I grew up in a Christian church that put a huge emphasis on social justice, on Christ’s message being one of radical empathy and selflessness. One passage that always stuck with me was Luke 3:11: “Whoever has two coats must share with anyone who has none.” Well, I had two working kidneys. There were people with none. What to do next felt pretty clear.
Dylan Matthews, “Why I gave my kidney to a stranger – and why you should consider doing it too“
1. Series introduction
When I began this blog, I listed ten things that I like about effective altruism. This was not an idle exercise. I spent three years of my life working for, and with effective altruists. I continue to count many effective altruists among my friends and have substantial respect for many others.
I cannot say that I agree with effective altruists in all things. But it is important to acknowledge some things that effective altruists get right, even when many others do not. The purpose of this series is to highlight some things that effective altruists get right.
2. Post introduction
Over the past few years, effective altruism has been haunted by allegations of grift and inefficient spending. From expensive property purchases to outright fraud and grift, the story told by many media outlets is one in which effective altruism is not, in fact, an altruistic movement.
Certainly there have been too many grifters. But there have also been a number of impressively altruistic individuals associated with the effective altruism movement. Indeed, many of the movement’s leaders are significantly more altruistic than I am.
Whatever our disagreements, altruism is to be celebrated. This post reviews some ways in which many effective altruists have preached altruism and put their money, their safety, and even their organs where their mouths are.
3. Organ donation
One of the great tragedies of modern medicine is the scarcity of vital organs needed to prevent suffering and death in transplant patients.
Some scarcities make sense: we only have one heart. Others make less sense: our kidneys, while valuable, come in pairs. It is a great sacrifice to donate a kidney, though the sacrifice is dwarfed by the benefits to recipients.
I don’t always agree with Scott Alexander, but on one point we do agree.
Between 25-50% of Americans say they would donate a kidney to a stranger in need … yet only 200 people (0.0001%) donate kidneys to strangers per year.
This is a puzzling gap, and one that altruists should aim to close.
Scott Alexander donated his kidney to a total stranger. So did Alex Berger, the CEO of Open Philanthropy. So did Dylan Matthews, who also wrote about the experience for Vox.
Many other effective altruists have donated their kidneys and described the experience on the EA Forum. These include Rich Armitage, Tom Ash, Elizabeth Klugh, and Nicole Janeway.
Some do more. For example, Tom Ash co-founded Waitlist Zero, a nonprofit aimed at supporting kidney donors.
Some decide between alternatives, such as kidney donation and partial liver donation. Others do both. Still others donate other vital biological materials such as bone marrow.
Despite acknowledging the strength of the moral case for kidney donation, I am unlikely to donate a kidney. So, I suspect, are most critics of effective altruism. And so, I suspect, are many readers of this blog. I think it is worth taking a moment to be impressed by this gap in altruistic commitments.
Others have been similarly struck. For example, Scott Alexander reports this conversation with a doctor during his donation experience:
The doctors asked “so what made you want to donate?” And I hadn’t rehearsed an answer to this one, so I blurted out “Have you heard of effective altruism?” I expected the worst. But the usual response was “Oh! Those people! Great, no further explanation needed.” When everyone else abandoned us, the organ banks still thought of us as those nice people who were always giving them free kidneys.
Kidney donations rightly increase the reputation of effective altruists as committed altruists.
4. Challenge trials
The COVID-19 pandemic was one of the most devastating in modern history. It is estimated to have caused at least ten million deaths and caused trillions if not tens of trillions of dollars in economic damages, together with immense losses in education and mental health, a slowdown in extreme poverty reduction, and damaging effects across many other sectors.
One of the most frustrating features of the COVID-19 pandemic is that working vaccines were produced in a timeline of weeks or months but took years to deploy. In the interim, they were delayed by long and costly medical trials.
Some of that delay reflects a valuable emphasis on rigorously testing vaccines to ensure that they are safe. But some of that delay reflects an unfortunate fact about the types of tests that can be done. The most rigorous, effective and rapid tests would be randomized control trials in which participants are deliberately infected with COVID-19 in order to monitor the progress of the disease in a clinical setting.
These human challenge trials are legally restricted in many jurisdictions, and even when they are not, many people are not willing to sign up for them.
There are, to be fair, some good reasons for caution about challenge trials. The history of medicine is replete with trials in which participants, often from disadvantaged backgrounds, were coerced, lied to or misled into accepting dangerous study conditions that left them dead or severely injured. No advocate of challenge trials should want to introduce anything that could lead to such conditions being repeated.
At the same time, responsibly conducted challenge trials with willing and informed volunteers were one of the best tools available for accelerating the development of COVID-19 vaccines. During the height of the COVID-19 pandemic, effective altruists played a leading role in advocating for challenge trials. They have repeatedly and publicly argued for challenge trials, and been involved with organizations such as 1DaySooner that aim to bring these trials to fruition.
Effective altruists did not merely advocate for challenge trials. They also volunteered for them, willingly accepting infection with a number of potentially deadly illnesses to accelerate progress towards a cure.
Effective altruists have voluntarily been infected with maladies including COVID-19, dysentery, hepatitis C, malaria, and Zika virus. Some even went on to donate their participation fees to effective charities.
This is a great and commendable risk that will save lives down the road.
5. Giving pledges
Toby Ord and Will MacAskill are the cofounders of the effective altruism movement. Given their influence and the large number of high-level appointments that they hold, both could be fabulously wealthy. Instead, both have pledged to give everything above the British median income (currently between $40-50k USD) to charity. As Ord puts it:
I calculate that the money I give away can save between 2,000 and 10,000 lives (taking into account the total cost of medication, delivery, and administration). Compared with this, the benefit that I would get from spending the money on myself is clearly quite insignificant. Indeed, there are strong arguments that by donating to the most cost-effective charities, your money goes more than 10,000 times as far as if you spend it on yourself.
Ord and MacAskill are not alone in this. Julia Wise of the Community Health Team donates half of her income to charity. Allan Saldanha, profiled by The Guardian, donates three-quarters of his income. The leaders of many effective altruist organizations, including the Center for Effective Altruism, Open Philanthropy, Giving What We Can, 80,000 Hours, and Rethink Priorities have all pledged to give at least 10% of their earnings to charity.
They are not alone in this. Toby Ord founded Giving What We Can, an organization which encourages individuals to pledge 10% of their income towards charitable causes. To date, they have moved hundreds of millions of dollars in donations and secured billions of dollars in pledged funds. Despite the influx of billionaire donors, a number of effective altruists continue to save and donate extensively to charitable causes. Some even take voluntary salary reductions to work for effective altruist organizations with minimum impact on the organizations’ operating budget.
6. Conclusion
This post looked at several ways in which many effective altruists are remarkably altruistic. We saw that effective altruists have actively campaigned for and engaged in organ donation during their own lifetimes. They have done the same with challenge trials, even those for deadly diseases with no known cures. And we saw that many effective altruists have donated at least 10% of their incomes to charity, or in many cases substantially more than this. All of these behaviors are prevalent among leaders of many of the best-known effective altruist organizations, including the movement’s founders.
None of this is meant to excuse grift or excessive spending. But it is important to tell a balanced story which situates recent incidents against a background of profound, often unthinkable altruism. Many effective altruists are significantly more altruistic than I am, and than many of their critics are. This is a good thing, and it should be celebrated.
Leave a Reply