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At the framework level

The basic framework you envision seems to have a certain fixed level of charitable resources (potential "sacrifice"), to be stewarded and spent in a utility-optimizing way over time. Once spent, these resources are gone. In this framework, asking "is the amount I would have to donate to the best charity to accomplish the same benefits as donating a kidney less than the price for which I would sell my kidney?" is a coherent and useful question, because you plan to offset your charitable contributions by that amount ... (read more)

2jefftk13y

This is potentially a critical flaw in my framework. I wasn't think about it this way, but training myself to be ok with giving more would be a very good thing. (Below I answer your questions about my framework as though I still follow it, because while your point is good enough that I may give it up, I haven't yet.) I had forgotten that. In this case, then, you're right that our respective valuations of saving the life of an under-5 year old and giving an adult with kidney failure another ten years are going to be different. (My natural draw is actually even stronger towards saving/protecting children than a DALY approach gets you, but I think this is instinctive and excessive.) The big problem is that my money can go so much farther in generating happiness and reducing suffering when spent on other people that it has the potential to make every money-related decision really hard. If every dollar I spent on myself came with the question "why aren't you giving this to people that need it more?" I would be a wreck. I want all decisions I make in my daily life to have only minor consequences. So I set an "I will donate exactly $X this year to the best organization(s) I can find" limit, and don't have to be constantly struggling with whether I should be giving more. [1] While this is phrased in terms of money, I convert all other potential utilitarian-virtuous actions into a dollar value so that I am not constantly being pressured to change my giving limit. Imagine I think fair trade chocolate is improves the world, but that it doesn't improve the world as much as the AMF. If I thought of my "chocolate buying decision" as totally separate from my "how much to donate decision" I might buy fair trade chocolate. But I also would believe that it would be better for me to buy the cheap chocolate, which I think tastes the same, and donate the savings to the AMF. Except my donation limit wouldn't allow that. So I set things up so that if I were to spend an extra $X to buy

Altruistic Kidney Donation

AlexanderB13y30

Not sure what to say about this. I don't talk about it much with strangers. My friends and family seemed to think that donating a kidney was a bigger deal than giving away or foregoing a lot of income; I don't really agree. Broadly, I think that donating a kidney has convinced people I have more "skin in the game" than just working for GiveWell has, and I can think of one or two cases where this has made them more likely to take my advice on charitable donations. I think that if I were more comfortable talking about organ donation, it would be po... (read more)

Altruistic Kidney Donation

AlexanderB13y20

Just to be clear, I think that in jkaufman's argument, the $400 is not the opportunity cost of undergoing surgery, but rather an estimate of the amount of money AMF would require to achieve comparable benefit as donating a kidney.

I agree that if you had to forego income during surgery or incur other costs, then it would be reasonable to add those onto the other side of the ledger as you propose. As I mentioned above, though, I think that's typically not the case; medical leave policies are often quite generous in these cases, and public funds are available for incurred costs.

Altruistic Kidney Donation

AlexanderB13y160

A couple disclosures right off the bat: I donated a kidney to a stranger last year and I work for GiveWell (but this post represents my views, not GiveWell's).

I think this is a really interesting and informative analysis (you might also be interested in David Barry's post along the same lines). However, I think these both miss a few important points:

Living kidney donation operations involve significant savings for the health system, on the order of $100,000 (coming from averting the need for dialysis, which is extremely costly) (Matas and Schnitzler 2003

... (read more)

0jefftk13y

I turned the specific question of whether my "sort potential actions by expected return and work our way down" approach is the right way to look at it into a top level discussion post.

4jefftk13y

Does this account for the costs of the transplant operation and followup costs such as anti-rejection drugs? While I agree that a donation to the health system is positive, I would expect it to have an effect mostly by decreasing how much we pay into it instead of health outcomes. I would be surprised if the benefit here was even 1:1000 compared to AMF. This applies on both sides of the question, though. There are also economic benefits of fewer people getting malaria. I don't know the relative magnitudes of these. Ok; I'm going to update the post with a 3x multiplier due to chains. Because I estimated DALYs just from an overall $/life-saved and an estimate at life expectancy then we the question here is whether I'm right to treat one life saved via a malarial net as four times more valuable than ten additional years via a kidney donation. We don't have to bring DALYs into it. (I do think DALYs are a pretty much the right thing to look at. As far as I can tell, I care about happiness and avoiding suffering, where two years of at joy-minus-suffering level X matter twice as much as one year at level X. For saving a newborn vs an adult there's the further issue that emotional attachments to the deceased of people who survive are probably much larger in the adult's case, causing a lot more pain at their death. But neither the AMF's nor kidney donation's benefit comes much from an effect on newborns, so that doesn't apply here.) That's unfortunate. I would really like it if GiveWell could give me $/life-saved that corrected for these issues and was as accurate enough to take literally. How far off do you think this number is? 2x? 100x? Isn't medical leave generally unpaid, especially for elective surgeries? If you miss two weeks of work and take home $50K/year then that's about $2K in missed pay. This is how I think we should think about it, yes. Well phrased. Yes. I would do this. Let's say I, as you seem to be suggesting, compartamentalize my giving. I might

0JGWeissman13y

If the opportunity cost of donating a kidney is $400, because of the opportunity costs of not being productive during the surgery and recovery, then you are effectively donating $400 in addition to your kidney to the cause of giving someone else a kidney. It seems reasonable that the $400 would come out of your charity budget, and you should consider if another charitable cause could use it more effectively.

3juliawise13y

Wow, thanks for writing that. What has been your experience of this tenor change?

LESSWRONG
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