QALYs are empirically known to be oversimplified and more a theoretical economists tool to derive general optimization potential that a precise tool.
The four theoretical assumptions underlying QALYs are invalid (quality of life should be measured in consistent intervals; life years and QOL should be independent; people should be neutral about risk; and willingness to sacrifice life years should be constant over time).
They are neither recommended for individual health care decisions where they
place[s] disproportionate importance on physical pain or disability over mental health. The effects of a patient’s health on the quality of life of others [..] do not figure into these calculations.
nor on the population as an aggregate where
the weight assigned to a particular condition can vary greatly, depending on the population being surveyed.
Also if you want to use it as a tool to personally rate some means you should consider that
those who do not suffer from the affliction in question will, on average, overestimate the detrimental effect on quality of life, compared to those who are afflicted.
So I propose that you choose a more elaborate tool set if you want to optimize a complex goal. Otherwise you fall into the same trap as you wat to avoid from UFAI: Overoptimizing oversimple goals.
I wanted a concrete discussion about how a total utilitarian (TU) should act, not one about what exactly their utility function should be. I think total QALYs are at least a better approxmiation of a TU social welfare function than other simple social welfare functions (life expectancy, GDP per capita, education, reported happiness, etc.), since they are all average measures. For all of these except happiness, you can construct a “total” version:
Life expectancy becomes total years lived,
GDP per capita becomes total GDP, and
Average education level becomes total years of education.
If you don’t like how ambiguous QALYs are, you can use total years lived (QALYs without the quality adjustment) or total GDP as social welfare functions (although total GDP seems suspect because a TU might prefer two people living on, say, $10000 a year to one person living on $50000). The total number of adult years lived would also be a reasonable metric.
Basically, since the implied social welfare functions of most donors and charities seem very far from any reasonable TU social welfare function, even fairly oversimplified metrics can be much better than the status quo from a TU’s perspective. In general, an effective altruist with unusual values has to worry less about oversimplifying, since even a crude social welfare function can be (from their perspective) much better than what people currently do.
I wanted a concrete discussion about how a total utilitarian (TU) should act,
Maybe you should have more clearly said so. And mentioned the less satisfactory measures too.
How do you handle the ‘mere addition paradox’ (Parfit)? Do you
assert that higher utility living is on a completely different scale from, and thus incomparable to, the bottom levels of utility, or
deny that there is anything wrong with the ‘repugnant conclusion’?
(quoting Wikipedia)
It seems to be the latter.
I personally again think that it is not simple addition. Adding a life directly affects all the other lifes around it. This will never be a simple addition (except if you make it so like in Brave New World where new lifes arise in ‘bottles’). Same if you ‘subtract’ below average lifes. Also watch out for the szenarios which from a total utilitarian perspective look good too: wire heading and other psycho engineering which just change your valuation of the state (‘happy slaves’).
I’m not entirely sure whether you
propose QALYs as a means to optimize a total utilitarians goals or
discuss what you as a total utilitarian could do best to optimize this goal or
something else related to both
I assume the former because you wrote
In general if you choose any oversimplified scheme to optimize for you will not earn what you want. What gets measured gets optimized.
The following quotes are from Wikipedia: http://en.wikipedia.org/wiki/Quality-adjusted_life_year
QALYs are empirically known to be oversimplified and more a theoretical economists tool to derive general optimization potential that a precise tool.
They are neither recommended for individual health care decisions where they
nor on the population as an aggregate where
Also if you want to use it as a tool to personally rate some means you should consider that
So I propose that you choose a more elaborate tool set if you want to optimize a complex goal. Otherwise you fall into the same trap as you wat to avoid from UFAI: Overoptimizing oversimple goals.
I wanted a concrete discussion about how a total utilitarian (TU) should act, not one about what exactly their utility function should be. I think total QALYs are at least a better approxmiation of a TU social welfare function than other simple social welfare functions (life expectancy, GDP per capita, education, reported happiness, etc.), since they are all average measures. For all of these except happiness, you can construct a “total” version:
Life expectancy becomes total years lived,
GDP per capita becomes total GDP, and
Average education level becomes total years of education.
If you don’t like how ambiguous QALYs are, you can use total years lived (QALYs without the quality adjustment) or total GDP as social welfare functions (although total GDP seems suspect because a TU might prefer two people living on, say, $10000 a year to one person living on $50000). The total number of adult years lived would also be a reasonable metric.
Basically, since the implied social welfare functions of most donors and charities seem very far from any reasonable TU social welfare function, even fairly oversimplified metrics can be much better than the status quo from a TU’s perspective. In general, an effective altruist with unusual values has to worry less about oversimplifying, since even a crude social welfare function can be (from their perspective) much better than what people currently do.
Maybe you should have more clearly said so. And mentioned the less satisfactory measures too.
How do you handle the ‘mere addition paradox’ (Parfit)? Do you
assert that higher utility living is on a completely different scale from, and thus incomparable to, the bottom levels of utility, or
deny that there is anything wrong with the ‘repugnant conclusion’?
(quoting Wikipedia)
It seems to be the latter.
I personally again think that it is not simple addition. Adding a life directly affects all the other lifes around it. This will never be a simple addition (except if you make it so like in Brave New World where new lifes arise in ‘bottles’). Same if you ‘subtract’ below average lifes. Also watch out for the szenarios which from a total utilitarian perspective look good too: wire heading and other psycho engineering which just change your valuation of the state (‘happy slaves’).