My day job is mental health services research: I want to improve the care provided to adolescents and children in North American health systems. But from the viewpoint of effective altruism this is far from the best thing I could be doing with my life. Let’s see if I can defend my choice.
Effective altruism is a philosophy and
a growing social movement that combines both the heart and the head: compassion guided by data and reason. It’s about dedicating a significant part of one’s life to improving the world and rigorously asking the question, “Of all the possible ways to make a difference, how can I make the greatest difference?”
Will MacAskill is a leading exponent of effective altruism. Thomas Nagel gives a fair summary of the argument in a review of MacAskill’s book:
first, the good of any one individual is of no more importance, from the point of view of the Universe, than the good of any other; and second, that as a rational being, each of us is required to aim at good generally – so far as it is attainable by our efforts – not at a particular part of it. The rational ideal, then, would be to subordinate one’s own point of view completely, for evaluative purposes, to the point of view of the Universe, and to find a way to live that produces more good, impartially measured, than any available alternative.
So am I doing the best thing I could by these lights? Perhaps the most salient thing my work might help accomplish is preventing suicides by children and youth. But as I wrote previously, the resources required to prevent a North American suicide could be invested to prevent many more child deaths elsewhere:
the Give Well Foundation estimates that the cost per child-life-saved of an anti-malarial bed net is about $2800. If so, you could save more than 150 children in malarial regions for the cost of preventing one youth suicide in America [$450,000/life-saved].
So unless I someday make a breakthrough that radically reduces the cost of preventing a suicide, then I’m not doing the best that I could by effective altruistic criteria.
But there are also some things I could say in my defence. First, we can ask what the impartial viewpoint actually requires. Second, can and should all of us focus our lives on the choices required by that viewpoint?
So, what does the impartial viewpoint require? No one knows what the most effective thing to do is. MacAskill recognizes this and provides rough but useful guidelines for how to find an effective investment of your time and resources: You should work on problems that have large scale, are neglected, and are tractable (that is, where your effort can achieve a measurable good).
By these guidelines, research on mental health looks fairly good. Mental health problems have enormous scale. From Christopher Murray’s project to estimate the global burden of disease:
In 2010, mental and substance use disorders accounted for 183·9 million DALYs [disability-adjusted life years] (95% UI 153·5 million–216·7 million), or 7·4% (6·2–8·6) of all DALYs worldwide. Such disorders accounted for 8·6 million YLLs [years of life lost to premature mortality] (6·5 million–12·1 million; 0·5% [0·4–0·7] of all YLLs) and 175·3 million YLDs [years lived with disability] (144·5 million–207·8 million; 22·9% [18·6–27·2] of all YLDs). Mental and substance use disorders were the leading cause of YLDs worldwide.
Mental health and substance abuse are also neglected relative to their cost in morbidity and mortality.
But as I showed in the comparison of suicide prevention to anti-malarial bed nets, these problems aren’t nearly as tractable, right now, as infectious diseases in the developing world.
Once upon a time though, nearly all medical problems were intractable. They became tractable through research. A large scale, neglected, but currently intractable problem is an important — albeit high risk — place to invest research effort.
Second, we need to question whether every ethical choice can or should be made from the impartial viewpoint.
The impartial viewpoint weighs the needs of every human equally. But most of our ethical choices are made looking at those who are near to us in our social network: our families first, our neighbours next, then our country, then the world.
We do this because we are built this way. And because we acquire responsibilities and duties toward these proximal others just because we have direct relationships with them. I have duties toward my wife because I made promises when I married her. I have duties toward my children because I fathered them. And similarly, I want to improve the mental health of children in Canada because I enjoy the benefits of its civilization. My skill as a researcher was in fact the specific reason why Canada let me come live here.
Nagel puts it this way:
values that are specifically dependent on the perspective of the individual agent seem to be at least an important part of the ground for what we have reason to do, and to recognize those values is not inconsistent with acknowledging that, from the impersonal point of view, all individuals are equally valuable.
That is, we have morally valid reasons to act stemming from both the impartial view and the partial view we see from our location in the social network.*
We need to balance, somehow, the obligations that each view generates. Although I believe I can defend my choice of life, that doesn’t mean that I am satisfied with how I am balancing my obligations. More of my effort and charity should be directed by the impartial view. I agree with Nagel when he agrees
with… MacAskill that… preferences [for causes based on the partial view] are often carried to ridiculous lengths, with very wasteful results. The effective altruism movement is doing great service in focusing attention on the greatest needs [from the impartial view], which can be met at the smallest cost.
* I want to add that the contrast between the impartial view and the view from our nexus in the social network is something like the contrast between the views of Mr. and Mrs. Ramsay in To the Lighthouse. Write me a note if you agree.
