All of joshcmorrison's Comments + Replies

Why you should consider becoming a nondirected kidney donor

Thanks for writing this Nicole!

Agree about 2ish weeks off work as the standard, though Alexander and I donated ~ten years ago, and I have some (purely anecdotal) sense that the surgery experience (and recovery) for people like Nicole who've donated since then at a big center might be better. 

Also, I think this Annals of Internal Medicine meta-analysis on the risks of kidney donation is a good resource for people who feel comfortable reading academic papers.

A Critical Review of Open Philanthropy’s Bet On Criminal Justice Reform

Yeah it's unclear how much of the 20% reduction is due to OP's work or would happen counterfactually. My main point with that number is that reductions of that size are very possible, which implies assuming a 1-10% chance of that level of impact at a funding level 10-100x OP's amount is overly conservative (particularly since I think  OP was funding like 25%  of American CJR work -- though that number may be a bit off). 

Another quick back of the envelope way to do the math would be to say something like: assume 1. 50% of policy change is due... (read more)

A Critical Review of Open Philanthropy’s Bet On Criminal Justice Reform

Thanks for putting this together! I think criticizing funders is quite valuable, and I commend your doing so. My main object-level thought here is I suspect much of the disagreement with the OP funding decision is based around the 1%-10% estimate of a $2B-$20B campaign leading to a 25%-75% decrease in incarceration. Since, per this article, incarceration rates in the U.S. have declined 20% (per person) between 2008 and 2019, your estimates here seem somewhat pessimistic to me. 

My guess is at the outset, OP would have predicted a different order of mag... (read more)

6NunoSempere2mo
Thanks Josh, I particularly appreciate your quantified estimates of likelihood/impact. Not sure how that follows; what would be needed for counterfactual/shapley impact would be a further reduction in the absence/reduction of funding. If OP donates $5B and the imprisonment rate goes down another 20%, but would have gone down a 20% (resp 15%) anyways, the impact is 0 (resp 5%).
Some potential lessons from Carrick’s Congressional bid

Am a bit late to this but wanted to jot down a few thoughts:

  1. Does EA Represent Electoral Constituents? Since EA is cosmopolitan and disregards national and possibly temporal boundaries, does that mean  EA politicians will prioritize non-voters over the interest of voters? A lot of EAs may feel like which Americans have health insurance coverage or have a right to an abortion is less important than Africans dying of malaria or humanity going extinct. But 1. is this a legitimate basis for democratic politics and 2. if legitimate, will espousing it inhere
... (read more)
Demandingness and Time/Money Tradeoffs are Orthogonal

Thanks Caroline for writing this! I think it's a really rich vein to mine because it pulls together several threads I've been thinking a lot about lately.

One issue it raises is should we care about the "altruist" in effective altruists? If someone is doing really useful things because they think FTX will pay them a lot of money or fund their political ambitions, is this good because useful things happen or bad because they won't be a trustworthy agent for EA when put into positions of power? My instinct is to prefer giving people good incentives than selec... (read more)

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 just
... (read more)
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 (maxim... (read more)

1Arepo9mo
'I think EA nonprofits should try to be funded by non EA donors (/expand the EA community) to the extent possible' The extent possible for 'weird' EA projects is often 'no extent'. We have applied to various non-EA grants that sorta kinda cover the areas you could argue we're in, and to my knowledge not received any of them. I believe that to date close to (perhaps literally) 100% of our funding has come from EAs or EA-adjacent sources, and I suspect that this will be true of the majority of EA nonprofits. 'Assuming that shared EA values fully solve the problem' is exactly what we're trying to avoid here. Typical nonprofit salaries just work on the assumption that the person doing the job is willing to take a lower salary with no upside, which leads to burn out, lack of motivation and sometimes lack of competence at EA orgs. We're trying to think of a way to recreate the incentive-driven structure of successful startups, both to give the staff a stronger self-interest-driven motivation and to make future such roles more appealing to stronger candidates.
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 up... (read more)

2Arepo9mo
I really hope this isn't true for EA donors. For most EA organisations, the staff are the supermajority of the cost anyway, so the only questions should be whether this sort of incentive scheme motivates them to be more or less productive per $ than a flat salary, and zooming out, whether such schemes would encourage more total high value work to get done. Again, are we talking about EA donors? If so, I'd hope they were neutral on what motivated the staff except inasmuch as it related to how much they could get done. This seems plausibly insurmountable to me. Compare for-profit startups: I would be very surprised if those that offered their employees stock-based comp didn't outperform those that offered them internally judged results-based comp. (do any of them even do the latter?)

I'm much more excited about results-based compensation than funding-based compensation, for nonprofit employees.

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" b
... (read more)
2NunoSempere9mo
I don't have any immediate reply, but I thought this comment was thoughtful and that the forum can probably use more like it.
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.

3MikeJohnson9mo
Most likely infectious diseases also play a significant role in aging- have seen some research suggesting that major health inflection points are often associated with an infection. I like your post and strongly agree with the gist. DM me if you’re interested in brainstorming alternatives to the vaccine paradigm (which seems to work much better for certain diseases than others).
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.

1rpdrewes7y
Thanks for your reply. The JAMA article you cite is not a good one for this discussion, I think, because the median followup was just 6.3 years. The mortality curves for donors and properly matched controls don't start moving apart until about 10 years. At 15 years, the difference is quite pronounced. At 20 years post donation, donors are looking at 50% increased mortality compared to properly matched controls. Kidney donation is still a huge benefit for recipients, and may be a net benefit, but it is a much bigger risk (I believe) for donors than has been portrayed. Yet major donor web sites (Stanford, Maryland Medical Center) haven't caught up to the research.
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 go... (read more)

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?

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

To follow up on Alexander's point a bit, I think applying the charitable benefits standard to non-charity decisions leads to some really weird results. For example, say someone who identifies as an EA chooses to give 10% of her income each year to a GW charity, and she’s choosing employment between being a schoolteacher for $50K a year or a job that’s not especially prosocial that pays $55K a year; say she has no innate preference between them, prefers to make more money all things being equal, and that being a schoolteacher would be worthmore than the $50... (read more)

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

In terms of opt-out, I only know the data in the U.S. but basically while it might be a good idea, it's unlikely to yield significant increases: it seems like such an attractive decision architecture/nudge type intervention, but when you dig in, it's a much closer call (which is why Sunstein and Thaler don't recommend it, for example).

The current American system is more of a hybrid than clear opt-in. Right now, about 75% of those who could become deceased donors ultimately consent to do so (about 40-50% are registered as organ donors and of the remainder,... (read more)

1lukeprog7y
I haven't studied organ donation, but I was under the impression that the current state of the (admittedly non-experimental) evidence suggested that switching to opt-out would likely yield significant (though not huge) increases in organ donation, e.g. see here [http://www.biomedcentral.com/1741-7015/12/131] and here [http://www.bmj.com/content/338/bmj.a3162.long]. Is it easy for you to explain, or link me to, the reasons for your skepticism?
Kidney donation is a reasonable choice for effective altruists and more should consider it

(re: political credibility) -- Ehhh, let's say you become a doctor because you think healthcare is important. You want to help people and by being a doctor, you hope to have the status to advocate politically for expanding access to healthcare. I don't see how your authority is impugned because of your desire for advocacy. I think what you're going for is the loss of authority if you have an ulterior motive that cuts against the stated motive -- e.g. if you join a church for political gain but don't believe in god. As a kidney donor, though, your desire to give and desire to change policy are aligned.

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

Austen, I see your point but think you have the wrong model of how social movements work. Basically any successful social movement I can think of (e.g. civil rights, women's rights, gay rights) has had extremists who were important to the movement and has included acts of extremism that were historically important to the movement's self-identity. More to the point, it's impossible to know ahead of time what acts will end up considered extremist, so it's silly to criticize an action that aligns with the movement's values as being against the movement becaus... (read more)

3Austen_Forrester8y
I think you are confusing radicalism of getting attention with that of the form the social change will take. For example, Emily Davison ran onto a race track as a PR stunt, but all she was seeking was voting rights for women, not the right for them to walk around naked. Nelson Mandela was jailed for economic terrorism to bring attention to his cause, but he simply wanted blacks to enjoy the freedoms whites had – nothing radical about that. PETA does crazy publicity stunts sometimes, and perhaps they've had a net benefit, but they do them to bring attention to the abuse of animals on farms, mostly, not to emancipate domesticated dogs and cats. We should make a distinction between extremism in publicity measures with that of the demands that activists are making on society. To look at EA, the demands it makes on people should also be reasonable: give according to impact, not feelings; be irreplaceable, especially for the more important causes, etc. Making unreasonably large demands on people could result in people rejecting even the easier actions. For instance, studies demonstrate that to promote veganism, it's actually more effective to promote vegetarianism, and let the vegetarians eventually gravitate towards veganism, than it is to directly promote veganism, which results in people not even giving up meat, because avoiding animal products completely is so demanding to people that they end up rejecting the whole veg thing altogether. Please don't take my comments as policing, I like your post and I think donating kidneys is great, I just wouldn't want to see a CNN segment on EA discussing kidney donation as viewers may use it as an excuse to reject EA altogether.
Kidney donation is a reasonable choice for effective altruists and more should consider it

Politically, it probably wouldn't be feasible to allow organ sales, but there are a lot of intermediate policy alternatives likely sufficient to end the shortage by supporting donors better (just to start, you could pay lost wages and travel, but you could also provide health insurance, tax credits, or an annuity to donors). If you think that's a good idea (we think it would save about 160K QALYs annually), donating your kidney gives you unique moral authority and power in advocating that policy.

Also you might be interested in signing this open letter if you support benefit for donors --http://www.ustransplantopenletter.org/home.html

0RyanCarey8y
But it's a kind of moral authority that might disappear when you look at it too closely right? If the reason you're donating is to get the moral authority, then it's not clear that it's a virtuous act anymore! Another policy change is opt-out for (after-death) organ donation rather than opt-in. How do you feel about the likely effectiveness of that?
Kidney donation is a reasonable choice for effective altruists and more should consider it

Got it! Thanks for explaining that, and I do think we wrote it in a confusing way (sorry!). There are two separate facts --1. the half-life for all living donor grafts is 14.2 years (figure 6.7 here http://srtr.transplant.hrsa.gov/annual_reports/2012/pdf/01_kidney_13.pdf). 2. Expected lifespan for those who receive any kidney transplant between the years of 60 and 64 in particular is 14.0 years. (See p. 266 here -- http://www.usrds.org/2013/pdf/v2_ch5_13.pdf).

Expected lifespan can vary from graft survival half-life both because half-lives are different fr... (read more)

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

Bernadette, maybe I'm misunderstanding your point, but the 14 year estimate is for patients 60-64 who receive a transplant (this might be a bit unclear as we wrote it though). Patients 60-64 on dialysis can expect 5.1 years of life, so that gives a 8.9 differential, which when you discount years by disability comes to 8.29 or about 8, which is our (admittedly imprecise) estimate. We don't think it's skewed in an optimistic direction though. To be clear, the 14-year overall estimate is 8 per transplant * 1.75 per marginal transplants created by starting a c... (read more)

2Bernadette_Young8y
Here's how you present the calculation * average half life of graft is 14.1 years across all transplants (which I've confirmed is what your defence data is discussing) * patients aged 60-65 on dialysis have life expectancy 5.2 years * therefore patients aged 60-65 on dialysis will gain 8.9 years from transplant. I think that's implausible for the reasons above.