I could then donate to effective charities).

The reasons for a kidney donation are because it feels good to know you're directly helping a specific person in a legible way/amount, significantly more effectively than a lot of charities people donate to [though less effective than The Best EA Charities] while being legibly good to even non-EA people.

I am not saying the following applies to Scott's donation, but, accounting for the more direct effects, I think I would be counterfactually causing harm if I donated one of my kidneys now:

With the time and money spent on donating a kidney, I could improve the world much more by donating to the best animal welfare charities (or, in my view, to the best opportunities to decrease AI risk).
I would be helping a person by donating a kidney, but increasing the suffering of factory farmed animals in the process, and I just do not know what would be the net effect. In other words, even neglecting the opportunity cost I discuss just above, it is unclear to me whether donating a kidney is harmful/beneficial.

One could argue I should still donate a kidney because people will hold me more highly for doing so, e.g. letting me decide on the recipients of their donations, such that indirectly I end up having greater impact. However, I am wary of pursuing actions which have harmful direct effects on the grounds of beneficial indirect effects outweighting them. A priori, we should arguably expect the indirect effects to correlate with the direct effects.

A lot of non-EA people have strong negative bias toward the "you could work extra hours and donate the money to slightly decrease factory farming" thinking, but pretty much everyone is in favor of donating organs.

Alas, pretty much everyone eats factory-farmed animals, and I think that is quite bad. On the other hand, I would guess the current level of donations in the EA community is below optimal.

Sorry if I misunderstood the criticism you were making above. Obviously I can't speak for Scott, but I am very sympathetic to the choice to donate a kidney even if it's not maximally cost-effective.

I thought Scott's post inspiring too! Yet, I still want to be as alstruistic as possible.

MintSnap6mo14

On your first bullet point, I think everyone agrees kidney donation is not maximally cost effective^[1]. It is far more effective than most mainstream charity, so it still seems to be under the EA larger umbrella, but the associated cost would probably come at least partially out of the "warm fuzzy" bucket and not the "max utility" bucket.

On your second point, I think that argument is internally consistent but most people will be repelled by it. I am vegan and donate to animal charities, and I think it's definitely nonoptimal that people continue creating demand for factory farming. However, I am still extremely opposed to humans dying against their will if we have a (reasonable-cost) solution.

Scott's post above is specifically aimed at helping people who are already interested in donating a kidney (the majority, at least according to surveys) have an easier time donating. I don't think it is primarily focused on convincing EAs in unrelated cause areas to donate a kidney, so you're likely not the target audience.

If you oppose other people donating kidneys on the grounds that it will probably increase meat consumption:

Being nice to other value systems is a very important heuristic, even if those value systems are slightly net negative to you. Debating the effectiveness of kidney donations on the EA forum is obviously fair game, but in general, refusing to play nice with e.g. organ donation is considered a large defection in >=95% of people's value systems, and I think you stand to lose a lot more than you gain if you pick that battle.
If following a value system to its logical extremes requires supporting outcomes that feel deeply morally wrong, probably something is wrong either with the value system or how it's being applied^[2]. To me, opposing healthcare to reduce the poor meat-eater problem feels sufficiently morally wrong that if I reached the same conclusion, I would rather change my moral system than bite the relevant bullets.

I hope this doesn't come off as adversarial; I think we're from closely-adjacent moral systems, and I disagree with you but am also very happy to talk to someone that cares a lot about animal suffering.

^{^}
At least for people making incomes I associate with EAs. For people making less than median income who have less chance to work and donate, it may be a relatively more effective option?
^{^}
My hand-wavey version of this argument would be that I think we have a lot of (biologically & culturally) hard-coded immunities to ideological extremes. Unfortunately the immunity is stupid & inarticulate, but it is often legitimately useful and I don't want to discard it unless I'm really really sure.
My other version of this argument would be that I have a sense of "right" and "wrong" that my moral system is built on top of. I'm not convinced that "right" and "wrong" are features of the universe that it is even coherent for me to imagine without the internal sense bit. There is nothing about either the suffering of a chicken or a kidney dialysis patient that is bad unless I have an internal sense that suffering itself is bad. So debating mortality past the point where the outcomes achieved seems wrong feels pointless. Most arguments in favor of a moral system make the outcome feel more right upon reflection, which is why I like to read arguments in favor of specific moral systems.

Vasco Grilo6mo3

Thanks for elaborating, @MintSnap^[1]!

If you oppose other people donating kidneys on the grounds that it will probably increase meat consumption

I do not oppose neither support people donating kidneys, as I do not know whether is good/bad.

Being nice to other value systems is a very important heuristic, even if those value systems are slightly net negative to you. Debating the effectiveness of kidney donations on the EA forum is obviously fair game, but in general, refusing to play nice with e.g. organ donation is considered a large defection in >=95% of people's value systems, and I think you stand to lose a lot more than you gain if you pick that battle.

I like the post you linked! I do not think this criticism applies so much because I am not refusing to play nice with organ donation. I am just arguing that it is not a robustly good way to increase welfare once one accounts for effects on animals. Note I am also moderating the conclusions of my quantitative analyses based on considerations like the ones you are pointing out. I estimated a random human causes 12.1 times as much suffering to factory-farmed animals as the happiness of human life. A naive interpretation of this would imply more human deaths being good, but that is not my takeaway. I just conclude saving lives may be beneficial/harmful.

If following a value system to its logical extremes requires supporting outcomes that feel deeply morally wrong, probably something is wrong either with the value system or how it's being applied^[2]. To me, opposing healthcare to reduce the poor meat-eater problem feels sufficiently morally wrong that if I reached the same conclusion, I would rather change my moral system than bite the relevant bullets.

That is another great heuristic! However, I would say most people do not have strong intuitions in favour of saving random human lives, otherwise GiveWell's top charities (which save a life for 5 k$) would receive way more money. Accordingly, I do not view not supporting/opposing donating organs as being against common intuitions. If I strongly opposed organ donations, I would be going against common sense, but as I said I do not oppose neither support organ donations.

On the other hand, I do think most people (and I am no exception) have strong intuitions about saving a person (spatially or relationally) close to us being clearly good, and I support this position too, even if the saved person ends up eating lots of animals. Similarly, I strongly oppose killing people^[2], regardless of how much animals they are consuming.

I hope this doesn't come off as adversarial; I think we're from closely-adjacent moral systems, and I disagree with you but am also very happy to talk to someone that cares a lot about animal suffering.

Thanks for the thoughtful comments!

^{^}
I am tagging you to let you know of my reply, as I originally only replied "Thanks for elaborating!".
^{^}
Interestingly, people often kind of support killing people by being in favour of wars. I generally do not.

denyeverywhere6mo-14