There’s offering a trade, and there’s extortion. Sometimes people are honestly uncertain or mistaken about which one is happening, or correctly believe that something described as the former is in fact the latter.
So at first I felt good about understanding, say, why legal kidney sales might be bad. Then I noticed that despite having a visceral sense of one dimension of the costs, I had not in fact become (much) less confused about what counts as extortion and how to handle intuitions about sacredness in the real world.
Another example of sacred value, very similar in felt-sense-of-intuition (I think?) is the “Hospital has the opportunity to purchase a replacement heart for a child who will die without one. How much should they be willing to spend on the heart?” This produces outrage responses of “they should pay whatever it takes?”
But in this case, paying for the heart is clearly coming at the expense of other hospital equipment or staff that could have been purchased that also could have saved lives.
I think the outrage here is similar to what many people instinctively feel about letting people sell kidneys. But in the hospital case it seems pretty unequivocably good to put a price on a life.
Some tentative thoughts/brainstorm:
It might be that the felt senses of outrage are in fact different, if you focus on them. (I suspect they are slightly different, but not optimistic that this can reliably inform you about which ones are good)
It (I assume) is the case that if you’re sufficiently well informed about the world, you can make the correct consequentialist calls about what to do, but this is computationally difficult.
In the case of the selling kidneys… the world where rent extraction leaves poor people in the same state but with less kidneys seems bad, but also, does leave the world with a bunch of fewer dead people, which isn’t nothing
Actually, there’s a probably an upper limit on how many sick people need kidneys. I assume that there are many fewer people that need kidneys than there are poor people, which might mean this particular trade is unlikely to result in increased rents (since it’s not a reliable enough increase for metaphorical landlords to increase it)
I should mention that I’m not at all sure that in the particular case of kidneys, permitting sale would be bad. What I am fairly confident of is that most people who are sure it’s obviously good haven’t actually considered some important factors. (I suspect that this is also true of most of those who are sure it’s obviously bad, but I don’t think that’s news here.)
Some relevant considerations on the examples being considered:
The Hospital budget example
The hospital’s budget is a socially determined fact, not a pure material constraint, and it’s an iterated game with a chicken component. By taking the budget as a given, the administrator is allying with the budget-setters who want the hospital to do constrained optimization within the given budget, and not pushing against the constraint by expanding the hospital’s mission. (Cf the Obama administration’s decision not to modify the government’s burn rate after Congress refused to raise the debt ceiling, even as this brought a default steadily closer, because accepting the optimization constraint would ipso facto grant the other side a victory. This is a pretty normal thing in budget & other legislative fights. More generally, refusing to understand tradeoffs is an effective way not to have to make them.)
I expect people will feel less outrage at the decision that acknowledges “tradeoffs” in the following modified scenarios:
A desert island scenario where a fixed budget corresponds directly to a fixed pool of resources, and resource allocation doesn’t affect budget size.
An “uneconomic” expense that seems very good but doesn’t fit people’s sense of what a hospital ought to be doing.
The kidney example
There’s also a reasonable heuristic that people who profit from an inequity are disproportionately likely to be complicit in perpetuating it. Complicity level can take intermediate values between 0 and 1. Even if right now the people excited about buying kidneys aren’t excited about causing poverty, and there’s no one with a current financial interest in lowballing the costs of donating, we can reasonably expect this to change if kidney sales become legal.
The likely bad outcomes would be things like someone getting scammed into giving a kidney when it’s not as good a deal as they’d been led to believe, and the money doesn’t adequately compensate them for the ensuing health problems. I don’t see why I’d expect to find out about whether that sort of thing’s happening in Iran.
The hospital example is an excellent illustration of my confusion at separating trades from other decisions. There IS a price on that life. That’s in the territory, it costs X to pay for the heart. No amount of outrage changes that, and considering it sacred only prevents making rational decisions about it.
So at first I felt good about understanding, say, why legal kidney sales might be bad. Then I noticed that despite having a visceral sense of one dimension of the costs, I had not in fact become (much) less confused about what counts as extortion and how to handle intuitions about sacredness in the real world.
Another example of sacred value, very similar in felt-sense-of-intuition (I think?) is the “Hospital has the opportunity to purchase a replacement heart for a child who will die without one. How much should they be willing to spend on the heart?” This produces outrage responses of “they should pay whatever it takes?”
But in this case, paying for the heart is clearly coming at the expense of other hospital equipment or staff that could have been purchased that also could have saved lives.
I think the outrage here is similar to what many people instinctively feel about letting people sell kidneys. But in the hospital case it seems pretty unequivocably good to put a price on a life.
Some tentative thoughts/brainstorm:
It might be that the felt senses of outrage are in fact different, if you focus on them. (I suspect they are slightly different, but not optimistic that this can reliably inform you about which ones are good)
It (I assume) is the case that if you’re sufficiently well informed about the world, you can make the correct consequentialist calls about what to do, but this is computationally difficult.
In the case of the selling kidneys… the world where rent extraction leaves poor people in the same state but with less kidneys seems bad, but also, does leave the world with a bunch of fewer dead people, which isn’t nothing
Actually, there’s a probably an upper limit on how many sick people need kidneys. I assume that there are many fewer people that need kidneys than there are poor people, which might mean this particular trade is unlikely to result in increased rents (since it’s not a reliable enough increase for metaphorical landlords to increase it)
Avoiding getting confused about the price of a life vs value of a life might help a lot.
I should mention that I’m not at all sure that in the particular case of kidneys, permitting sale would be bad. What I am fairly confident of is that most people who are sure it’s obviously good haven’t actually considered some important factors. (I suspect that this is also true of most of those who are sure it’s obviously bad, but I don’t think that’s news here.)
Some relevant considerations on the examples being considered:
The Hospital budget example
The hospital’s budget is a socially determined fact, not a pure material constraint, and it’s an iterated game with a chicken component. By taking the budget as a given, the administrator is allying with the budget-setters who want the hospital to do constrained optimization within the given budget, and not pushing against the constraint by expanding the hospital’s mission. (Cf the Obama administration’s decision not to modify the government’s burn rate after Congress refused to raise the debt ceiling, even as this brought a default steadily closer, because accepting the optimization constraint would ipso facto grant the other side a victory. This is a pretty normal thing in budget & other legislative fights. More generally, refusing to understand tradeoffs is an effective way not to have to make them.)
I expect people will feel less outrage at the decision that acknowledges “tradeoffs” in the following modified scenarios:
A desert island scenario where a fixed budget corresponds directly to a fixed pool of resources, and resource allocation doesn’t affect budget size.
An “uneconomic” expense that seems very good but doesn’t fit people’s sense of what a hospital ought to be doing.
The kidney example
There’s also a reasonable heuristic that people who profit from an inequity are disproportionately likely to be complicit in perpetuating it. Complicity level can take intermediate values between 0 and 1. Even if right now the people excited about buying kidneys aren’t excited about causing poverty, and there’s no one with a current financial interest in lowballing the costs of donating, we can reasonably expect this to change if kidney sales become legal.
Selling kidneys is legal in Iran. I haven’t heard of any disaster that happened as a result...
The likely bad outcomes would be things like someone getting scammed into giving a kidney when it’s not as good a deal as they’d been led to believe, and the money doesn’t adequately compensate them for the ensuing health problems. I don’t see why I’d expect to find out about whether that sort of thing’s happening in Iran.
The hospital example is an excellent illustration of my confusion at separating trades from other decisions. There IS a price on that life. That’s in the territory, it costs X to pay for the heart. No amount of outrage changes that, and considering it sacred only prevents making rational decisions about it.