All of Austen_Forrester's Comments + Replies

I didn't mean to imply that it was hopeless to increase charitable giving in China, rather the opposite, that it's so bad it can only go up! Besides that, I agree with all your points.

The Chinese government already provides foreign aid in Africa to make it possible to further their interests in the region. I was thinking of how we could possibly get them to expand it. The government seems almost impossible to influence, but perhaps EAs could influence African governments to try to solicit more foreign aid from China? It could have a negative consequence, h... (read more)

8
Gregory Lewis
6y
For the record FRI isn't a subsidiary of CEA. There's other things about the parent that are objectionable, but good taste - belatedly - stops me elaborating more.

I agree that financial incentives/disincentives result in failures (ie. social problems) of all kinds. One of the biggest reasons, as I'm sure you mention at some point in your book, is corruption. ie. the beef/dairy industry pays off environmental NGOs and government to stay quiet about their environmental impact.

But don't you think that non-financial rewards/punishment also play a large role in impeding social progress, in particular social rewards/punishment? ie. people don't wear enough to stay warm in the winter because others will tease them for being uncool, people bully others because they are then respected more, etc.

0
RobBensinger
6y
Non-financial incentives clearly play a major role both in dysfunctional systems and in well-functioning ones. A lot of those incentives are harder to observe and quantify, though; and I'd expect them to vary more interpersonally, and to be harder to intervene on in cases like the Bank of Japan. It isn't so surprising if (say) key decisionmakers at the Bank of Japan cared more about winning the esteem of particular friends and colleagues at dinner parties, than about the social pressure from other people to change course; or if they cared more about their commitment to a certain ideology or self-image; or any number of other small day-to-day factors. Whereas it would be genuinely surprising if those commonplace small factors were able to outweigh a large financial incentive.

It could be a useful framing. "Optimize" to some people may imply making something already good great, such as making the countries with the highest HDI even better, or helping emerging economies to become high income, rather than helping the more suffering countries to catch up to the happier ones. It could be viewed as helping a happy person become super happy and not a sad person to become happy. I know this narrow form of altruism isn't your intention, I'm just saying that "optimize" does have this connotation. I personally prefer &... (read more)

Of course, I totally forgot about the "global catastrophic risk" term! I really like it and it doesn't only suggest extinction risks. Even its acronym sounds pretty cool. I also really like your "technological risk" suggestion, Rob. Referring to GCR as "Long term future" is a pretty obvious branding tactic by those that prioritize GCRs. It is vague, misleading, and dishonest.

For "far future"/"long term future," you're referring to existential risks, right? If so, I would think calling them existential or x-risks would be the most clear and honest term to use. Any systemic change affects the long term such as factory farm reforms, policy change, changes in societal attitudes, medical advances, environmental protection, etc, etc. I therefore don't feel it's that honest to refer to x-risks as "long term future."

1
Robert_Wiblin
7y
The term existential risk has serious problems - it has no obvious meaning unless you've studied what it means (is this about existentialism?!), and is very often misused even by people familiar with it (to mean extinction only, neglecting other persistent 'trajectory changes').
0
Gentzel
7y
You seem to be missing the part where most people are disagreeing with the post in significant ways.

By regular morals, I mean basic morals such as treating others how you like to be treated, ie. rules that you would be a bad person if you failed to abide by them. While I don't consider EA superorogatory, neither do I think that not practicing EA makes someone a bad person, thus, I wouldn't put it in the category of basic morals. (Actually, that is the standard I hold others to, for myself, I would consider it a moral failure if I didn't practice EA!) I think it actually is important to differentiate between basic and, let's say, more “advanced” morals be... (read more)

I think it may be useful to differentiate between EA and regular morals. I would put donating blood in the latter category. For instance, treating your family well isn't high impact on the margin, but people should still do it because of basic morals, see what I mean? I don't think that practicing EA somehow excuses someone from practicing good general morals. I think EA should be in addition to general morals, not replace it.

0
DC
7y
I'm curious what exactly you mean by regular morals. I try (and fail) to not separate my life into separate magisteria but rather seeing every thing as making tradeoffs with every other thing, and pointing my life in the direction of the path that has the most global impact. I see EA as being regular morality, but extended with better tools that attempt to engage the full scope of the world. It seems like such a demarcation between incommensurable moral domains as you appear to be arguing for can allow a person to defend any status quo in their altruism rather than critically examining whether their actions are doing the most good they can. In the case of blood, perhaps you're talking about the fuzzies budget instead of the utilons? Perhaps your position is something like 'Regular morals are the set of actions that, if upheld by a majority of people, will not lead to society collapsing and due to anthropics I should not defect from my commitment to prevent society from collapsing. Blood donation is one of these actions', or this post?

Perhaps I got it wrong, but I thought that the premise of your position that EA outreach should proportionally represent what people who identify as EAs consider their favourite cause is that EAs (however “effective altruist” is defined) are morally and intellectually superior to the public. I know for a fact that this is the prevailing attitude EAs have. I would really like to know why it is not enough to educate the public on EA-related issues. Why should the public care what is the favourite cause of an upper class 25 year old who donates $500 a year to... (read more)

My point was that EAs probably should exclusively promote full-blown EA, because that has a good chance of leading to more uptake of both full-blown and weak EA. Ball's issue with the effect of people choosing to go part-way after hearing the veg message is that it often leads to more animals being killed due to people replacing beef and pork with chicken. That's a major impetus for his direct “cut out chicken before pork and beef” message. It doesn't undermine veganism because chicken-reducers are more likely to continue on towards that lifestyle, probabl... (read more)

0
KevinWatkinson
7y
On the face of it, the idea does sound quite good. However, we need to place it into a broader movement context and look at how it has been evaluated to consider how effective it is likely to be, and what other impacts the approach has that aren’t immediately clear. A central issue with EA is that it says for instance, that we need to consider scope, neglectedness and tractability, but meeting this criteria doesn’t then lead to effectiveness, or optimal outcomes, it just flags that it is an approach worth more consideration. Consequently, we can note the ‘pragmatic’ trend in EA support for animal related groups, but this trend isn’t well understood, and neither is it contextualised. Where we are trying to be inclusive and encourage more people into EA then this is the type of thing we need to consider, so we need to consider things like ideology and organisational / movement culture when determining how groups inter-relate and what impact this has. I think for many people who are looking at different aspects of EA, they don’t have the time to do this, and expect EAAs to do this work, but there isn’t any evidence this form of evaluation has been taking place up to now. My own observation of the movement is that this is a neglected area, and will likely be quite important in terms of inclusion. In terms of EA, the trade off would be making EA look more appealing by diminishing it in terms of elitism, specifically where a certain ‘lower’ section of EAs were to say they aren’t like the ‘higher’ ones. The corollary in the animal movement is to claim veganism is extreme, all or nothing, fundamentalist, angry, crazy, puritan, dogmatic, absolutist, hardline and so on. These are stereotypes that Matt Ball, Tobias Leenaert and Brian Kateman have played on in order to centre their pragmatic (or not vegan) approach. I think people who have paid attention to what they say are likely to recognise this (see in particular Matt Ball’s recent Vox video), it is just that rights act

One thing to keep in mind is that people often (or usually, even) choose the middle ground by themselves. Matt Ball often mentions how this happens in animal rights with people deciding to reduce meat after learning about the merits vegetarianism and mentions that Nobel laureate Herb Simon is known for this realization of people opting for sub-optimal decisions.

Thus, I think that in promoting pure EA, most people will practice weak EA (ie. not cause neutral) on their own accord, so perhaps the best way to proliferate weak EA is by promoting strong EA.

0
KevinWatkinson
7y
This can be an issue, but i think Matt Ball has chosen not to present a strong position because he believes that is offputting, instead he undermines the strong position and presents a sub optimal one. However, he says this is in fact optimal as it reduces more harm. If applied to EA we would undermine a position we believe might put people off, because it is too complicated / esoteric, and present a first step that will do more good.
1
MichaelPlant
7y
I didn't follow your point about atheism. I don't think EA is for or against religion in any way. I didn't follow your second point either. I'm suggesting the EA outreach organisations should not treat the public as marks and that we should respect the public. You were the one who suggested "Outreach should be based on what is likely to attract the masses to practice EA"

I totally understand your concern that the EA movement is misrepresenting itself by not promoting issues proportional to their representation among people in the group. However, I think that the primary consideration in promoting EA should be what will hook people. Very few people in the world care about AI as a social issue, but extreme poverty and injustice are very popular causes that can attract people. I don't actually think it should matter for outreach what the most popular causes are among community members. Outreach should be based on what is like... (read more)

7
MichaelPlant
7y
It's exactly this line of thinking I expect to blow up in our faces and do less good over the long run. How would you feel if you thought I considered you one of the stupid "masses" (your word) and I was trying to manipulate you to do something I didn't personally believe? You'd dislike me, distrust me, not want to do what I told you and probably tell other people EA was full of suspicious people. No one wants to be taken for an idiot. I didn't follow your 2nd point I'm afraid.

I don't see how TYLCS is selling out at all. They have the same maximizing impact message as other EA groups, just with a more engaging feel that also appeals to emotions (the only driver of action in almost all people).

Matt Ball is more learned and impact-focused than anyone in the animal rights field. One Step for Animals, and the Reducetarian Foundation were formed to save as many animals as possible -- complementing, not replacing, vegan advocacy. Far from selling out, One Step and Reducetarian are the exceptions from most in animal rights who have traded their compassion for animals for feelings of superiority.

0
KevinWatkinson
7y
Maximising impact wouldn't necessarily rely on messaging that undermines other groups in the broader animal movement. I don't think it is a good thing to take such an approach either in relation to Effective Altruism or in the broader animal movement. Matt Ball's recent vox article stated that people love animals and hate vegans and that we need to act on this. I think this isn't a good thing, particularly where someone as respected as Matt Ball is equating vegans to hezbollah through someone as dedicated to animal exploitation as Bourdain. This of course is quite an extreme example compared to what many 'pragmatists' (for instance Tobias Leenaert) have been doing for some time. Yet it has become a dominant theme in Effective Altruism, and it isn't justified. Instead, i would argue it is actually quite harmful. In terms of where we should be aiming, then i believe we ought not be undermining veganism on an institutional basis, as Reducetarianism and One Step put forward (so they shouldn't utilise a misrepresentation of veganism to privilege their approach). Neither would recycling anti-vegan rhetoric or irrational justifications for animal consumption reflect well on the integrity of Effective Altruism, nor is there any evidence for it being a particularly 'effective' approach, beside it being popular among people who have been conditioned to exploit animals. However, popularity need not be pursued through the replication of carnism, or the utility of the carnist system, there are other values and methods with which to make appeals. It's also really not a question of superiority, this is something which is generally brought up to dismiss the issue. Instead it is a question of integrity, responsibility and consideration. I think these are all central values of Effective Altruism, and they need to be applied.

I really respect the moderators of this forum for allowing me to advocate for public safety (ie. criticize NUE) and removing comments that could endanger public safety (ie. advocating suicide)!

Those radicalization factors you mentioned increase the likelihood for terrorism but are not necessary. Saying that people don't commit terror from reading philosophical papers and thus those papers are innocent and shouldn't be criticized is a pretty weak argument. Of course, such papers can influence people. The radicalization process starts with philosophy, so to say that first step doesn't matter because the subsequent steps aren't yet publicly apparent shows that you are knowingly trying to allow this form of radicalization to flourish. Although, NUE... (read more)

-1
kbog
7y
Yeah, and you probably think that being a negative utilitarian increases the likelihood for terrorism, but it's not necessary either. In the real world we deal with probabilities and expectations, not speculations and fantasies. This is silly handwaving. The radicalization process starts with being born. It doesn't matter where things 'start' in the abstract sense, what matters is what causes the actual phenomenon of terrorism to occur. So your head is too far up your own ass to even accept the possibility that someone who has actually studied international relations and counterinsurgency strategy knows that you are full of shit. Cool. You are a textbook concern troll. Welcome to EA, honey. Everyone here is altruistic, you can't get special treatment. But they're not. You think they're promoting it, or at least you want people to think they're promoting it. But that's your own opinion, so presenting it like this constitutes defamation. But I have read those materials. And it's not self-evident. And other people have read those articles and they don't find them self-evident either. Actually, it's self-evident that they don't promote it, if you read some of their materials. What bullshit. If you actually worried about this then you wouldn't be saying that it's a direct, self-evident conclusion of their beliefs. So either you don't know what you're doing, or you're arguing in bad faith. Probably both.

Have you considered combining the "GiveWell for impact investing" idea with the Effective Altruism Funds idea and create an EA impact investing biz within your charity? You could hire staff to find the best impact investing opportunities and create a few funds for different risk tolerances. Theoretically, it could pay for itself (or make serious money for CEA if successful enough) with a modest management fee. I'm not sure if charities are allowed to grant to businesses, but I know they can operate their own businesses as long as it's related to their mission.

Entering China would be awesome. So many people with money and no one's donating it. It ranks dead freaking last on the World Giving Index. Which in a way is a good thing... it means lots of room to grow!

China's domestic charities are usually operated and funded by the government (basically part of the government). And starting this year, the government has basically taken control of foreign NGO's in China.

Often, rich Chinese elect to donate to foreign NGOs because they are more credible. Besides, being government-controlled, charities in China are not k... (read more)

Blind people are not a discriminated group, at least not in the first world. The extreme poor, on the other hand, often face severe discrimination -- they are mistreated and have their rights violated by those with power, especially if they are Indians of low caste.

Comparative intervention effectiveness is a pillar of EA, distinct from personal sacrifice, so they are not interchangeable. I reject that there is some sort of prejudice for choosing to help one group over another, whether the groups are defined by physical condition, location, etc. One always ... (read more)

0
Dawn Drescher
7y
Thanks! In response to which point is that? I think points 5 and 6 should answer your objection, but tell me if they don’t. Truth is not at issue here (if we ignore the parenthetical at the very end that isn’t mean to be part of my argument). I’d even say that Peter Singer deals in concepts of unusual importance and predictive power. But I think it’s important to make sure that we’re not being misunderstood in dangerous ways by valuable potential allies.

Peter, even if a trachoma operation cost the same as training a guide dog, and didn't always prevent blindness, it would still be an excellent cost comparison because vision correction is vastly superior to having a dog.

2
drbrake
5y
And moreover it doesn't just improve vision, it removes a source of intense pain.

They encourage cooperation with other value systems to further their apocalyptic goals, but mostly to prevent others from opposing them. That is different from tempering "strong NU" with other value systems to arrive at more moderate conclusions.

LOOOOL about your optimism of people not following FRI's advocacy as purely as they want! Lets hope so, eh?

It's the only negative utilitarianism promoting group I know of. Does anyone know of others (affiliated with EA or not)?

-4
inconvenient
7y
Exactly, despite the upvotes, Soeren's argument is ill-founded. It seems really important in situations like this that people vote on what they believe to be true based on reason and evidence, not based on uninformed guesses and motivated reasoning.
3[anonymous]7y
Many antinatalists who are unaffiliated with EA have similar beliefs. (eg, David Benatar, although I'm not sure whether he's even a consequentialist at all.)

I know they don't actually come out and recommend terrorism publicly... but they sure go as far as they can to entice terrorism without being prosecuted by the government as a terrorist organization. Of course, if they were explicit, they'd immediately be shut down and jailed by authorities.

I promise you this – all those who endorse this mass termination of life ideology are going to pay a price. Whether by police action or public scrutiny, they will be forced to publicly abandon their position at some point. I implore them to do it now, on their volition.... (read more)

8[anonymous]7y
I really don't like how you are accusing people without evidence of intentionally promoting violence. This is borderline libel. I agree that someone could take their ideology and use it to justify violence, but I see no reason to believe that they are intentionally trying to "entice" such actions.
4[anonymous]7y
I think your gripe is with consequentialism, not atheism per se. And don't forget that there are plenty of theists who do horrible things, often in the name of their religion. The X-Risks Institute, which is run by /u/philosophytorres, specializes in agential risks, and mentions NU as one such risk. I don't whether FHI has ever worked on agential risks. It is evident that the majority of EAs are atheist/irreligious, but I am not aware of any EA organizations actively promoting atheism or opposing theism. Who uses EA as a "means to promote atheism"? Coincidentally, the closest example I can recall is Phil Torres's work on religious eschatological fanaticism as a possible agential x-risk.

LOL. Typical of my comments. Gets almost no upvotes but I never receive any sensible counterarguments! People use the forum vote system to persuade (by social proof) without having a valid argument. I have yet to vote a comment (up or down) because I think people should think for themselves.

8
Richard_Batty
7y
You can understand some of what people are downvoting you for by looking at which of your comments are most downvoted - ones where you're very critical without much explanation and where you suggest that people in the community have bad motives: http://effective-altruism.com/ea/181/introducing_ceas_guiding_principles/ah7 http://effective-altruism.com/ea/181/introducing_ceas_guiding_principles/ah6 http://effective-altruism.com/ea/12z/concerns_with_intentional_insights/8p9 Well-explained criticisms won't get downvoted this much.
3
the_jaded_one
7y
Actually you got 7 upvotes and 6 downvotes, I can tell from hovering over the '1 point'.

Those guiding principles are good. However, I wished you would include one that was against doing massive harm to the world. CEA endorses the “Foundational Research Institute,” a pseudo-think tank that promotes dangerous ideas of mass-termination of human and non-human life, not excluding extinction. By promoting this organization, CEA is promoting human, animal, and environmental terrorism on the grandest scale. Self-styled “effective altruists” try to pass themselves off as benevolent, but the reality is that they themselves are one of the biggest threats to the world by promoting terrorism and anti-spirituality under the cloak of altruism.

4[anonymous]7y
I mostly agree with you. It honestly does worry me that the mainstream EA movement has no qualms about associating with FRI, whose values, I would wager, conflict with the those of the majority of humankind. This is one of the reasons I have drifted away from identifying with EA lately. It's a stretch to say FRI directly promotes terrorism; they make it clear on their website that they oppose violence and encourage cooperation with other (non-NU) value systems. The end result of their advocacy, however, may be less idealistic than they anticipate. (It's not too hard to imagine a negative utilitarian Kaczynski, if their movement gains traction. I think there's even a page on the FRI website where they mention that as a possible risk of advocating for suffering-focused ethics.) I don't know what you mean by "anti-spirituality".
4
the_jaded_one
7y
Also, I am somewhat concerned that this comment has been downvoted so much. It's the only really substantive criticism of the article (admittedly it isn't great), and it is at -3, right at the bottom. Near the top are several comments at +5 or something that are effectively just applause.
4
the_jaded_one
7y
Specifically?
[anonymous]7y17
0
0

Fair point about not doing harm but I feel like you're giving the Foundational Research Institute a treatment which is both unfair and unnecessary to get your point across.

I'm a little confused as to why you are trying to promote a cause that you think is low priority and financially inefficient. Anyhow, I don't find your anti-corporate stance convincing. Lack of corporate involvement (ie. to distribute analgesics) is the missing link preventing some countries from having functional palliative care in some countries according to Dr. Foley. It's important to work with all stakeholders for progress in any space. The affordable anti-retroviral movement made progress by working with pharma. The risks of working with industry in ... (read more)

3
Lee_Sharkey
7y
Hi Austen, Just to clarify, I'm not trying to promote or demote the cause. I'm aware that the cause is of interest to some EAs, and as someone in a good position to inform them, I thought something like this would help them make their own judgement :) I'm just sharing info and trying to be impartial. Sorry if I my comments gave the impression that I thought it was low priority and financially inefficient. To reiterate I've withheld strong judgement on its priority, and I said I haven't looked into its financial efficiency compared with other interventions. Because its importance/effectiveness depends heavily on ethical value preferences, both of these question are hard for me to take strong stances on. My apologies for seeming contrary here, but I'm not taking an anti-corporate stance either. I made those points because the way you had originally put it made it seem like you believed that access to pain relief was unique in that corporate influence didn't carry much risk compared with other causes. Unfortunately, it isn't so. Of course pharma involvement is essential, yet the history of this very cause illustrates the risks. I'd agree with you that lack of corporate involvement is the missing link in some aspects of increasing access, but we should both be specific about the sectors we're talking about to avoid appearing broadly pro-corporate or anti-corporate, which we both agree is unhelpful. I haven't got a wide enough grasp of the palliative care movement to say if it suffers from an anti-corporate agenda. 'Global health' in general tends to be pretty anti-pharma, and it's hard to argue that the short-term externalities of the existing capitalistic model of drug development and production favours the 'Global health' agenda over the agenda of 'health in the developed world'. So Global health's culture of being anti-pharma is at least understandable, even if it relies on discounting the potentially-positive long-term externalities of the capitalistic model. It

One good thing about this space is that, unlike so much other policy work, access to pain relief doesn't have corporations interfering by paying off government, etc. If anything, corporations would stand to gain by increasing access to pharmaceuticals. So much other policy advocacy is stifled by corporate interference, so palliative care has a huge advantage in that regard. Would it be possible for advocates to work with pharma corporations to lobby for increased access? I know that sometimes governments have good regulations in place but can't find corpor... (read more)

2
Lee_Sharkey
7y
Hi Austen, Thanks for all your interest! I would have to disagree on your point about corporate influence. Pharma has been implicated heavily in the current opioid epidemic in the States and elsewhere. See the John Oliver expose for a light introduction (link above). In this area, if anything, there is even more reason to be wary of pharma influence because the product is so addictive when misused. Pharma does do some positive work - I'm aware of a BMS-funded training hospice in Romania (Casa Sperantei). I've only heard good things about it. You've hit on an accepted strategy for promoting pain relief access/palliative care. One only knows one has succeeded in making a MoH care about the area when it does something about it, such as developing a policy. The 'public health approach' to increasing access to pain relief/palliative care, supported by WHO, recognizes policy as the foundation on which other progress can be built. Without it, success in other areas of the approach (namely medicine availability, education, and implementation) is much less likely. Kathy Foley and colleagues introduce the public health approach here http://www.jpsmjournal.com/article/S0885-3924(07)00122-4/pdf Regarding tractability: The issue is likely to be more tractable in some countries than in others, and so it's hard for me to give anything but a range. I'm adding retrospective justification for my choice of low-moderate tractability here, but compare this cause to similar ones assessed by 80k. The scores given to them according to their scoring matrix are: Smoking in the Developing World - 3/6; Health in poor countries - 5/6; Land Use Reform - 3/6; (Where 3 is "Some possible ways to make progress, with significant controversy; Significant uncertainty about how to approach, solution at least a decade off; many relevant people don’t care, or some supportive but significant opposition from status quo.") Judging by the rest of the scoring matrix I think a range of 2 - 3.5 in most c

Thank you, Lee, for this eye-opening and thorough introduction to the issue of lack of access to analgesics. I can't believe the scale of the problem! With the immense scale and striking neglectedness of the problem, and the potential for leaps in gains with changes to state/national policies, I'm sure it deserves a high priority for changemakers.

Causes like this are why I've always thought that effective altruism is just as important to be taken up in poor countries as much as rich ones – internal changemakers are invaluable here, as you've stated. Unive... (read more)

7
Lee_Sharkey
7y
Thanks Austen! Yes, it's actually very large. So large, in fact, that it seems to be taken for granted by many people in those countries with low access. I've withheld strong judgement on whether it should be a cause area that other EAs should act on. I think it could be a particularly attractive area for EAs with certain ethical preferences. Before funding programmes such as PPSG's, further analyses of the cause and the programme(s) are warranted. I'd be open to suggestions on how to carry those out from anyone with experience, or I'd be happy to discuss the matter with anyone interested in taking it forward themselves.

I appreciate you posting on this forum, carneades. Your take on international development is in line with economic principles and what I've learned from people from Africa and India. EA badly needs this type of debate. What I am not hearing from you or others who take your point of view, however, is solutions. While your general criticisms of international aid are valid, what are the solutions? How do we help people in poor countries to develop and be more independent? There are charities like One Acre Fund that seem to only have a positive impact because increasing self-sufficiency. Should poverty philanthrobucks focus on those? What specific charities or interventions would you recommend?

7
jimrandomh
8y
Huh? I am genuinely confused as to what you mean by that.

I've always thought the same as you, Ian. Great point about foundations, BTW. Very few people are willing to only give to the highest EV charity across all causes and countries, therefore they might as well give as effectively as possible within whatever criteria they have (ie. domestic, homeless). The only argument to the contrary is that there is a counterfactual if the all-or-nothing purist form of EA is broken and people donate to top domain-specific charities that would have given to the best cause neutral charity. I doubt there is much of a counterfa... (read more)

Very good report, James. I have a few comments:

  1. The DALYs calculated for mental health don't factor in the huge effect that mental health has on physical health. This may be laboursome to estimate, but should at least be considered. And you mentioned that people with MNS issues are often treated horrendously by their family/society, but that also hasn't been factored into the DALY cost estimate. An MNS disorder with a 0.4 DALY could really have a 0.9 DALY when you factor in mistreatment. I realize this is probably impossible to do, but it important to rec
... (read more)
0
egastfriend
8y
Re: DALY's for physical vs. mental health, in our full report we cite Vigo 2016 ( http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(15)00505-2/abstract ) which lays out a strong argument for using a 2x adjustment for mental health DALY's. That's the approach we take in the paper.
0
JamesSnowden
8y
Thanks Austen. This is really helpful feedback. 1. Yes I agree. This is important but very hard to quantify. Of course the causal relationship goes both ways (poor physical health poor mental health) but it's probable that mental health disorders have worse downstream effects than most physical health problems (economic productivity, stigma, impact on carers, physical health). We tried to capture these qualitatively at the beginning of the report but could have been clearer that they weren't included in the cost-effectiveness calculations. 2. Thanks - this is really interesting. The $1000 figure came from here: http://dcp-3.org/sites/default/files/resources/15.%20Self%20Harm%20Pesticide%20Ban.pdf but that excludes morbidity. I'll check out the Eddleston paper. 3. This is exciting 4. Agreed kind of. Room for more funding is a tricky one. In the long term, the treatment gap is so high that there's a LOT of room to scale. But we've also included StrongMinds forecast expenditure based on current plans as it may be relevant for short term ability to productively use more funding. In any case, conclusion is the same. The organisation can absorb more funding in the short term, and in the long term there's huge room to scale. 5. Should have been more clear. Fit with key themes was evaluated as: Evidence generating] AND [Preventative child health OR Task-shifting model] We'll be updating this before sharing it more widely. Would be great to chat more about pesticide bans if you're available?

Excellent paper! One important factor in LMIC mental health work is sustainability. Take helplines. Far as I know, they are locally funded in poor countries, yet there are very few of them. A foreign NGO or individual could have an extremely high impact founding a helpline in a location, turning the fundraising and operation over to the local community once it gets going, and then repeating the process in subsequent cities. Dependency on foreign donors is always a last resort. The absolute cost of running a helpline is less important than the ability of th... (read more)

0
egastfriend
8y
I agree that helplines could have a very high impact. It's not mentioned in the paper, but we did look into it -- we weren't able to find an organization that we had enough confidence in to recommend. Could be an interesting challenge for an EA social entrepreneur or philanthropist to take on, though!

Hi pasha,

Suicide prevention is an extremely neglected area and I believe has many high impact opportunities that are not yet taken up. 85% of suicides are in the developing world, little of which are covered by helplines, so I would think proliferating helplines would be high impact, especially when you factor in the low opportunity cost of this volunteer-based activity. India, in particular, is desperate for more helplines. One way of reducing cost is by having calls to the helpline automatically directed to volunteers' phones, so that they don't need to... (read more)

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0
e19brendan
8y
Pasha & Austen, fantastic suggestions. Pasha, I'd be happy to do some research on effectiveness of hotlines or brainstorm proxies with you. Austen, I'm really excited to hear more about what you're doing with PPP. I'm quite interested in suicide prevention and I think the neglectedness and avertable suffering and death make it an essential focus for our time and effort. I think that most in the EA community (as well as global health more broadly) question tractability, which is all the more reasons to demonstrate pathways to effective reduction in suicide. I would love to hear more about what you're doing, and potentially get involved. I'm hoping to get together folks in EA who are interested in global mental health. Please let me know if you'd be willing to chat!

When you mention the $1000/DALY by "Stronger Minds," are you referring to strongminds.org? I asked them if they had a cost estimate for DALYs but never received a reply. If it does refer to StrongMinds, do you know if they have predicted a cost per DALY once there viral group therapy model of treating depression grows significantly? Mayberry says in his TED talk that he expects it to become cheaper as it grows.

Also, does your discussion of DALYs for mental health interventions only include YLD, or also YLL? I would think there could be a large difference between the two considering the huge impact depression has on morbidity and mortality (comparable to obesity).

0
MichaelPlant
8y
Are you saying you didn't check footnote 45 of my paper? Outrageous! The $1000/DALY figure comes from "Patel, V et al. (2015). Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities. The Lancet. These figures should be treated with caution. As the authors note, p1681 “hardly any published evidence exists on the cost-effectiveness of population-based or community-level strategies in or for low-income and middle-income settings" " I'm afraid I don't know exactly who conducted the studies they refer to. My criticism of MH intervention is more in terms of the way QALYs don't seem to capture YLD in the same way a happiness-based approach would. I'm afraid I don't, but probably should, know how Givewell's $100 malaria figure is split between YLD and YLL and how the $1000 depression figure is split between YLD and YLL. I actually found it incredibly hard to find that sort of information, maybe because I'm a health economist and don't know where to find it. If you know, please tell me! In retrospect, I'm probably not careful enough in the paper and I'll have to re-write it for the next draft. I say that QALYs underrate mental health by quite a bit, and on DALY estimates malaria is 10x cheaper, so maybe mental health treatments are in the right sort of ballpark already. Really I'd want to know how much depression and malaria each reduce happiness ('happiness' to be more carefully specified) whilst sufferers as still alive, and how much they increase mortality. Then you can do a more principled cost-effective analysis where you plug in how bad you think being dead is for someone. Unfortunately no one seems to be in the business of measuring health in terms of experienced happiness, so we may not be able to try and answer this question for some time.

I disagree about the cause area and organization being more important than the intervention. To me, it's all about the intervention in the end. Supporting people that you "believe in" in a cause that you think is important is basically a bet that you are making that a high impact intervention will spring forth. That is one valid way of going about maximizing impact, however, working the other way – starting with the intervention and then supporting those best suited to implement it, is also valid.

The same is true for your point about a funder spe... (read more)

I think INT would be more clear/useful if it was applied to the most high impact intervention of the cause, rather than the cause itself. Because a cause can be low in scale and neglectedness but high in tractability if there is one very high impact intervention that has been ignored or simply isn't known about. Or vise versa – the scale and neglectedness could be high while it's best intervention isn't that promising (thus the cause has low tractability). So the importance in this usage would be that of the best intervention of the cause being successful ... (read more)

Absolutely. That is such a common tactic. I think all of the criticisms against EA use one cheap rhetorical trick or another. Someone needs to make up a definitive web page that lists all the criticisms of EA with responses, and most importantly, calls out the rhetorical device that was used. It's mostly the same tired, discredited criticisms and persuasive tricks that are used over and over, so rather than responding to each individually, we can simply refer people to the web page.

Can anybody submit an essay or do authors have to meet certain qualifications?

What is the desired range of length, if any? Is there any provision in submitting to a journal for originality? I want to avoid writing something that is similar to something already published. I'll double check myself, of course, but I could still miss it.

Are you SURE that's the deadline? ;^)

1
AlasdairGives
8y
9000 words - http://commons.pacificu.edu/eip/styleguide.html

The most common way of helping many people by a small amount is through business. Whether it's one you've started or one you work for, in a large business you can make many, many people's lives slightly (at least) better by improving upon, or inventing a new, superior service or product. Businesses can scale up far more than charities. And if you create a social-impact focused business, you can also significantly improve each of your clients' lives. Businesses have improved the world far more than charities have, through economic growth and technological progress.

The fact of the matter is that people in the EA community are prejudiced against anyone different from them and look for any justification to keep them out. Since there are no genuine justifications, it generally takes the form of instilling fear of the unknown into others, no different from any other type of bigotry: “But if we let blacks in this school, who knows what will happen! We must keep them out because, well, you just never know what horrible things may happen!”

The whole premise of the debate is prejudiced. EA's being more accepting of people di... (read more)

It may be more technically correct not to have neglectedness as a separate criterion, but I find that it is the single most important factor in cause prioritization, despite the fact that it's only utility is its affect on the other two factors. Just my personal observation. For example, the causes that I think have the highest expected value: pesticide poisoning, self harm/suicide, depression in the Third World, loneliness, are all great in magnitude and have huge potential for progress precisely because they have been severely neglected. That's why I've ... (read more)

I completely agree that neglectedness is often the route cause of the size and tractability, but that's the whole point. Neglectedness only matters inasmuch as it affects the other two criteria and is included on it's own mostly to aid analysis of tractability – it has no value on it's own. For instance, if a cause is low in importance/scale and tractability, it wouldn't matter what the neglectedness is at all. I think the neglectedness factor only comes into play if a problem is important and tractable (including on the margin), yet crowded. In that case,... (read more)

0
Robert_Wiblin
8y
An alternative option would be to scrap neglectedness as an independent criterion and consider it in importance and tractability. I think we agree on the the systemic/scalable distinction - perhaps I just expressed myself poorly.
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