Effective altruism focuses on efficiency. Any action that fails to effect the maximum possible benefit is considered suboptimal. But isn’t this standard for use of one’s time and money too harsh? As long as one is making some sort of positive impact on the world, isn’t that enough? Can’t one live ethically without devoting all of one’s energy and attention to helping others?
Here’s a relevant scenario:
Imagine a military doctor who comes across a battlefield laden with hundreds of injured soldiers in severe pain. The doctor calls for assistance, but the additional medical units will not arrive for thirty minutes. However, the doctor happens to have with him a bag of pain medicine that he can use to palliate the suffering around him. Would it be acceptable for him to treat five of the soldiers and then stop to read a comic book, arguing that he has produced some positive change in aggregated welfare and he needn’t spend all of his effort helping others? Similarly, would we countenance his decision to spend most of his limited supply of pain killer on the mildly injured patients nearest to him, even though many of those a bit farther away are in absolute agony? I believe that the answers ought to be ‘no’. Rather, triage - giving greatest medical attention to those who can be helped most in the least amount of time - represents the ethical imperative under these circumstances.
Yet how are other situations any different? In choosing how to spend one’s time, what to do with one’s money, what to pursue in one’s career, and how to devote one’s life, we are making the same choice as the doctor wondering whether to treat suffering patients or read a comic book; the only difference is that the consequences of the latter option are not so immediate and tangible. Similarly, decisions as to which efforts to pursue and which actions to undertake are tantamount to the choice that the doctor faces regarding which patients to treat. Those who say, ‘I realize that this undertaking will not relieve as much suffering as possible, but at least I’m doing something,’ are in effectively the same position as the doctor who treats only those mildly injured patients nearest to him, because he is ‘at least doing something’.
But isn’t this focus on efficiency cold-hearted? Doesn’t strict triage neglect the pain of those who don’t get preferential treatment? As an illustration of this objection, I recall one scene from And the Band Played On - a film about the first years of medical encounter with HIV - in which one character scoffed at a legitimate concern about a large pecuniary expenditure, saying that it was insensitive to care about money when lives were at stake.
In the real world, though, we can’t do everything. Resources are limited, and we inevitably face choices between helping one being or another. Triage is not an act of harshness; it represents the highest form of mercy and compassion.
‘On triage’ is an edited version of an essay originally posted on Brian Tomasik’s website, Essays on Reducing Suffering.
Comments
I agree with you wholeheartedly, Brian. I think that the most ethical thing to do is help as much as you can.
I’d like to add a nuance to the idea though. What matters most is somebody’s “willpower heart rate”. I liken it to a school where gym class isn’t judged in terms of absolute performance, but in terms of heart rate. If somebody’s naturally awful at jogging, but has a heart rate of 80% her maximum capacity during her run, she’s trying her darndest and is given an A.
The explicit reasoning of how this applies to being an effective altruist is as follows:
Premise 1: To choose to help 100 suffering strangers over 1 suffering friend can be emotionally challenging. It can also be hard to compel yourself to give away large portions of your income. Essentially, it takes willpower to be an effective altruist.
Premise 2: Research has found that willpower is like a muscle. It gets stronger with exercise, gets tired, and is limited (1).
Conclusion 1: If people have a certain maximum willpower ability, and if their “willpower heart rate” is at maximum capacity for helping people, saying they should give more is asking the impossible. It’s like asking Gandhi to bench press as much as Arnold Schwarzenegger. Instead, people should be placed on the ethical spectrum based on how high their willpower heart rate is relative to their max, not their absolute willpower ability.
Conclusion 2: to increase our ability to be altruistic, we can increase our willpower strength
(1) Summary of findings on our “willpower muscle” http://psycnet.apa.org/journals/bul/126/2/247/
Further reading: A book on the science of willpower and how to increase it: The Willpower Instinct by Kelly McGonigal
Thanks, Xio! What a great reply. I agree with everything you said.
This means that a person in such a position does active harm if they do not fulfill their assigned duties, compared to not entering the position in the first place, because they were counted on by others.
A private individual may argue that there already are professional positions, institutions and resources officially devoted to solving certain altruistic problems. For instance, it may be politically assumed that alleviating poverty is a government’s responsibility, and while private donations are certainly paiseworthy, they have the indirect effect of reducing pressure on bad governments who should have fulfilled their role effectively instead.
Of course, altruists who find themselves in a world in which there is suffering for which no one has officially taken responsibility (e.g. wild animals), or institutions and officials not doing their job properly, will still feel a responsibility to compensate for that. But in some such cases the most effective altruistic action may be to create or publicly insist on the responsibility of relevant professionals and institutions rather than engage in - potentially psychologically unsustainable - patterns of self-sacrifice.
This means that a person in such a position does active harm if they do not fulfill their assigned duties, compared to not entering the position in the first place, because they were counted on by others.
A private individual may argue that there already are professional positions, institutions and resources officially devoted to solving certain altruistic problems. For instance, it may be politically assumed that alleviating poverty is a government’s responsibility, and while private donations are certainly paiseworthy, they have the indirect effect of reducing pressure on bad governments who should have fulfilled their role effectively instead.
Of course, altruists who find themselves in a world in which there is suffering for which no one has officially taken responsibility (e.g. wild animals), or institutions and officials not doing their job properly, will still feel a responsibility to compensate for that. But in some such cases the most effective altruistic action may be to create or publicly insist on the responsibility of relevant professionals and institutions rather than engage in - potentially psychologically unsustainable - patterns of self-sacrifice.
Sorry, a part of my comment was cut off. The first paragraph referred to the position of the military doctor, who was specifically assigned the function, leading to other people not being assigned that same function. Neglecting the duty to which they have committed not only harms patiens by inaction, but also by unexpected inaction that could have been compensated by others if they had expected it.
I completely agree, Hedonic Treader. Creating official responsibilities where none yet exist (e.g., for wild animals) is possibly the most sustainable long-term social and psychological mechanism to ensure that someone takes action.
There’s a quote: “Justice, not charity.” While “justice” isn’t exactly the word I would use because it doesn’t always align with reducing suffering, I do like the general sentiment expressed.
I published a German translation of this blog post: www.giordano-bruno-stiftung.ch/blog/triage-entscheidungsokonomie-im-alltag/
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