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My Left Kidney

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Re: My Left Kidney

#121

Post by TeMPOraL »

TheDong wrote: post #80
woodruffw wrote: post #64

I know a few people who have donated kidneys (both to friends and strangers), and I find it admirable (and supererogatory). At the same time, I think this post demonstrates a kind of selective unawareness that I’ve seen members of the EA community demonstrate. A significantly less charitable summary of Scott’s situation is “our prospective kidney donor is newly-married high-stress professional with a history of SSRI…

We have a long waiting list for recipients, and we don't have an excess of donors to be picky with. Why are you assuming Scott was not "able to see" the explanation you laid out, when in all likelyhood that thought has crossed his mind (he's thought about this far more than you, a commenter who speculated that in 5 minutes)? Perhaps he thought of it, and decided saying it would be even meaner to the hospital... which…

> Like, if they rejected him from bureaucratic incompetence as they tried to filter out people who can't consent to surgery? Fine, incompetence is bad, but fine.

I'd be even more charitable to them: it's not incompetency, but waste inherent in a bureaucratic process, which is a consequence of scale. Sure, it would be better if Scott was interviewed with someone dedicated and empowered, who could hear and verify the full story, understand the context. But there are only so many people able to do this and willing to accept responsibility for making a bad call - and healthcare system can't afford them anyway. The bureaucratic process focused on effectively minimizing false positives will introduce a lot of false negatives - but it's also much more streamlined and cheaper to run at scale. And sure, it sucks to be the one rejected by an effectively automated process[0], but it's better for everyone than not having any process at all.

--

[0] - I maintain that bureaucracy is software running on a distributed system made of meat instead of networked silicon. It has the same dumb failure modes because it's the same thing.

Re: My Left Kidney

#122

Post by abainbridge »

inglor_cz wrote: post #116
illys wrote: post #107

The author states: "the risk of dying from the screening exam was 1/660" And demonstrates with: "This involves a radiation dose of about 30 milli-Sieverts. The usual rule of thumb is that one extra Sievert = 5% higher risk of dying from cancer, so a 30 mS dose increases death risk about one part in 660." Sorry but there is a flaw here: calculation seems good but conclusion is completely wrong. Calculation: increased…

"the risk of dying from the screening exam was 1/660" For someone as smart as Scott Alexander, this is an astonishing mistake. If CTs were such death machines, we would have seen a worldwide epidemics of CT-related cancers. There is no way you can cover up such a strong signal, given that people are screened all the time. Edit: thanks for unleashing such an interesting debate. I guess the problem is in my perception.…

The paper he links to [1] broadly agrees with his statement, eg "An estimated 1 in 270 women who underwent a coronary angiography CT at age 40 will develop cancer from that CT (1 in 600 men), compared with an estimated 1 in 8,100 women who had routine head CT at the same age (1 in 11, 080 men)".

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635397/

Re: My Left Kidney

#123

Post by abainbridge »

abainbridge wrote: post #122
inglor_cz wrote: post #116

Earlier quoted context omitted.

"the risk of dying from the screening exam was 1/660" For someone as smart as Scott Alexander, this is an astonishing mistake. If CTs were such death machines, we would have seen a worldwide epidemics of CT-related cancers. There is no way you can cover up such a strong signal, given that people are screened all the time. Edit: thanks for unleashing such an interesting debate. I guess the problem is in my perception.…

The paper he links to [1] broadly agrees with his statement, eg "An estimated 1 in 270 women who underwent a coronary angiography CT at age 40 will develop cancer from that CT (1 in 600 men), compared with an estimated 1 in 8,100 women who had routine head CT at the same age (1 in 11, 080 men)". 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635397/

The thing I don't understand is that if the CT scan is more dangerous than having a kidney removed, then surely they'd take the kidney out to see if it was compatible with the recipient rather than give you such a dangerous scan.

Re: My Left Kidney

#124

Post by giraffe_lady »

charia wrote: post #55
ajkjk wrote: post #31

Earlier quoted context omitted.

Well... maybe they're both. Plus a kooky crypto-embezzlement cult. Probably depends on who you get. My skepticism to the EA movement is of the form: I can respect the underlying idea but I have very little faith in many of the actual people to do it. Also, EA sorta bakes in utilitarianism as a premise and (from my experiences in the ACX comment section) basically finds any non-utilitarian argument to be literally uni…

This is a quite uncharitable view of things. EA utilitiarians aren't spending their life on optimizing numbers, they're trying to use numbers to guide decisions on how to better impact life. People can follow a value systems and still understand that other value systems exist. The EA view of things is pretty simple to understand. Given the premise of limited resources, and a belief that all lives are worth the same,…

> The EA view of things is pretty simple to understand. Given the premise of limited resources, and a belief that all lives are worth the same, how can you best improve human livelihood?

Not quuiiite. Many other groups would accept that value, framed that way, maybe even a majority of people. What differentiates EA isn't their intention to improve livelihood, but their belief that it is possible to know how to do that.

And in fact other groups also have high confidence in their understanding of how to achieve this goal. It's not obvious to me that EA's approach to the constraints is more effective than the noble eightfold path or love your neighbor as yourself.

Re: My Left Kidney

#125

Post by nyssos »

rolisz wrote: post #60
raverbashing wrote: post #52

Earlier quoted context omitted.

True, fixed. But the groups have some overlap

Do they? Aren't EAs mostly doomers? I haven't followed the debate closely.

> Do they?

Not really, but they're both descended (in part) from the same early 2000s Bay Area counterculture-technoutopian-libertarian milieu.

Re: My Left Kidney

#126

Post by snarkconjecture »

pcthrowaway wrote: post #67

While I've appreciated some of the author's articles in the past, I think the numbers in this one miss the mark quite a bit. > the risk of dying from the screening exam was 1/660 > The usual rule of thumb is that one extra Sievert = 5% higher risk of dying from cancer, so a 30 mS dose increases death risk about one part in 660. Well not quite. First of all, this assumes that exposure events are additive over a lifeti…

No, multiplying the incidence by 1.05 is incorrect. The 5% figure is additive.

ICRP Publication 103 is pretty unambiguous; e.g. Table A.4.2 gives total figures of about 400-600 "cases per 10,000 persons per Sv".

Re: My Left Kidney

#127

Post by giraffe_lady »

sashank_1509 wrote: post #71
timmytokyo wrote: post #65

Earlier quoted context omitted.

A lot of EAs, including the author of this piece, are also really into IQ, eugenics and "human biodiversity" (aka race science). Consider that Scott Alexander (aka squid314) once expressed a desire to donate to "Project Prevention", a eugenics charity formulated to pay undesirables to sterilize themselves [1][2]. [1] https://en.wikipedia.org/wiki/Project_Prevention [2] https://web.archive.org/web/20131230050925/http:…

I don’t see anything wrong with the charity you mentioned. It certainly isn’t what normal people consider eugenics though technically that charity might meet its definition. If you are a crack addict, you shouldn’t be anywhere close to having children. You will ruin the child’s life first and foremost. Apart from that you will create an undue burden to society, neither of which is fair. First they should cure themsel…

That is what normal people consider eugenics.

Re: My Left Kidney

#128

Post by abainbridge »

snarkconjecture wrote: post #120
inglor_cz wrote: post #116

Earlier quoted context omitted.

"the risk of dying from the screening exam was 1/660" For someone as smart as Scott Alexander, this is an astonishing mistake. If CTs were such death machines, we would have seen a worldwide epidemics of CT-related cancers. There is no way you can cover up such a strong signal, given that people are screened all the time. Edit: thanks for unleashing such an interesting debate. I guess the problem is in my perception.…

It would be astonishing if it were a mistake. And yes, it's a detectable signal. "in a large population-based cohort it was found that up to 4% of brain cancers were caused by CT scan radiation" --somewhere on Wikipedia CT scans vary in dosage. Wiki gives ~10 Sv for an abdominal CT; I don't know where Scott got 30, but maybe the kidney screening is multiple scans or otherwise higher dose. Or he was wrong by a factor…

> I don't know where Scott got 30

The text where he says that is a clickable link! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635397/

Re: My Left Kidney

#129

Post by TeMPOraL »

snarkconjecture wrote: post #120
inglor_cz wrote: post #116

Earlier quoted context omitted.

"the risk of dying from the screening exam was 1/660" For someone as smart as Scott Alexander, this is an astonishing mistake. If CTs were such death machines, we would have seen a worldwide epidemics of CT-related cancers. There is no way you can cover up such a strong signal, given that people are screened all the time. Edit: thanks for unleashing such an interesting debate. I guess the problem is in my perception.…

It would be astonishing if it were a mistake. And yes, it's a detectable signal. "in a large population-based cohort it was found that up to 4% of brain cancers were caused by CT scan radiation" --somewhere on Wikipedia CT scans vary in dosage. Wiki gives ~10 Sv for an abdominal CT; I don't know where Scott got 30, but maybe the kidney screening is multiple scans or otherwise higher dose. Or he was wrong by a factor…

> I don't know where Scott got 30, but maybe the kidney screening is multiple scans or otherwise higher dose.

Scott called it "multiphase abdominal CT". Quick searching on-line suggests[0] that the "multiphase" here stands for doing 3-4 scans within a minute or two of each other, as the contrast agent diffuses through the organ, giving you multiple images that inform you about different parts of the target structure.

> Wiki gives ~10 Sv for an abdominal CT; (...) Or he was wrong by a factor of 3

If what I wrote above is correct, then it tracks - ~10 mSv for one CT, multiplied by 3-4 scans done in a multiphase CT, gives you ~30-40 mSv, which matches the number Scott posted.

--

[0] - https://www.barnardhealth.us/dynamic-contrast/multiphasic-im... - First link I found; CTRL+F "multiphase", as the relevant information is spread throughout the comments section.

Re: My Left Kidney

#130

Post by eru »

bradley13 wrote: post #115
illys wrote: post #107

The author states: "the risk of dying from the screening exam was 1/660" And demonstrates with: "This involves a radiation dose of about 30 milli-Sieverts. The usual rule of thumb is that one extra Sievert = 5% higher risk of dying from cancer, so a 30 mS dose increases death risk about one part in 660." Sorry but there is a flaw here: calculation seems good but conclusion is completely wrong. Calculation: increased…

You're not wrong, but he's probably farther off that that. Danger from radiation doesn't scale linearly, although (to be extra safe) standards are set as if it is. In fact, there is some evidence that small doses of radiation can even be beneficial (hormesis).

That discussion is already in the linked article.
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