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katydee comments on Don't Build Fallout Shelters - Less Wrong
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The point is that it takes less money to increase the utility of someone living in a third-world country by a fixed amount than to increase the utility of some living in a first world country by the same amount.
That's true, but the discount factor still applies. Helping people in the third world is cheap enough relative to helping people in the first world that it makes up for the reduced utility per year of life saved.
The same discount factor applies to helping yourself in probability branches where you experience disasters, at the expense of ones where you don't.