All of PeterSinger's Comments + Replies

Fact checking comparison between trachoma surgeries and guide dogs

Why is the choice not directly comparable? If it were possible to offer a blind person a choice between being able to see, or having a guide dog, would it be so difficult for the blind person to choose?

Still, if you can suggest better comparisons that make the same point, I'll be happy to use them.

Hi Peter,

Some examples that might be useful:

1) Differences in income

A US college graduate earns about 100x more than GiveDirectly recipients, suggesting money can go far further with GiveDirectly. (100x further if utility ~log-income.)

2) The cost to save a life

GiveWell now says $7500 for a death prevented by malaria nets (plus many other benefits) Rich country governments, however, are often willing to pay over $1m to save a life of one of their citizens, a factor of 130+ difference. https://800... (read more)

Fact checking comparison between trachoma surgeries and guide dogs

These are good points and I'm suitably chastened for not being sufficiently thorough in checking Toby Ord's claims,
I'm pleased to see that GiveWell is again investigating treating blindness: In this very recent post, they say: "We believe there is evidence that cataract surgeries substantially improve vision. Very roughly, we estimate that the cost-effectiveness of cataract surgery is ~$1,000 per severe visual impairment reversed.[1]"
The footnote reads: "This estim... (read more)

2Jeff Kaufman4y
It looks like GiveWell put that project on hold in January 2018: []
agree :)
Fact checking comparison between trachoma surgeries and guide dogs

I don't understand the objection about it being "ableist" to say funding should go towards preventing people becoming blind rather than training guide dogs

If "ableism" is really supposed to be like racism or sexism, then we should not regard it as better to be able to see than to have the disability of not being able to see. But if people who cannot see are no worse off than people who can see, why should we even provide guide dogs for them? On the other hand, if -- more sensibly -- disability activists think that people who are unab... (read more)

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.
2Dawn Drescher5y
Here’s what I usually found most unfortunate about the comparison, but I don’t mean to compete with anyone who thinks that the math is more unfortunate or anything else. 1. The decision to sacrifice the well-being of one person for that of others (even many others) should be hard. If we want to be trusted (and the whole point of GiveWell is that people don’t have the time to double-check all research no matter how accessible it is – plus, even just following a link to GiveWell after watching a TED Talk requires that someone trusts us with their time), we need to signal clearly that we don’t make such decisions lightly. It is honest signaling too, since the whole point of EA is to put a whole lot more effort into the decision than usual. Many people I talk to are so “conscientious” about such decisions that they shy away from them completely (implicitly making very bad decisions). It’s probably impossible to show just how much effort and diligence has gone into such a difficult decision in just a short talk, so I rather focus on cases where I am, or each listener is, the one at whose detriment we make the prioritization decision, just like in the Child in the Pond case. Few people would no-platform me because they think it’s evil of me to ruin my own suit. 2. Sacrificing oneself, or rather some trivial luxury of oneself, also avoids the common objection why a discriminated against minority should have to pay when there are [insert all the commonly cited bad things like tax cuts for the most wealthy, military spending, inefficient health system, etc.]. It streamlines the communication a lot more. 3. The group at whose detriment we need to decide should never be a known, discriminated against minority in such examples, because these people are used to being discriminated against and their allies are used to seeing them being discriminated against, so when someone seems to be saying
The objection about it being ableist to promote funding for trachoma surgeries rather than guide dogs doesn't have to do with how many QALYs we'd save from providing someone with a guide dog or a trachoma surgery. Roughly, this objection is about how much respect we're showing to disabled people. I'm not sure how many of the people who have said that this example is ableist are utilitarians, but we can actually make a good case that using the example causes negative consequences for the reason that it's ableist. (It's also possible that using the example as it's typically used causes negative consequences by affecting how intellectually rigorous EA is, but that's another topic). A few different points that might be used to support this argument would be: * On average, people get a lot of value out of having self-esteem; often, having more self-esteem on the margins enables them to do value-producing things they wouldn't have done otherwise (flow-through effects!). Sometimes, it just makes them a bit happier (probably a much smaller effect in utilitarian terms). * Roughly, raising or lowering the group-wise esteem of a group has an effect on the self-esteem of some of the group's members. * Keeping from lowering a group's esteem isn't very costly, if doing so involves nothing more than using a different tone. (There are of course situations where making a certain claim will raise or lower a group's esteem a large amount if a certain tone is used, and a lesser amount if a different tone is used, even though the group's esteem is nevertheless changed in the same direction in either case). * Decreases in a group's ability to do value-producing things or be happy because their esteem has been lowered by someone acting in an ablelist manner, do not cause others to experience a similarly sized boost to their ability to be happy or do value-producing things. (I.e. the truth value of claims that "status games are zero sum" has l
If I try to steelman the argument, it comes out something like: Some people, when they hear about the guide dog - tracheoma surgery contrast, will take the point to be that ameliorating a disability is intrinsically less valuable than preventing or curing an impairment. (In other words, that helping people live fulfilling lives while blind is necessarily a less worthy cause than "fixing" them.) Since this is not in fact the intended point, a comparison of more directly comparable interventions would be preferable, if available.
Fact checking comparison between trachoma surgeries and guide dogs

Regrettably, I misspoke in my TED talk when I referred to "curing" blindness from trachoma. I should have said "preventing." (I used to talk about curing blindness by performing cataract surgery, and that may be the cause of the slip.) But there is a source for the figure I cited, and it is not GiveWell. I give the details in The Most Good You Can Do", in an endnote on p. 194, but to save you all looking it up, here it is:

"I owe this comparison to Toby Ord, “The moral imperative towards cost-effectiveness,” http://www.givi... (read more)

EDIT: this comment contains some mistakes [] To begin with, I want to say that my goal is not to put blame on anyone but to change how we speak and act in the future. I am looking at this table [] from the cited source (Loss of Vision and Hearing, DCP2 []). It’s 77% cure rate for trachoma that sometimes develops into blindness. Not 77% cure rate for blindness. At least that’s how I interpret it, I can’t be sure because the cited source of the figure in the DCP2’s table doesn’t even mention trachoma! From what I’ve read, sometimes recurrences happen so 77% cure rate from trachoma is much much more plausible. I'm afraid Toby Ord made the mistake [] of implying that curing trachoma = preventing blindness. What is more, Toby Ord used the same DCP2 report that GiveWell used and GiveWell found major errors [] in it. To sum up very briefly: Regarding Fred Hollows Foundation, please see GiveWell’s page [] about them and this blog post []. In my eyes these discredit organization’s claim that it restores sight for $25. In conclusion, without further research we have no basis for the claim that trachoma surgeries can prevent 400, or even 40 cases of blindness for $40,000. We simply don't know. I wish we did, I want to help those people in the video. I think one thing that is happening is that we are too eager to believe any figures we find if they support an opinion we already hold []. That severely