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Comment author: ete 22 November 2016 08:01:16PM 2 points [-]

Agree with the overall thrust, but

"letting people sell their organs after they're dead doesn't seem like it would increase the supply that much"

seems very suspect. If you could sell the rights to your organs, there's now incentive to set up a "pay people to be signed up for organ donation" business. This is also not harmful to the donor, unlike kidneys.

Also, for added horror, a link to this may be worth including somehow.

Comment author: Gram_Stone 22 November 2016 10:40:08PM 1 point [-]

"letting people sell their organs after they're dead doesn't seem like it would increase the supply that much"

seems very suspect. If you could sell the rights to your organs, there's now incentive to set up a "pay people to be signed up for organ donation" business. This is also not harmful to the donor, unlike kidneys.

True. More than anything I was trying to bite off a small piece of the larger 'organ market question'. Given your comment, a better way to do this would have been to note that even perfectly allocating all cadaveric organs would still be insufficient to get a kidney to everyone who needs one. Although one thing I don't like about your proposal is that things could get very shady if people 'don't consent' to have their organs taken after they've already sold their rights and have therefore 'legally consented'. In my scheme I imagine people not getting paid unless the kidney's already out.

Also, for added horror, a link to this may be worth including somehow.

Just for added horror, or is there a larger point? (It's okay if there's no larger point. I ask because I've seen a general 'you don't want to legally create new incentives around organ trade, look at China' sort of objection that I didn't address in the article and that I would be prepared to address if that's where you're going.)

Kidney Trade: A Dialectic

5 Gram_Stone 18 November 2016 05:19PM

Related: GiveWell's Increasing the Supply of Organs for Transplantation in the U.S.

(Content warning: organs, organ trade, transplantation. Help me flesh this out! My intention is to present the arguments I've seen in a way that is, at a minimum, non-boring. In particular, moral intuitions conflicting or otherwise are welcome.)

“Now arriving at Objection from Human Dignity,” proclaimed the intercom in a euphonious female voice. Aleph shot Kappa and Lambda a dirty look farewell and disembarked from the train.

Kappa: “Okay, so maybe there’s a possibility that legal organ markets aren’t completely, obviously bad. I can at least quell my sense of disgust for the length of this train ride, if it really might save a lot more lives than what we’re doing right now. But I’m not even close to being convinced that that’s the case.”

Lambda nodded.

Kappa: “First: a clarification. Why kidneys? Why not livers or skin or corneas?”

Lambda: “I’m trying to be conservative.  For one, we can eliminate a lot of organs from consideration in the case of live donors because only a few organs can be donated without killing the donor in the process. Not considering tissues, but just organs, this narrows it down to kidneys, livers, and lungs. Liver transplants have … undesirable side effects that complicate-”

Kappa: “Uh, ‘undesirable side effects?’ Like what?”

Lambda: “Er, well it turns out that recovering from a liver donation is excruciatingly painful, and that seems like it might make the whole issue … harder to think about. Anyway, for that reason; and because most organ trade including legal donations is in kidneys; and because most people who die on waitlists are waiting for kidneys; and because letting people sell their organs after they're dead doesn't seem like it would increase the supply that much; for all of these reasons, focusing on kidneys from live donors seems to simplify the analysis without tossing out a whole lot of the original problem. Paying kidney donors looks like it’s a lot closer to being an obvious improvement in hindsight than paying people to donate other organs and tissues. If you wanted to talk about non-kidneys, you would have to go further than I have.”

Kappa: “Okay, so just kidneys then, unless I see a good reason to argue otherwise. The first big problem I see is that surgery is dangerous. So how are you not arguing that we should pay a bunch of people to take a bunch of deadly risks?”

Lambda: “As with any surgery, patients are at greater risk than usual immediately after having such a serious operation. The standard response is, "The risk of death from a kidney transplant in the form of a natural frequency is merely 1 in 3000, which is about the same as the risk of death from a liposuction operation." But to my knowledge there are only four studies that have looked at this, some finding little risk, others finding greater risk, some finding no increased risk of end stage renal disease, others finding increased risk of end stage renal disease. Both sides have been the target of methodological criticisms. I'm currently of the opinion that the evidence is too ambiguous for me to make any confident conclusions. I'm thus inclined to point out that we already incentivize people to do risky things with social benefits, such as military service, medical experimentation, and surrogate pregnancy. So saying that it's immoral to incentivize people to donate kidneys seems to imply that it's immoral to incentivize people to do at least some of those other things.”

Kappa: “Fine. Let’s assume that incentivizing people to take the personal risk is morally acceptable, just for the sake of argument. What makes you think that a market would improve things? How do I know you’re not the sort of person who thinks a market improves anything?”

Lambda: “Suppose you have a family member who needs a kidney transplant, and you’re not compatible. Suppose further that a stranger approaches you at the hospital and explains that they have a family member who needs a kidney and that they also aren’t compatible with their family member. However, claims the stranger, the two of you are compatible with one another’s family members. They will donate their kidney to your family member only if you will donate your kidney to their family member. Ideally, we would like this trade to take place. Would you donate your kidney? If not, why not?”

Kappa: “First I would want to know how the stranger accessed my medical records. At any rate, I don’t think I would. What if I donate first, and they back out after I donate? What if their family member dies before or during surgery and they no longer have an incentive to donate their kidney to my family member?”

Lambda: “Indeed, what if? In more than one way, it’s risky to trade kidneys as things are today. On the other hand, if you could reliably sell your kidney and buy another, you wouldn’t have to worry about being left out in the cold. Your kidney may be gone, but no one can take your revenue unless you make a big mistake. If the seller backs out, you can always try to buy another one.”

Kappa: “But there are already organizations with matchmaking programs that allow such trades to take place. They solve the trust problem with social prestige and verification procedures and other things. What more would a market get you, and how much does it matter after considering the additional problems that a market might cause? What are you really suggesting, when you can't use words like 'market'?

Lambda: "The ban prevents the use of money in organ trades, so what do you use in its place, and what have you lost? In the place of money, you use promises that you'll donate your kidney. The first way that promises are worse than money is that they're a poor store of value. If I trade my promise for a stranger's promise, and the stranger loses their incentive to donate, then the promise loses its value. Even if I only want to use the money to buy a kidney, I would prefer receiving money because I can be confident that I can later retrieve it and exchange it for a kidney as long as someone is selling one that I want. The second way that promises are worse than money is that they're a poor medium of exchange. Because each individual promise has associated with it some specific conditions for donation, promises aren't widely acceptable in trade. At the moment, we have to set up what are essentially incredibly elaborate barters to make trades that are more complex than simple donations from one donor to one recipient. It seems like both of these factors might prevent a number of trades that could be realized even given the currently low supply, particularly trades that might occur across time."

Kappa: “Right, but like I said, what about the additional problems that markets cause? Tissues sold by corporations in the U.S. in 2000 were more expensive than tissues sold by public institutions in the EU in 2010. And some of their products aren’t even demonstrably more useful than public alternatives; they deceive consumers! How is that supposed to make things better?”

Lambda: “This is a case where I would argue that there isn’t enough regulation. It’s true that with the wrong laws you can get situations like, say, the one where corporations encourage new parents to harvest and privately store autologous cord blood for large sums even though there’s no evidence that it’s more effective than the allogenic cord blood that's stored in public banks. But is an unqualified ban the only way to stop the rent-seeking? Why couldn’t you throw that part out but keep the trust, all via regulation? Remember also that you can store cord blood in a bank, but at the moment you can only store kidneys inside of a living human body. It seems like that would make it a lot harder to arbitrage."

Kappa: "What about egalitarian concerns? Wouldn't these incentives disproportionately encourage the poor to sell their organs?"

Lambda: "Whether lifting the ban makes things more egalitarian or less depends on your reference frame. The poor will have a greater incentive to sell their organs than the rich just like the poor usually have a greater incentive to sell other things than the rich. The idea behind the egalitarian objection is that the ban prevents this and it's more egalitarian if no one can legally sell their organs at all. But illegal organs already tend to flow from the poorest countries to the richest countries for the very reasons that you fear lifting the ban, and lifting the ban decreases U.S. demand for foreign organs by increasing domestic supply. In this reference frame, lifting the ban is more egalitarian, replacing the current sellers who receive little to no compensation, high risks, and poor post-operative care, with U.S. sellers who would receive more compensation, have lower risks, and receive better post-operative care."

Kappa: “In a market, I would guess that the average recipient wants to receive a kidney a lot more than the average donor wants to donate one. This could spell disaster for a market solution. What makes you think this wouldn’t happen with a kidney market?”

Lambda: “Empirically, the Iranian organ market has eliminated kidney waitlists in that country. The U.S. and Iran may be quite different, but they'd have to be different in the particular way that makes markets work there and markets not work here for that argument to follow. Besides, the U.S. spends about $72,000 per patient per year on dialysis, whereas the U.S. only spends about $106,000 on transplant patients in the first year, and about $24,000 per transplant patient per year, so the government should be willing to subsidize kidney suppliers in the case of market failure without intervention.”

Kappa: "Geez. Uh... what about impulsive donations? You'd be encouraging irresponsibility."

Lambda: "That seems like a weak one. Legislate waiting periods. And this isn't exactly a problem particular to legal kidney markets."

Kappa: "I have you now, Lambda! Even if all of these things are true, the fact remains that most people, including me, are disgusted by the very idea of exchanging our organs for money! How ever would you overcome our repulsion?"

Lambda: "You do have me, Kappa."

Kappa: "I'll grant you that, but no politician can lose by being against- I mean, what?"

Lambda stood up and walked solemnly to the window.

"How ever would I overcome your repulsion?"

Comment author: Brillyant 14 November 2016 05:23:45PM *  1 point [-]

The election has made me consider one of the opening argument's for the neoreactionary movement a bit more seriously. I have doubts about the goodness of democracy.

Specifically, I don't think the average voter knows anything. About a third of voters can't identify the three branches of government and half don't know their state has two senators.. I've seen polls saying something like 40% of Republicans believe Barack Obama is not a U.S. citizen. I know many people personally who sincerely believe he is a secret Muslim.

But policy governing 300+ million people in the ever-more-complex Universe we inhabit is super fucking complicated.

How can we trust the electorate to make these decisions? Why should we? How do they know anything relevant to the decision they are being asked to make when they vote? Why is there any reason to believe there will be a correlation between what the people will with their vote and what is actually good for the people?

I have no idea if Trump or Clinton (or Gary Johnson) is "best" for America's interests. I'm not even sure most Americans know what "best" means for them.

Comment author: Gram_Stone 14 November 2016 05:34:16PM 1 point [-]

I think these are important points, but an important counterpoint is the subject of The American System and Misleading Labels:

How much of the benefit of living in a democracy is in the small influences that voters occasionally manage to exert on the political process? And how much of that benefit is from power-wielders being too scared to act like historical kings and slaughter you on a whim?

Arguably, the chief historical improvements in living conditions have not been from voters having the influence to pass legislation which (they think) will benefit them, but, rather, from power-wielders becoming scared of doing anything too horrible to voters. Maybe one retrodiction (I haven't checked) would be that if you looked at the history of England, you would find a smooth improvement in living conditions corresponding to a gradually more plausible threat of revolution, rather than a sharp jump following the introduction of an elected legislature.

This debate is the main reason that I'm fascinated by post-democratic ideas, but dial my skepticism up to 11 with regards to their real-world consequences.

Comment author: MrMind 14 November 2016 01:45:33PM *  7 points [-]

T̶o̶ ̶s̶u̶m̶m̶a̶r̶i̶z̶e̶ ̶t̶h̶e̶ ̶a̶r̶g̶u̶m̶e̶n̶t̶ ̶m̶a̶d̶e̶ ̶a̶g̶a̶i̶n̶s̶t̶ ̶Y̶u̶d̶k̶o̶w̶s̶k̶y̶'̶s̶ ̶r̶e̶a̶s̶o̶n̶i̶n̶g̶:̶ (see my comment below on why the strikethrough)

Here's a summary of the original counter arguments that commenters have brought against Yudkowsky :

1 - Hillary is not necessary a better B player than Trump
2 - existing level B players might deluding themselves that they are making a good job at maintaining the status quo
3 - the local optima might be surrounded by a valley of worse equilibrium, but only if you care about the wellbeing of the whole world equally: if you care only for America's interest, then other equilibria might be more beneficial
4 - Trump was actually testing the waters with his moves, when elected he is going to revert to a saner, albeit different, policy
5 - he is weighting personal experience regarding level B too much, possibly such a level don't exists or its importance isn't too high
6 - Trump's move wasn't bad: Yudkwosky didn't take into account the support of other intellectuals in the same sphere
7 - the letter of those condemning Trump weren't motivated by real preoccupation with Trump declarations but by political enmity

I'll group the answers thusly:

  • the letter was real but it didn't matter: 4, 6, 7
  • Clinton is not a better B player: 1
  • level B isn't real: 2, 5
  • outside equilibria are worse only for others: 3

Thank you to everybody.
This was a very productive and high quality discussion, to me a strong proof that LessWrong is far from dead.

Comment author: Gram_Stone 14 November 2016 05:23:44PM *  2 points [-]

Upvoted. Thank you for hosting.

6 - Trump's move wasn't bad: Yudkwosky didn't take into account the support of other intellectuals in the same sphere

Both user:hg00 and I argued that Eliezer stopped searching for expert opinions in a motivated way, but I concluded that relying on expert opinion, which ultimately appears to indicate that Trump will probably have more negative effects on our foreign policy than Clinton, was correct anyway. The OP specifies that the purpose of the discussion is to evaluate methodology, and remains silent on the evaluation of conclusions. I request that the summary you've written be edited to reflect this. (Removing the phrase 'Trump's move wasn't bad' seems sufficient to me; maybe explicitly mention motivated cognition?)

I also tentatively suggest appending the summary to the OP once you expect that you won't have to edit it again.

Comment author: Gram_Stone 13 November 2016 08:30:29PM *  8 points [-]

The foreign policy issue is coming up a lot. Apparently some people are arguing that Hillary may have been just as dangerous but for different reasons. I don't think myself an expert, so I'm using the 'look at what experts think' heuristic, somewhat like Eliezer.

We all know about the open letter from Republican national security experts.

In a relatively highly upvoted comment, hg00 points out that Eliezer omitted a similar letter from 88 retired high-ranking military officers.

hg00 omits that Clinton received 95 endorsements from retired military leaders (later 110).

The Atlantic points out that Mitt Romney received 500 endorsements in 2012. So both lists of endorsements may be historically low.

An article in the Washington Post cites surveys conducted by the Teaching, Research, and International Policy (TRIP) Project implying that most international relations experts (IR) positively regard Clinton's ability to conduct international relations, and that expert opinions are considerably less polarized than public opinion on each candidate's ability to conduct international relations:

This survey, the ninth in a series of snap polls conducted by the Teaching, Research and International Policy (TRIP) Project, includes responses from 744 of the 4,078 IR scholars teaching and/or researching at colleges and universities throughout the United States.


Which candidate reflects the foreign policy views of IR scholars?

An overwhelming majority (82 percent) responded “Hillary Clinton” (see Figure 1, below). Just under 4 percent of the scholars surveyed said “Donald Trump,” while 14 percent chose to write in a third-party candidate, other national political figure, or some variation on “none of the above.”

We asked respondents to identify their own political leanings, and Figure 2 shows a similar preference order is apparent across the ideological spectrum. Clinton most closely reflects the foreign policy views of 90 and 84 percent of liberal and moderate respondents, respectively. Exactly half the conservative IR scholars in our poll prefer Clinton, while only 7 percent prefer Trump. Among no ideological subgroup does Trump come close to breaking out of third place.


IR scholars lean left, but this preference for Clinton over Trump likely reflects respondents’ expertise on foreign policy as much as their ideology. To illustrate this point, consider a recent Pew Research Center survey of the general public, which asks which candidate would do a better job on foreign policy. Among conservative members of the public, 54 percent prefer Trump to Clinton, but only 7 percent of conservative foreign policy experts prefer Trump. And while 23 percent of self-described moderate voters believe that Trump would be better on foreign policy, only 5 percent of moderate scholars agree.

[We] asked IR scholars how the election of Clinton or Trump would affect relations between the United States and its allies. Figure 3 shows that over 95 percent of scholars said Trump would have a negative effect on relations between the United States and NATO states, and 91 percent of scholars believe that the election of Donald Trump would cause NATO allies to doubt the U.S. commitment to the defense of Europe. By comparison, about 3 percent of scholars said Clinton would have a negative effect on relations between the United States and its NATO allies, and only 2 percent said her election would lead NATO allies to doubt the U.S. commitment.


Who will deal best with Russia?

On the campaign trail, Trump asked, “When you think about it, wouldn’t it be nice if we got along with Russia?” He has argued that the United States would be better off finding common ground with Russia and cooperating more effectively to defeat the Islamic State and negotiate a settlement in Ukraine.

IR scholars we surveyed are skeptical that Trump’s purported dealmaking skills would benefit the United States. Our respondents believe that any future deals between Russia and a Trump administration would be “less likely” to benefit the United States. Broadly speaking, scholars see the election of Hillary Clinton as a continuation of Obama’s foreign policy and thus expect “no effect” of a Clinton presidency (see Figure 4).

Willing to discuss this (maybe the surveys are less reliable than they appear?), but based on expert opinion, I believe that Clinton would have had better effects on our foreign policy. Given the outsized effects of the POTUS's foreign policy positions, I perceive Trump's election as an event with large negative expected value.

At the moment, I think EY could have looked into his objection a little more, and I also think it pans out in his favor anyway. For now at least.

Comment author: Manfred 21 October 2016 05:14:50AM *  1 point [-]

Bostrom published that in 2002? Wow!

With amnesia, in room A there is 1 observer-moment per moment over the total occupied time T => T observer moments, while in room B there are 1000 observer-moments per moment over some other time T' => 1000 T' observer moments.

If the people in room B stick around long enough that T=T', then there are more total observer moments in room B. If each person gets the same amount of time (as suggested in the comment two above), then T'=T/1,000,000 and are more observer moments in room A.

(For more rigor, we might think of "observer-moment" as a density function rather than discrete occurrences).

Comment author: Gram_Stone 21 October 2016 11:53:05AM 1 point [-]

Bostrom published that in 2002? Wow!

I always see you commenting on Stuart Armstrong's posts, so I actually just assumed you were alluding to that work in the great-great-grandparent. I wonder if I should start erring on the side of assuming that people do want pointers to the literature.

Comment author: philosophytorres 20 October 2016 07:58:05PM 1 point [-]

As for your first comment, imagine that everyone "wakes up" in a room with only the information provided and no prior memories. After 5 minutes, they're put back to sleep -- but before this occurs they're asked about which room they're in. (Does that make sense?)

Comment author: Gram_Stone 20 October 2016 10:45:55PM *  1 point [-]

I thought you might like to hear about some of the literature on this problem. Forgive me if you're already aware of this work and I've misunderstood you.

Manfred writes:

If people are memory-wiped at some interval, then this increases the probability I should assign to being in room B - probability of being in a specific room, given that your state of information is that you suddenly find yourself in a room, is proportional to the number of times "I have suddenly found myself in a room" is somebody's state of information.

In Anthropic Bias: Observation Selection Effects in Science and Philosophy, Nick Bostrom describes a thought experiment known as 'Mr. Amnesiac' to illustrate the desirability of a theory of observation selection effects that takes this kind of temporal uncertainty into account:

Mr. Amnesiac, the only observer ever to exist, is created in Room 1, where he stays for two hours. He is then transported into Room 2, where he spends one hour, whereupon he is terminated. His severe amnesia renders him incapable of retaining memories for any significant period of time. The details about the experimental situation he is in, however, are explained on posters in both rooms; so he is always aware of the relevant non-indexical features of his world.

Not unlike Manfred's arguments in favor of betting on room B under imperfect recall, Bostrom's solution here is to propose observer-moments, time intervals of observers' experiences of arbitrary length, and reason as though you are a randomly selected observer-moment from your reference class, as opposed to just a randomly selected observer (in philosophy, Strong Self-Sampling Assumption vs. Self-Sampling Assumption). With this assumption and imperfect recall, you would conclude in Mr. Amnesiac that the probability of your being in Room 1 = 2/3 and of being in Room 2 = 1/3, and that you should bet on Room 1.

But I don't think there's anything mysterious there. If I understand correctly, we are surreptitiously asking the room B people to bet 1000 more times per observer than the room A people. Yet again, the relevant consideration is "How many times is this experience occurring?"

Nitpick: If we do include imperfect recall, doesn't this actually just make us indifferent between room A and room B, as opposed to making us prefer room B? Room A people collectively possess 100 trillion observer-moments that belong to 100 trillion observers, room B people collectively possess 1000 observer-moments per observer times 100 billion observers = 100 trillion observer-moments that belong to 100 billion observers. Our credence should be 50/50 and we're indifferent between bets. Or am I confused?

Comment author: Gram_Stone 20 October 2016 12:22:21AM 2 points [-]

Here's a stab: If I understand you correctly, then every observer's experience is indistinguishable from every other's, so my credence in the proposition "I'm in room A" is 0.999 and my decision policy is "Bet that I'm in room A." If 100 trillion + 100 billion people choose room B, then 100 trillion will lose and 100 billion will win. If 100 trillion + 100 billion people choose room A, then 100 billion will lose and 100 trillion will win.

Comment author: Arielgenesis 01 October 2016 03:01:57AM *  0 points [-]

I just thought of this 'cute' question and not sure how to answer it.

The sample space of an empirical statement is True or False. Then, given an empirical statement, one would then assign a certain prior probability 0<p<1 to TRUE and one minus that to FALSE. One would not assign a p=1 or p=0 because it wouldn't allow believe updating.

For example: Santa Claus is real.

I suppose most people in LW will assign a very small p to that statement, but not zero. Now my question is, what is the prior probability value for the following statement:

Prior probability cannot be set to 1.

Comment author: Gram_Stone 01 October 2016 03:19:47AM *  2 points [-]

Actual numbers are never easy to come up with in situations like these, but some of the uncertainty is in whether or not priors of zero or one are bad, and some of it's in the logical consequences of Bayes' Theorem with priors of zero or one. The first component doesn't seem especially different from other kinds of moral uncertainty, and the second component doesn't seem especially different from other kinds of uncertainty about intuitively obvious mathematical facts, like that described in How to Convince Me That 2 + 2 = 3.

Comment author: Gram_Stone 01 October 2016 01:31:11AM 3 points [-]

I know it was slightly tangential, but the organ matchmaking software was really interesting to me. I doubt this is how the idea was conceived, but I think when you look at it in a particular way, it seems like a really elegant solution to an important coordination problem.

(Content note: organ trade.)

Currently, a big stumbling block with organ trade is that suppliers can only supply organs in an altruistic context because of moral intuitions about the respective sanctities of life and money; buying and selling organs is impure. This is really bad because it limits most donations to those from family members and those from people who donate their organs upon death. Family members aren't always compatible, and organs from cadavers don't last as long and are more likely to contain cancers. If you're incompatible with a family member or you want to splurge on the extra expected lifespan afforded by a non-cadaveric organ, you can't sell your organ and use the money to buy a compatible/non-cadaveric one from someone else. There seem to be a great many trades that don't take place because of solvable spatial and temporal constraints that would be avoided by the use of a medium of exchange like money. So, the legal organ trade is relatively inefficient in most countries.

The really cynical version of the problem that you're trying to solve, before you ever write the extremely important matchmaking algorithms that are easy to overlook from this point of view, is "How do I efficiently allocate organs without buying or selling them?" The current system of organ donation is practically a barter system, there must be a coincidence of wants between donor and recipient. So, one interpretation of what matchmaking software does is make pledges to donate organs into a medium of exchange when you can't use the normal medium of exchange for political reasons. When you make pledges to donate into a credible signal that you will in fact donate given the satisfaction of a certain set of easily verifiable conditions, you can use that signal in place of money to make more complex trades that you couldn't otherwise make with 'pure barter'.

Kind of useless armchair scholarship I guess, but I thought it was elegant.

(After cursory research I lean pro-legal organ trade (something more market-like than what exists today); willing to expand on this if anyone's interested in collecting a new contrarian opinion.)

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