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comment by Holly_Elmore · 2019-05-13T17:25:26.263Z · EA(p) · GW(p)
People who are doing direct work, if they expect three weeks of their work to produce more QALYs than donating.
It may be worth considering whether the enforced rest from donating a kidney would have some of the benefits of taking a vacation for you.

This could be turned into a searing satire of EA. "Earn a rest from the work that's too marginally impactful to pause for a few weeks by donating a kidney. To you, post-surgical recovery will seem like a vacation!"

comment by Milan_Griffes · 2019-05-13T14:45:30.879Z · EA(p) · GW(p)
... People who are doing direct work, if they expect three weeks of their work to produce more QALYs than donating.

I've heard a similar argument – good cause prioritization researchers are rare enough that the 3 in 10,000 risk of death during the operation is too high (risk of death high enough that people like this donating kidneys would be bad in expectation).

Curious what you think of that? Seems plausible, but could easily be motivated reasoning.

comment by Holly_Elmore · 2019-05-13T17:33:34.106Z · EA(p) · GW(p)

I'd like to propose another group that shouldn't donate: people with a pre-disposition to conditions that require treatment with medication that is hard on the kidneys.

I'm really glad I didn't try to donate my kidney a few years ago before I knew I would need to be taking a med (probably for the rest of my life) that can cause serious renal damage. In fact, kidney damage is a major reason people have to go off this drug and often they don't find an equivalent cocktail for dealing with the disease symptoms.

I imagine getting treated with any brutal medication is harder with one kidney. I hope this is something discussed with altruistic donors, but I never hear about it. I only hear about how you'd be higher up on the transplant list if you had kidney disease, and that that's an advantage because most kidney disease would have hit both kidneys (were they there) anyway. But that makes me imagine disease arising within the kidney or the body, not kidney damage due to treating other conditions.

comment by GMcGowan · 2019-05-13T16:42:09.829Z · EA(p) · GW(p)

Interesting angle that I hadn't considered before!

Presumably this reasoning would change the calculus for a lot of other actions one could take as well? E.g. various types of global development spending that pay off in the future (e.g. deworming) would become worse relative to spending that pays off soon (e.g. bednets).

Rather than a mere 14 QALYs, kidney donation produces hundreds if not thousands of expected QALYs.

I feel that this may be too strong a claim. In the very long run, I would expect the population to rise to whatever the carrying capacity was (or whatever level was agreed on by the AI or something). So saving a life now would be good (+~7 years) but not worth thousands of years of QALYs, as a new person might well have come into existence if the kidney donee had died.

In particular, this argument reminds me of discussions about cryonics possibly being an EA cause - e.g. Jeff Kaufman's essay on the subject here [LW(p) · GW(p)]. Excerpt of the most relevant part:

If you're a total hedonistic utilitarian, caring about there being as many good lives over all time as possible, deaths averted isn't the real metric. Instead the question is how many lives will there be and how good are they? In a future society with the technology to revive cryonics patients there would still be some kind of resource limits bounding the number of people living or being emulated. Their higher technology would probably allow them to have as many people alive as they chose, within those bounds. If they decided to revive people, this would probably come in place of using those resources to create additional people or run more copies of existing people.