joshcmorrison

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The Bioethicists are (Mostly) Alright

Thanks for writing this! I run 1Day Sooner (and have a lots of thoughts about bioethics), so I have a special interest. 

I really agree with the point that complaints about bioethics are less about the positions of individual bioethicists than the outcomes of bioethical institutions. So I think it's worth asking why these institutions lead to frustrating outcomes. Some briefly sketched out, somewhat simplistic thoughts:

  • Conservatism: Structurally, bioethical scrutiny adds friction to accomplishing whatever action it is being applied to. Providing a justification takes time and effort (as does reviewing the quality of that justification and suggesting and making remedial measures). That friction reduces unethical action but it also reduces action of all types, and the cost of that general inaction is not accounted for in bioethical review. One line I like to use about IRBs/RECs is that they're like a driver who  has only a brake and no gas pedal. But I think more broadly the academic act of ethical inquiry problematizes decisions into potential mistakes, which increases the complexity of the decision being made and therefore the difficulty in making it. (To be clear, one could argue this tradeoff of fewer ethical abuses for reduced dynamism is worthwhile)
  • Parochialism: Because bioethical institutions often exist to translate legal regulations into practice, they are embedded in local concerns and are not cosmopolitan. They are more likely to focus case-by-case (and have insufficient incentive to create rules that would apply globally), and they also are unlikely to take the lives of people outside of rich countries seriously (which matters particularly in a research context).
  • Illiberalism: In many cases, bioethicists are partially acting as agents for subjects (like research participants) who do not choose them and have no ability to appeal their judgments. Because bioethicists are  (1)  in fact different from the people on whose behalf they are making decisions and (2) (unconsciously) motivated to maintain their power/resources, their decision-making is imperfect and paternalistic. 
  • What Are Bioethics For? I think retreating to the safety of the academy (i.e. separating the generally reasonable intellectual arguments of bioethicist academics from the practical decision-making of translating biomedical regulation into practice) is not a tenable move for the bioethics field to make. Bioethics exists (i.e. is largely funded) to help solve problems in medical and biological spaces. If in practice, those problems are being solved poorly, that seems like something the bioethics field needs to take up and solve. Otherwise, what's the use? We could  just have philosophers, biolawyers, and doctors. 
Have any EA nonprofits tried offering staff funding-based compensation? If not, why not? If so, how did it go?

Yeah I wasn't really talking about EA donors per se: I think EA nonprofits should try to be funded by non EA donors (/expand the EA community) to the extent possible and that we also shouldn't assume there's a clear differentiation between EA and non-EA donors.

That said, I do think the tax effect I outlined would reasonably be of concern to EA donors  or insofar as it's not because the compensation mechanism will definitely create better results, it may make the argument a bit circular. I also think there's a principle/agent problem with donors (maximize impact) and non-profit staff (motivated consciously or unconsciously in part by maximizing compensation/job security), and it would be a mistake to assume that shared EA values fully solve that problem. 

Have any EA nonprofits tried offering staff funding-based compensation? If not, why not? If so, how did it go?

This is an intriguing idea, and I'm all for experimentation in nonprofits generally and with compensation specifically. I also find nonprofit performance incentives potentially valuable and interesting.

One problem I see is lots of funders would hate this: from their perspective it creates a sort of tax on their donation. Instead of the whole donation going to whatever new thing they'd want to fund, a percentage gets set aside for current employees. I think this is part of the reason (per Jared's smart reply) that grantwriting commissions are looked down upon in the industry. 

Another problem could be that lots of donors want to feel like nonprofit employees are not motivated by money, and implying otherwise could make the nonprofit unatttractive. 

I think the broader principle-agent issue is that funding and results are orthogonal to one another (probably the central problem for nonprofits generally), so compensating based on funding raised incentivizes employees to pursue flashy or unfairly charismatic projects, overpromise, and embellish or lie about results. (Though to be clear, nonprofits/nonprofit fundraisers already face these incentives). 

One analogous idea I've noodled around with a bit is results-based bonuses where you set a goal, a probability of success, and a dollar figure for achieving the goal, and you set aside a pool of money where if the employee achieves the result they receive the amount it's worth divided by the estimated probability of success. If my job were an example, this would look something like if 1Day Sooner's goal is to have a 50% chance of our work being the but-for cause of saving ~4 million DALYs by 2030, you could set aside $100K of my compensation each year and if we achieved the goal, I'd receive 2x that. one problem is a lot of results take a long-term to materialize (and are hard to prove/calculate reliably), and you might have to pay too many premiums (to adjust for risk + time value of money) to make it worth it.

Pathways to impact for forecasting and evaluation

I'm very much not a visual person, so I'm probably not the most helpful critic of diagrams like this. That said, I liked Ozzie's points (and upvoted his post). I'm also not sure what the proper level of abstraction should be for the diagram -- probably whatever you find most helpful.

A couple preliminary and vague thoughts on the substantive use cases of forecasting that insofar as they currently appear do so in a somewhat indirect way:

  • Developing Institutionally Reliable Forecasts: This seems to fall under the "track record" and maybe "model of the world" boxes, but my idea here would be if you can develop a track record of accurate forecasting for some system, you can use that system as part of an institutional decision-making process when it forecasts a result at a certain probability. Drug development would be a good example: the FDA could have a standard of authorizing any drug that a reliable forecaster gave a >95% probability of licensure (or of some factual predicate like efficacy). Another set of applications could be in litigation (e.g. using reliable forecasters in a contract arbitration context). The literature around prediction markets probably has a lot of examples of use cases of this type. It might be difficult, though, to create a forecasting system robust to the problem of becoming contaminated and gamed when tied to an important outcome. 
  • Predictive Coding: There's an idea in neuroscience that perception involves creating a predictive model of the world and updating the model in response to errors reported by sensory data. Some people (like Karl Friston and Andy Clark) argue that action and perception are largely indistinct and run on the same mechanism -- so you act (like lifting your hand) via your brain predicting you will act. SlateStarCodex has a good summary of this. It seems like developing more fine-grained, reliable, and publicly legible forecasting machinery may have useful applications in policy-making by perhaps allowing the construction of a rudimentary version of something analogous. Some of the ideas under my first bullet might fit this concept, but you could also imagine having mechanisms that target the reliable forecast (using the forecast as a correlate of whatever actual change you're trying to achieve in the world). Another way of thinking of this might be to use forecasting to develop a more sophisticated perceptual layer in  policy-making. 
EA Should Spend Its “Funding Overhang” on Curing Infectious Diseases

Not opposed to EA anti-aging research, but my intuition would be targeting infectious disease allows for more rapid iteration and proof of concept because the solutions are easier to publicly demonstrate in the short term. So I think it provides better training for EA methods (which could in turn enhance aging research). 

 

Also, infectious disease affects poor people disproportionately and as such there's more likely to be a market failure and undersupply of resources rather than aging, which is a proportional problem between the rich and poor.

Should Effective Altruists Sign Up for Oxford’s COVID Challenge Study?

Thanks for the comments! Just wanted to quickly say that Larks's interpretation of our intention was correct: we view participation in this study is superogatory (and are really making the argument that this study might be in the range of actions that are considered effective altruist).

Kidney donation is a reasonable choice for effective altruists and more should consider it

The claim about donor survival is more based off of Segev, 2010, which does use controls matched on health (http://jama.jamanetwork.com/article.aspx?articleid=185508&resultclick=1). (There was an editing error in the footnote above, sorry about that).

Good point about the age-matching, which I'll update our website to reflect. Agree that the Mjoen piece definitely has value (which is why we included it), but there are other reasonable criticisms (like the controls all being drawn from the same region and from an earlier time period) raised as well.

Kidney donation is a reasonable choice for effective altruists and more should consider it

The U.S. is third in the world for deceased donation per million persons. The difference between us and the #1 (Spain, which has a suite of good deceased donation policies, one of which is a version of presumed consent) can be explained by our generally not accepting deceased donors over 70 and Spain doing so. http://onlinelibrary.wiley.com/doi/10.1002/lt.23684/full

Also, the kidney shortfall is 20K/yr. Total deceased donor kidneys are about 12K per year. Opinions differ as to what percent of those eligible to be deceased donors donate, but the official government estimate is 75% (I think a range of 50-75% is probably credible), so even if all eligible deceased donors donated, there would still be an enormous shortfall in kidney transplants each year.

If you were try to adapt the EA message to be more successful in the Spanish context, how do you think you'd do so?

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