Radical Moral Ideas: Cost-Effective Charities

This is the first of a series of posts I'm planning to write on moral ideas that would radically change our ethical priorities if we were to accept their premises. Each have a lot of extremely clever people convinced, although they tend to make an unconventional first impression.

How much do you care about other people?

Most people agree that killing is wrong. It doesn't seem to matter much whether this is by killing somebody in front of you with a gun, by deliberately failing to hit the brakes on your car, or by launching an inter-continental ballistic missile at their house. Somewhat more contentious is the division between active and passive killing. Is shooting somebody worse than deliberately failing to hit your brakes or failing to tell them that a particular item of food is lethally contaminated? To some degree, at the very least, all of this seems bad.

How much cost can a person be expected to bear to avoid killing? If your car's brakes are broken, and you must swerve your car into a ditch to avoid hitting a person, are you morally obligated to bear the cost of repairing your car? Peter Singer gives a powerful example that appears to decide the argument: if you must ruin your expensive shoes to rescue a child from a pond, you should surely do so.

If we accept these arguments then we've established that it is right to bear a cost of up to several hundred pounds in order to save the life of someone else. In fact, the most cost-effective charities can save lives for roughly this value¹. It seems imperative, therefore, to give much more money to these most cost effective charities.

A corollary of this is that you should not give money to less effective charities. Charities fighting cancer and helping the disabled have laudable aims, but their operating costs are high. Donations to them save fewer lives than donations to more cost-effective charities, thereby causing more people to die.

<sup>1. The NHS guidelines approve drugs that prolong lives2 at a cost of less than £20,000 annually.↩
2. Actually the relevant criterion is the quality adjusted life-year or QALY.↩</sup>