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army1987 comments on Open Thread, November 15-22, 2013 - Less Wrong Discussion
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Eliezer's answer (I can't find it at the moment) is that there are many more lives around, and it seems unlikely that U(875,431 people die) - U(875,430 people die) is that different from U(875,430 people die) - U(875,429 people die).
(OTOH, once you've spent $200 to save a life, you have $200 less, and so the marginal utility of another $200 is larger.)