Ari Ne’eman wrote an essay about effective altruism and disability rights in 2017 which quoted me and I have just gotten around to writing up a response to it.
I am going to skip the first part of the essay, which establishes that Peter Singer is quite ableist. I agree that Peter Singer is quite ableist, and anyway have literally never had a discussion with any effective altruist advocating for mass infanticide of disabled babies. It is not, I think, a live issue in the effective altruism community.
Later in the post, however, Ne’eman writes:
After all, from Singer’s utilitarian perspective there is no meaningful moral distinction to be made between charitable donations and social services like healthcare. Both are commitments a society makes to improving the conditions of its less fortunate. It would be illogical to argue for perfect efficiency in voluntary contributions and not with taxpayer funds. As Singer makes clear in his views on health policy, utilitarian thinking belongs in government just as much as it does in philanthropy.
By what right should the government fund wheelchairs when these funds might be more efficiently spent on paralysis prevention or cure research? How can we justify vocational rehabilitation services, which spend considerable sums helping disabled adults find employment, when non-disabled people might achieve similar outcomes for a fraction of the cost? If resources should always flow to their area of greatest efficiency, there is little hope for people with significant disabilities, a notoriously resource-intensive group to assist.
Indeed, the very idea of a welfare state comes under threat in this kind of moral calculus. Since effective altruism allows for no greater moral weight to be given to those in one’s own family or community, it becomes hard to justify expensive programs like housing assistance or in-home care for seniors and people with disabilities, which can cost tens of thousands of dollars per a person, when malaria net charities can save lives elsewhere at a fraction of the cost.
First, while this is a tangential issue, I would like to address the middle paragraph. It is far from obvious to me that buying people wheelchairs is less cost-effective than paralysis cure research, or that helping disabled people get jobs is less cost-effective than helping high-school dropouts or felons or whomever else get jobs. Ne’eman doesn’t link to any sort of cost-benefit analysis establishing this claim. And it’s also just… kind of a weird argument? “How does effective altruism deal with the fact that the issues I passionately advocate for are self-evidently worse ways to spend money than the issues I don’t advocate for, so self-evidently that I don’t even have to back up my claims in any way?” That seems like a bit of an own goal? I assume this is not what Ne’eman means but I am incredibly confused about what on earth he could mean.
On the main point: I’m not sure whether Ne’eman is arguing about Everyone Wakes Up A Perfect Utilitarian One Day World or the actual world we actually have right now, so I’m going to take each case one at a time.
The first piece of good news about Everyone Wakes Up A Perfect Utilitarian One Day World is that it is absolutely never going to happen. No effective altruist is a perfect utilitarian. (Some of us aren't even utilitarians at all.) I can’t overstate how unlikely it is that, not only will effective altruists convince every random nurse in Montana that they need to take the Giving What We Can pledge, but also all such nurses have decided to assess their every purchasing decision based on the greatest good for the greatest number.
Everyone Wakes Up A Perfect Utilitarian One Day World would definitely buy a lot of malaria nets. But there is not an infinite demand for malaria nets. At some point, everyone who needs a malaria net would have one, and we would spend money on other things. These things would… probably include wheelchairs? A wheelchair is only a few thousand dollars. That’s a pretty small price to make people able to leave the house and participate in their community! In fact, Everyone Wakes Up A Perfect Utilitarian One Day World may very well have more people have wheelchairs. It is difficult to imagine Everyone Wakes Up A Perfect Utilitarian One Day World doing much asset testing, and they’d certainly give wheelchairs to all the people in the developing world who can’t afford one.
I am really baffled at the idea that in Everyone Wakes Up A Perfect Utilitarian One Day World the malaria nets would come out of the wheelchairs budget instead of the the $100 million spent on the average big-budget movie or the $32 billion we spend every year on chewing gum. $32 billion would buy a heck of a lot of wheelchairs.
On the other hand, Ari Ne’eman might be referring to the actual world we actually exist in, in which case… no one is advocating for defunding housing assistance or vocational rehab? You can scroll down Open Philanthropy’s list of grants. They give money to political advocacy related to farmed animal welfare, pandemic preparedness, climate change, and criminal justice reform. (Although their criminal justice reform work has recently spun out into its own organization.) Defunding the welfare state is not on the list.
It’s true that if the government is spending money on pandemic preparedness and climate change, they’re not spending it on something else, but there’s no reason to assume that this would come from Medicaid cuts. I, for one, would hope we pay for pandemic preparedness by buying fewer fighter jets.
Actually existing effective altruism is, if anything, good for disability rights. Effective altruist Sam Bankman-Fried made the second-largest donation to Joe Biden’s re-election campaign, thus protecting the Affordable Care Act and Medicaid and making concrete improvements in the lives of disabled people.
I think the heart of my disagreement with Ne’eman comes earlier in the post:
Unfortunately, effective altruists take [concern for impact] a step further, arguing that impact is the only appropriate factor to consider in charitable contributions, with considerations like a community’s responsibility to its members discounted as illegitimate. Effective altruism does not just teach that it is better to contribute to malaria nets in Africa than to arts funding at home, a reasonable conclusion to most. Instead, the ideology goes a step further, arguing that one should invest in interventions in the developing world rather than things like homeless shelters or social services for low-income Americans in one’s own community. Anything less is unethical favoritism, since charitable dollars spent in one’s local communities require greater investment per life saved than those in more impoverished parts of the world.
So I live near Marin County, one of the richest counties in the United States. Marin is also home to the Buck Trust, a trust which has hundreds of millions of dollars which is only allowed to be used to help people in Marin County. Unfortunately, since Marin County doesn’t really actually contain many needy people in need of help, the money goes to symphony orchestras and high-school sports teams and bike paths and a study of French intensive gardening and giving some money to every kid in Marin with top grades. (Remember, these are some of the richest kids in the US.)
I live in Oakland. There are any number of people in Oakland who need the money more than a high school sports team in Marin does, starting with the people in the homeless encampment a few blocks away from me and continuing from there. But this money doesn’t go to people in Oakland, because Beryl Buck wanted to help people in her community.
That seems kind of… bad?
And if we say “never mind that this is ‘your community,’ it is wrong to spend hundreds of millions of dollars helping rich white people in Marin when there are poor black people in Oakland who need the money way more”… well, it brings to mind the question of why it’s okay to spend the money helping poor black people in Oakland and not helping poor black people in Africa. Is the system here that it’s outrageous if the other community is driving distance away but not if you’d have to take a plane?
Every egalitarian instinct rebels against what Ne’eman says in this essay. He functionally advocates for the richest people with the most capability to help to spend their time, resources, and money helping the people who need it the least.
There are, in fact, disabled people in the developing world. There are probably more disabled people in the developing world than in the developed world. Why did you decide that they don’t count? Why, when you’re helping severely disabled people, is there this whole group of severely disabled people in desperate need whom you’re ignoring?
There are some disabilities that aren’t represented much in the developing world, because developing-world healthcare systems can’t afford to take care of them, and so the people who have them are dead. As Ne’eman says when he discusses Singer’s view of infanticide, disabled people dying is bad.
In his conclusion, Ari Ne’eman writes:
By removing the attacks on disabled people, Singer’s ideas become milquetoast, almost mainstream liberal platitudes about being nice to animals and using data in decision-making. To put it another way, in so far as effective altruism is compatible with disability rights, it offers nothing new. And in so far as it is new, it is not compatible.
This is the section that it’s most unfair for me to write five years later, because it’s now way more obvious how effective altruism is different from mainstream liberalism.
I wish I lived in the world Ari Ne’eman does. Imagine if all charities rigorously collected information on their outcomes and made it publicly available—including their mistakes, the negative side effects, the flaws in the data collection, and the reasons to believe that it didn’t work at all. Imagine if a liberal eating meat was as unthinkable as them using the N word, and donating ten percent of your income to charities that helped people in the developing world was as normal as celebrating a gay friend’s wedding. Imagine if everyone responded to the Covid-19 pandemic by throwing billions of dollars at biosecurity and pandemic preparedness, and by realizing we were deeply unprepared for a pandemic and so we should get on issues like artificial intelligence that aren’t problems yet but might be soon.
It sounds very nice, Ari Ne’eman’s world. I want to move there.
Effective altruists talk a lot about ethics. It’s fun to get into the nitty-gritty of virtue ethics versus deontology. But, frankly, the core effective altruist beliefs are platitudes, the kind of thing I teach my four-year-old. “It is bad to hurt animals.” “Every person matters equally, even if they are poor or black or far away.” “We should care about the effects of our actions on future generations.” “We should try to figure out what ways of helping people work the best and do those instead of ones that don’t work as well.”
But if you actually take those platitudes seriously they lead to bizarre actions. You donate a kidney to a stranger. You skip a vacation to pay for children you don’t know not to get a disease you can’t pronounce. You shut down a charity that donors love because the evidence isn’t good enough. You decide that rather than being a doctor you’ll help sentient beings more if you become a food scientist and make soybeans taste really really good. You spend a lot of time talking about worries that sound like science fiction movies starring Arnold Schwarzenegger.
The new thing in effective altruism isn’t ableism. The new thing is that, unlike everyone else in the entire world, you should actually not flunk Applied Kindergarten Ethics.
And I can assure you that, should us Applied Kindergarten Ethics-Passers take over the world, we will definitely buy people wheelchairs.