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My Left Kidney

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Re: My Left Kidney

#241

Post by caturopath »

woodruffw wrote: post #82
OfSanguineFire wrote: post #78

Earlier quoted context omitted.

What’s the "community/cult" here? I’m apparently missing context.

Effective altruism, which is both a general (and not especially objectionable) variant of act utilitarianism, and also a specific community that has (fairly, to my eye) been accused of diverting money towards a particular set of reactionary worldviews held by its leadership.

EA isn't a form of act utilitarianism. Though EA certainly has a consequentialist flavor, it isn't the case that all (or even most?) EAs endorse utilitarianism (utilitarians aren't the only ones who care about scale). For example, Holden Karnofsky is explicitly non-utilitarian and Will MacAskill advocates making decisions based on considering (fundamentally, not just for optics) non-utilitarian ethical systems, though he is more utilitarian than someone like Karnofsky.

Re: My Left Kidney

#242

Post by allturtles »

I dunno, I feel like this whole article just makes it clear how fundamentally flawed the idea of calculating your way to good (in both the moral and the practical sense) decisions is. It's clear from the article that even the first-order effects of a kidney donation decision are incalculable: no one really knows the exact risk accrued from the CT scan, or the surgery, or the upside to the recipient. It doesn't seem OP included the direct costs of the transplant itself at all (all those tests and scans and screening interviews, the travel and lost time from work, and then the cost of the two surgeries). Then one could go on and on with calculating higher-order effects forever. ("I'm married to someone who gives $500K a year of their income to EA causes, but if I die in surgery there's a 5% chance they will commit suicide out of grief, denying XYZ dollars in future income to the cause...")

Indeed, OP tries to present a bunch of arithmetic to justify their decision, but admits that it ultimately rested on an emotional gut feeling: "It starts with wanting, just once, do a good thing that will make people like you more instead of less."

Re: My Left Kidney

#243

Post by eutropia »

makeworld wrote: post #233
mort96 wrote: post #117

This was an enjoyable read. The solution of giving people money to donate their kidneys is terrifying to me however. I do not like the thought of desperate people selling their internal organs to survive one bit. Of course, if inequality was dealt with and nobody was desperately poor, it would be a different question. If everyone had enough money to comfortably get by, and the extra $100,000 from a kidney donation wo…

The post mentioned a tax credit though. In theory the poorest people would benefit the least from this. But there could still be issues as you increase your income, I agree.

The modify NOTA people call for it to be a tax credit ($10k/yr for 10yr) or a check(also 100k split up over 10 years) from the federal government if you do not make enough money to pay federal taxes.

Re: My Left Kidney

#244

Post by germyj »

Aurornis wrote: post #50

> Obviously this kind of thing is why everyone hates effective altruists. People got so mad at some British EAs who used donor money to “buy a castle”. This feels like a spin on how this all went down. A lot of the anger about that group utilizing funds to, literally, buy a castle came from EA groups too. Trying to downplay the situation and pretend that the anger was only coming from uninformed outsiders feels like…

>Really feels like a subtle signal that if you don’t toe the line on every EA organization decision, you must be an outsider.

Bingo. I like Scott's writing in general, I've interacted with him a few times, and EA criticism is one of three or so topics where disagreement gets you the outsider treatment.

He's slightly more amenable if you can provide an example that would've been "more effective," but "this was a bad decision"-type critiques will default to "the bigwigs are smarter than you."

Re: My Left Kidney

#245

Post by Spooky23 »

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…

Abdominal stuff often involves CT scans that need to be done in phases. For brain stuff, some things require CT vs MRI.

Another risk is the contrast dye that’s often used in these studies. If you’re dealing with cancer monitoring or something that requires monitoring, you can develop allergies and poor reactions to that as well.

Re: My Left Kidney

#246

Post by Suzuran »

Waterluvian wrote: post #229
Suzuran wrote: post #221

Earlier quoted context omitted.

They only remove them if they have some kind of immediate risk of damage to the body - Necrosis or similar. On top of that, while your original kidneys won't have enough function to sustain life, any function they do have will take some burden off of the transplant kidney(s).

It makes complete sense once I think about it. My mental framing is too often based on technology. Ie. there’s two kidney slots that you can populate with one kidney each.

If it helps, you can think of all medicine as reverse-engineering and hacking a machine the vendor has ceased supporting and won't provide documentation for.

Re: My Left Kidney

#247

Post by scythe »

snarkconjecture wrote: post #118
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 did it wrong. One Sv increases your absolute risk of fatal cancer by an added 5% or so. It doesn't multiply it by 1.05. Quoting Wikipedia: "According to the International Commission on Radiological Protection (ICRP), one sievert results in a 5.5% probability of eventually developing fatal cancer based on the disputed linear no-threshold model of ionizing radiation exposure." Also, where on earth did you get 1% as…

The real logical problem with his approach is not the relative risk. It's not the linear no threshold model.

It's the use of effective whole body dose to estimate the risk associated with a dose to part of the body. Exactly zero radiation biology organizations recommend this. Most explicitly caution against using effective whole body dose to estimate radiation risk. Effective whole body dose is only used for population-level estimates.

For example, one of the most radiosensitive (wrt cancer) organs is the thyroid. But his thyroid is not in the beam. Also the skin is exposed more than the interior on CT, which increases the risk of skin cancer. These corrections are standard, while alternatives to LNTM are not standard.

Then there is the effect of age. Most radiation related cancers are delayed by a long time, and the faster that cells are dividing, the greater the risk of DNA damage. But Scott is old, which is also why older workers were preferred for cleanup at Fukushima.

D_eff can get you within an order of magnitude I suppose, but you shouldn't express it with two significant figures — it's misleading precision. You could say 1/1000 or maybe 1/700? But you really need more detail for any kind of meaningful medical decision.

Anyway, that's my rant as someone studying for the board exam.

Re: My Left Kidney

#248

Post by enragedcacti »

Aurornis wrote: post #54
BobaFloutist wrote: post #8

I respect the British organizers’ willingness to sacrifice their reputation on the altar of doing what was actually good instead of just good-looking. Surely their reputation is a factor in their ability to do good? Optics sometimes necessitate sacrificing the "mathematically superior choice" for one that's worse in the name of not pissing off a ton of people the support of whom you rely upon.

The way this post leaves no room for debate about how the decision was good and paints all of the people who disagree as ignorant outsiders feels very disingenuous. There was a lot of criticism coming from inside the EA community, too. It became taboo to criticize it with multiple EA figureheads (author of this article included) making definitive statements that any critics were wrong and the decision was unequivocal…

> The way this post leaves no room for debate about how the decision was good and paints all of the people who disagree as ignorant outsiders feels very disingenuous.

Agreed, I went to look for these thinkpieces to see what the arguments were since the guy with footnotes longer than some articles didn't cite any. Searching Google News for '"effective altruism" ( "castle" OR "Wytham" OR "£15m" )' netted 10 total results:

  - Three articles about a DIFFERENT castle in the Czech Republic also bought by effective altruists (What's the marginal utility of castles?)
  - One article about EVF (formerly CEA) claiming FTX funds weren't used to by Wytham Abby
  - A smattering of anti-EA of anti-SBF pieces that make single line references to the castle
Even just googling for the same you get one New Yorker article that makes offhand mention, then mostly forum threads and a couple blogs that are debating (pretty fairly imo) about whether it was an effective use of money.

I'm sure I could have missed some pieces but this looks like the classic and all too common "got mad about some random hyper-niche tweets but can't admit it"

Re: My Left Kidney

#249

Post by Crimson_Wool »

giraffe_lady wrote: post #145
nyssos wrote: post #138

Earlier quoted context omitted.

> 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. Ok, but that's not the competing option here. However good being a bodhisattva is, being a bodhisattva and saving someone from kidney failure is even better. And most people, of course, aren't going to become bodhisattvas at all: we're only choosing between being ordinary f…

Do all EAs donate kidneys? Or even at higher rates than other groups? Everyone thinks their religion makes them better at being good. EAs might be uniquely positioned to demonstrate it statistically, if it's true.

The number of people who altruistically donate kidneys per year in the USA is like 1-200, so the fact that Scott knows multiple EAs who did so (and that the kidney donor people are used to EAs) is pretty high-tier evidence that either there are a LOT more EAs than I thought, or they do it MUCH higher rates than the general population.

Re: My Left Kidney

#250

Post by timmytokyo »

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…

If you don't see anything wrong with a charity whose founder compares people to dogs and calls their children "litters", then I doubt there's anything I could say to make you disapprove of it.
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