5 ms·

Isn't saving lives part of the expected value? This is a genuine question. If you had the opportunity to save someone's life without any monetary reward, you wo

Isn't saving lives part of the expected value? This is a genuine question. If you had the opportunity to save someone's life without any monetary reward, you would do it, right? Because lives are very valuable. I'm having a hard time imagining knowing how to lead billions of people out of a pandemic and just...not doing it, I guess because it might limit some hypothetical future business opportunity. Not being facetious, I literally don't get it and assume I'm missing something.

JoshuaDavid 5y ago
> If you had the opportunity to save someone's life without any monetary reward, you would do it, right? There are some people who think like this[1], but this is very much not a mainstream consensus. At the margin, "lives" in the general sense (not "lives of people close to you" or "lives in your country") cost about $5,000 to save. A marginal cost of $5,000 to save someone's life does not say to me "society highly values all human lives". COVID vaccine distribution might well come in under that $5,000 / person mark -- looking at the data I see that neither Ethiopia nor Nigeria[2] has even received enough vaccine doses to vaccinate everyone over 65. So it seems plausible that fixing supply constraints could result in saving a few hundred thousand lives worldwide. As such, it might be worth it for some effective altruists to pitch in a couple of billion dollars to buy the rights from Moderna, if that would actually lead to a large enough supply increase to justify the expense. What I don't think makes sense is trying to change the legal landscape after the fact to obtain a bunch of vaccine doses off of Moderna's research without compensating them for it. When there's a pandemic, we want vaccines. Setting a precedent that you can't make money solving a pandemic would be a really, really bad idea. We want the opposite precedent, because we want lots of people trying the next time something like this happens -- as such, the options on the table should be "buy a bunch of doses" or "buy out the rights to make your own, and the consultants who have the domain knowledge to make it happen, at a price which makes the prior research worthwhile in expectation", rather than "try to avoid paying enough to make the research worthwhile in order to save a couple billion dollars when responding to a pandemic that cost tens of trillions". [1] https://www.givewell.org/ https://www.givewell.org/ [2] as far as I can tell, every other country that reports such things has received enough doses, though that doesn't necessarily mean they used those doses on the people at highest risk
JumpCrisscross 5y ago
> I'm having a hard time imagining knowing how to lead billions of people out of a pandemic and just...not doing it Once your experts are trained and hired, their lab built and years of precursor research funded, sure, the final step is easy. But several of those layers want to be paid. If they never go into medicine, or never go into vaccine research or never build the labs, you can be heartfelt all you want when the next pandemic hits, it won’t give you vaccines in a year.
- burkaman 5y ago
  I don't really understand, why would people stop going into medicine or starting research labs? How would Moderna releasing their process crash the entire field? I'm not making a general argument that all medical research should be publicly available forever (although...), I'm making a very specific argument that in this global emergency, the benefits massively outweigh the risks. "Should I save the world or should I protect my brand" is a joke, it's not even worth asking. I don't know if the polio analogy is overplayed at this point, but this is like polio. The vaccine needs to be freely available to the world. The absolute "worst case" is that Moderna faces increased competition in like 10 years and eventually goes out of business and its employees go work for different labs in different companies.
  - JumpCrisscross 5y ago
    > in this global emergency, the benefits massively outweigh the risks There is more than enough money to buy doses for everyone in the world at sticker price. This isn’t a debate about whether lives get saved, but about who pays for it.
MillenialMan 5y ago
Bluntly: no. Lives saved is probably not a significant component in the cost/benefit analysis when these companies are deciding how much they should invest in an avenue of research.
- burkaman 5y ago
  I understand that's not how they decide what to research, but I'm asking today, this second, why are they not factoring lives into the question "should I tell the world how to make my vaccine". I don't even know how to phrase this without sounding absurd. It's like a superhero letting the villain blow up a stadium because if the city is too safe then they might get bored and not be around when the next villain shows up in 20 years.
  - mhb 5y ago
    Do you know Peter Singer's parable of the shallow pond? Why is what you are puzzled about any different than asking yourself why you haven't donated everything you have right now to save lives in undeveloped parts of the world?
    - burkaman 5y ago
      Because of the magnitude and rarity of the problem, the proven effectiveness of their solution, and the ease of releasing it. I am not arguing that every second of every person's life should be devoted to maximum lifesaving utility. I do donate a lot of my income, but I save a lot for myself because I'm a normal self-interested person. I'm not asking anyone at Moderna to make some enormous sacrifice, I'm asking them to maybe risk some potential future business opportunities. Relative to the problem I don't even consider it a sacrifice at all. In my mind it's like an off-duty firefighter standing next to someone unconscious in a burning building and being able to easily drag them to safety, but deciding not to because it might give them back problems in a few years. It's an emergency, they know how to fix it and can do so easily, and the sacrifice is minimal compared to the danger.
      - 5y ago
bialpio 5y ago
What's more, in some cases you are required by law to at least try to save a life. For example, in some jurisdictions you are required to bring first aid to a victim of a car crash (assuming you won't endanger yourself in the process), failure to do so can result in jail time.
- bialpio 5y ago
  Concrete example is Polish Penal Code, article 162. Up to 3 years of jail time for failure to bring aid - there's a bunch of quantifiers that reduce the liability, but that's the gist of it.
creato 5y ago
> Not being facetious, I literally don't get it and assume I'm missing something. Moderna existed for 10 years and burned through billion(s?) of dollars before they earned any significant revenue. It doesn't matter how much I or anyone else want to save a life, I don't have 10 years and billions of dollars to spend attempting it.
- burkaman 5y ago
  I'm not asking Moderna to commit to 10 years of research, I'm asking them to release the thing they have in their possession this very moment, and accept the risk that they might face increased competition in 5 or 10 years as a result. This is a unique global emergency, I'm not saying everything they ever develop should be immediately in the public domain. Also, billions of those dollars were US government grants.

JoshuaDavid 5y ago

> If you had the opportunity to save someone's life without any monetary reward, you would do it, right? There are some people who think like this[1], but this is very much not a mainstream consensus. At the margin, "lives" in the general sense (not "lives of people close to you" or "lives in your country") cost about $5,000 to save. A marginal cost of $5,000 to save someone's life does not say to me "society highly values all human lives". COVID vaccine distribution might well come in under that $5,000 / person mark -- looking at the data I see that neither Ethiopia nor Nigeria[2] has even received enough vaccine doses to vaccinate everyone over 65. So it seems plausible that fixing supply constraints could result in saving a few hundred thousand lives worldwide. As such, it might be worth it for some effective altruists to pitch in a couple of billion dollars to buy the rights from Moderna, if that would actually lead to a large enough supply increase to justify the expense. What I don't think makes sense is trying to change the legal landscape after the fact to obtain a bunch of vaccine doses off of Moderna's research without compensating them for it. When there's a pandemic, we want vaccines. Setting a precedent that you can't make money solving a pandemic would be a really, really bad idea. We want the opposite precedent, because we want lots of people trying the next time something like this happens -- as such, the options on the table should be "buy a bunch of doses" or "buy out the rights to make your own, and the consultants who have the domain knowledge to make it happen, at a price which makes the prior research worthwhile in expectation", rather than "try to avoid paying enough to make the research worthwhile in order to save a couple billion dollars when responding to a pandemic that cost tens of trillions". [1] https://www.givewell.org/ https://www.givewell.org/ [2] as far as I can tell, every other country that reports such things has received enough doses, though that doesn't necessarily mean they used those doses on the people at highest risk

JumpCrisscross 5y ago

> I'm having a hard time imagining knowing how to lead billions of people out of a pandemic and just...not doing it Once your experts are trained and hired, their lab built and years of precursor research funded, sure, the final step is easy. But several of those layers want to be paid. If they never go into medicine, or never go into vaccine research or never build the labs, you can be heartfelt all you want when the next pandemic hits, it won’t give you vaccines in a year.

burkaman 5y ago
I don't really understand, why would people stop going into medicine or starting research labs? How would Moderna releasing their process crash the entire field? I'm not making a general argument that all medical research should be publicly available forever (although...), I'm making a very specific argument that in this global emergency, the benefits massively outweigh the risks. "Should I save the world or should I protect my brand" is a joke, it's not even worth asking. I don't know if the polio analogy is overplayed at this point, but this is like polio. The vaccine needs to be freely available to the world. The absolute "worst case" is that Moderna faces increased competition in like 10 years and eventually goes out of business and its employees go work for different labs in different companies.
- JumpCrisscross 5y ago
  > in this global emergency, the benefits massively outweigh the risks There is more than enough money to buy doses for everyone in the world at sticker price. This isn’t a debate about whether lives get saved, but about who pays for it.

MillenialMan 5y ago

Bluntly: no. Lives saved is probably not a significant component in the cost/benefit analysis when these companies are deciding how much they should invest in an avenue of research.

burkaman 5y ago
I understand that's not how they decide what to research, but I'm asking today, this second, why are they not factoring lives into the question "should I tell the world how to make my vaccine". I don't even know how to phrase this without sounding absurd. It's like a superhero letting the villain blow up a stadium because if the city is too safe then they might get bored and not be around when the next villain shows up in 20 years.
- mhb 5y ago
  Do you know Peter Singer's parable of the shallow pond? Why is what you are puzzled about any different than asking yourself why you haven't donated everything you have right now to save lives in undeveloped parts of the world?
  - burkaman 5y ago
    Because of the magnitude and rarity of the problem, the proven effectiveness of their solution, and the ease of releasing it. I am not arguing that every second of every person's life should be devoted to maximum lifesaving utility. I do donate a lot of my income, but I save a lot for myself because I'm a normal self-interested person. I'm not asking anyone at Moderna to make some enormous sacrifice, I'm asking them to maybe risk some potential future business opportunities. Relative to the problem I don't even consider it a sacrifice at all. In my mind it's like an off-duty firefighter standing next to someone unconscious in a burning building and being able to easily drag them to safety, but deciding not to because it might give them back problems in a few years. It's an emergency, they know how to fix it and can do so easily, and the sacrifice is minimal compared to the danger.
    - 5y ago

bialpio 5y ago

What's more, in some cases you are required by law to at least try to save a life. For example, in some jurisdictions you are required to bring first aid to a victim of a car crash (assuming you won't endanger yourself in the process), failure to do so can result in jail time.

bialpio 5y ago
Concrete example is Polish Penal Code, article 162. Up to 3 years of jail time for failure to bring aid - there's a bunch of quantifiers that reduce the liability, but that's the gist of it.

creato 5y ago

> Not being facetious, I literally don't get it and assume I'm missing something. Moderna existed for 10 years and burned through billion(s?) of dollars before they earned any significant revenue. It doesn't matter how much I or anyone else want to save a life, I don't have 10 years and billions of dollars to spend attempting it.

burkaman 5y ago
I'm not asking Moderna to commit to 10 years of research, I'm asking them to release the thing they have in their possession this very moment, and accept the risk that they might face increased competition in 5 or 10 years as a result. This is a unique global emergency, I'm not saying everything they ever develop should be immediately in the public domain. Also, billions of those dollars were US government grants.