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TheOtherDave comments on Efficient Charity: Do Unto Others... - Less Wrong
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I take it that you're suggesting marginal analysis based on the standard correct classical causal decision theory (in which no one is responsible for saving a life by donating blood unless someone would have actually died had that donation not been made) out of either belated humility about the probability of an SIAI-originating decision theory being correct, or because you're planning to actually convince someone and you don't want to invoke Hofstadterian superrationality in place of the standard correct decision theory?
:)
My guess would be that at the margin, a blood donation saves less than 0.00001 lives. (Otherwise, compensation would be increased for the paid donors). But, if you want to use a TDT/UDT style analysis, here are some relevant statistics from the American Red Cross:
Given these numbers, I would estimate that roughly 0.5 million (US) lives are saved (more accurately, extended) by blood products annually. If you adopt the assumption that all blood comes from voluntary, uncompensated donations, and divide those 0.5 million lives among the 16 million annual donations, you get one life saved for every 32 pints donated - not as much as jsteinhardt hoped, but still significant enough to earn a major warm-and-fuzzy.
I happen to administer a lot of blood to my patients, so let me answer some of the factual questions.
The way they calculate "up to 3 lives" is in the most trivial way: blood you donate is fractionated into red cells, plasma, and platelets. Each of those may go to a different recipient.
All blood administered to patients comes from voluntary, uncompensated donations. Plasma used in research studies may be compensated, but may not be transfused. This is the most important factor keeping our blood supply safe, and is far more effective than laboratory testing alone.
Given that blood banks need to keep a sufficient store of blood available of each type, rarer blood types are generally in greater need than, say, A After all, a larger proportion of blood of those types must be discarded. O blood is obviously highly useful in trauma situations, and is therefore in high demand as well.
The distribution of donors' and recipients' blood types should not be assumed to be equal: people with blood type A are significantly more likely to donate than people with blood type B. This exacerbates the discrepancies due to point 3.
The number of lives saved can be calculated in two ways:
a. the feel-good way. Every time a physician gives a unit of blood to a patient e does so believing it is a life-saving procedure. So if 3 units are given the patient's life was saved 3 times in rapid succession. (You have to be willing to save a life multiple times, because that's the analysis we're using for the rest of this discussion: multiple mosquito nets saved the same kid's life multiple times over his lifetime; that same kid was then saved by anti-diarrheal treatments; etc. The same analysis belongs here). Now, we subtract the number of patients who die, but that's a small number. So 26 million transfusions/16 million donations = 1.6 lives saved per donation.
b. the marginal way. Donations are currently sufficient for usage; we benefit in three ways from more donations. First, we can be slightly more profligate with trauma patients who have a low survival chance; this saves a minimal number of lives. Second, fresher blood is associated with better outcomes than older blood; the extent of this effect is unknown but is an area of current research interest. The calculation would have to look at the likelihood that your donation reduced the average shelf age of the blood being administered times the survival improvement from the fresher blood. Third, blood from multiparous women is associated with ARDS; an increase in donation would allow us to stop using it.
Thanks for data!
Only vaguely relatedly: if you have pointers to (or are willing to synthesize) a reliable calculation of expected lives-saved/deaths-caused by maintaining or discarding the existing Red Cross policies about who is "allowed" to donate blood, especially the relatively controversial ban on male donors with homosexual acts in their sexual history, I would be interested.
Full disclosure: I do have a personal/emotional stake in this question, but I really really don't want to set off a political/ethical conversation about it. I'm asking it here because, as with a lot of politically charged topics, the arguments I've found on both sides are mostly a case of framing the question so as to give the answer one wants to give, rather than so as to answer the question that was asked, and I'm looking for a more objective analysis.
I also wanted to ask this question.
Giving blood is important to me. It is so important that I have chosen not to pursue relationships with other men in order than I can continue to give blood without lying to do so. I expect that sooner or later, I will choose otherwise, and a sexual relationship will be important enough to me to sacrifice my ability to ever give blood again, and this distresses me.
I can accept that the risks of HIV may be high enough to make this a reasonable choice on the part of United Blood Services / Red Cross. However, I would like to be quite sure that this is the case, or to be told that my blood isn't as important as I previously though it was. I was previously giving blood on the impression that each donation saves around a twentieth of a life; this thread doesn't change that estimate enough for me to feel like I can stop donating in good conscience.
On the margins, I expect that each marginal pint of blood saves only a very small fraction of a life. As several readers pointed out, this doesn't mean that we should ordinarily be calculating on the margins, since it's not like you can use a pint of blood for something else instead; in terms of moral credit, you should think of yourself as part of a reference class of people who all choose to donate blood for around the same reasons, and who all get an equal share of the lives saved.
However, the Red Cross has already decided that they're willing to X out the entire homosexual community, and I would expect the reference class of those who refrain from sexual activity in order to continue donating blood to be small, and I would guess that if this entire reference class refrained from donating blood, not a single additional life might be lost.
Modern-day hospitals are not, so far as I know, blood-limited. They need a routine flow of blood in order to routinely save lives. They do not need more blood to save more lives. That's the impression I got, anyway; some quick Googling even said that they usually have enough blood to just use O-negative instead of matching types.
I hate to say this, but I think you're making the wrong sacrifices here. I estimate a very high information value for further investigation on your part; I would expect it to show that you were safe to stop donating blood and resume sexual activity without costing anyone one-twentieth of a life. If you're really feeling guilty or worried, resume sexual activity and send a donation to the Singularity Institute as a carbon offset. If you can speed up a positive Singularity by one minute that works out to around 100 lives, never mind increasing the probability.
I think I was accidentally misleading by failing to add that I'm bisexual. Not giving blood reduces my pool of potential romantic partners by roughly 10%, and doesn't prevent me from having fulfilling relationships. I don't think I would abstain from sex in order to give blood even if I knew I could save a life with each donation. Even if that's an incredibly selfish decision, I'm just not that good a person.
Regardless, the support of everyone who replied is very much appreciated.
...technically, doesn't speeding up a negative singularity also save lives-- the lives of those who would otherwise have been born and then killed but were instead never born and therefore couldn't be killed? In fact, I think speeding up a negative singularity actually "saves" more lives than speeding up a positive one using this calculation-- a quick Google search indicates ~250 people are born every minute and ~100 people die every minute.
Replace "save lives" with "extend lifespans." All the math will suddenly start working out better.
Agreed, I retrospect I should have phrased the original question in terms of QALYs or some similar metric.
In a fairly meaningful sense, no life has ever been saved before. Nobody has actually been prevented from dying yet. A positive singularity could change that.
I believe you can make an easier calculation: change the denominator from lives to units of blood. How much effort/money/social capital would it take you to convince one more person to donate one more unit? [ignore the cost to that person, as it's likely zero or slightly beneficial]. Calculate the effort it therefore would take you to replace yourself as a donor while keeping the blood supply constant; this should serve as an upper bound for the self-sacrifice you should make in terms of sexual restraint.
You make an excellent point. I clarified that the sexual restraint required is not as great as it may seem, but convincing other people to donate regularly (I have done so at least twice in my life) is still much less of a sacrifice.
(nods) For me, it's not a pragmatic question of whether I donate or not: after ~20 years in a mutually monogamous relationship, I am confident that my donating blood reduces the percentage of infected blood in the supply, regardless of my gender, and that's the metric that matters.
But I spent some time trying to make sense of the arguments pro and con, a few years back, and mostly came to the conclusion that I didn't trust anyone's arguments.
It is certainly true that if you divide the community of potential donors into two groups, and the frequency of blood-born pathogens is higher in group A than group B, and your filtering mechanisms aren't 100% reliable, then the blood supply is N% safer if you remove group A from potential donors.
It is equally certainly true that you can do that division in thousands of different ways, and each way of doing that division gets you a different N.
I was hoping to find a comparison of estimated Ns for different plausible policies, and perhaps a recommendation for the best policy.
What I found instead was that defenders of the existing policy were making the first argument and saying "See? The policy makes the blood supply N% safer! We have to keep doing it, to do otherwise would be unsafe!" while at the same time disregarding questions about how large N actually was (i.e.., how many lives were actually at stake? 1000? .001? Somewhere in between?) and whether a different policy might get you a much larger N, while opponents of the policy were disregarding the first argument altogether.
My conclusion is somewhat related. I have no particularly good reason to believe that I am better able to establish blood donation and usage policy than the Red Cross or the medical practitioners. I just give them my blood and they can use it or not as they see fit. I'd do it just for the health benefits anyway.
For my own part, I appreciate that the Red Cross (and etc.) is trying to satisfy multiple constraints, only one of which is the actual safety of their blood supply, and I don't object to that. But the constraints that apply to them in articulating a policy don't necessarily apply to me in donating blood.
On the other hand you have constraints that they do not have, not least of which is the lack of scaling benefits for your research and decision making efforts.
We are left with an optimal approach of considering what we know of our own blood that the collection agency does not (or is forbidden from discriminating on). We can approximate whether this knowledge would make the blood more suitable or less. Only if 'less' do we need worry about how significant that extra knowledge is.
We also need to worry if the answer is ‘more’ and because of that we decide to lie on the answer form so that we can donate.
I kind of get the impression that TheOtherDave is doing that, or at least would condone it under circumstances very much like his.
I don't do it, mostly because I'm so irritated by the policy that I've worked my way into a completely counterproductive "F--k it, then, donate your own f--king blood, see if I care" kind of sulk about it. I'm not proud of this, but there it is.
Yes, I condone it... indeed, I endorse it... in situations very much like mine.
They aren't assessing that risk in a logical fashion. If they were, they would have similar restrictions on donation by ethnic group. (It is possible that the Red Cross would like to do that also but knows that it is political unfeasible.)
Will Saletan has an article on this.