How To Save A Life

Saturday, 27 September, 2014

How much does it cost to save a life? Many people don’t even like to think about such a question—after all, isn’t it crass and vulgar to put a dollar value on human life? I don’t think so. Indeed, I think it’s actually immoral not to ask this question. The argument goes something like this:

1) Saving a life is a significant moral good, and saving more lives is preferable to saving fewer lives.

2) Donating all our charitable contributions to the charity that saves lives for the lowest cost will lead to more lives being saved than any other action we could take.

3) Therefore, we should donate all our charitable contributions to the charity that saves lives for the lowest cost.

4) In order to do this, we need to know how much it costs different charities to save a life.

So, how much does it cost to have a life? The online charity evaluator GiveWell has done some excellent analysis of this question. The issue is stupendously complicated, but let me just pick a ballpark figure. Based on the GiveWell data, I’d say the best charities can save a life for roughly $2,000. Maybe there are other benefits to these programs besides just saving lives, or other costs not captured in these numbers. But for the sake of this argument, that’s not very important.

This ought to put a lot of things in perspective. When I’m considering whether to donate to an art gallery, or an environmental group, or cancer research, I must remember that every $2,000 I give is one less life saved. That’s my ‘opportunity cost’—what I’m giving up to make this donation. So I had better be pretty damn sure that the money I’m donating to this other cause is going to have a significant positive impact, if this is to outweigh the forgone benefit of one life saved.

There are a lot of objections to this argument. We could debate about the merits of attempting to deal with deeper structural or social problems, rather than donating exclusively to specific global health initiatives (which, according to GiveWell, turn out to be the most cost effective). We could question the value of saving present lives versus future lives, and how that might affect our analysis. We could argue that life itself is not all that matters, and that we also should consider the good being done in improving quality of life. All of these objections, and many others like them, are completely valid and are worthy of discussion and serious consideration.

However, such objections also largely miss the point. Why is that? Because whatever else we propose to use our money or resources for—whether it be environmental activism, political reform, human rights protection, art preservation, or whatever else—we must remember this fact: every $2,000 spent on such causes could have instead been used to save the life of one human being. In arguing that we ought to donate time or money to a particular cause, we must always remember that this represents time, money, and effort that could have been used to save lives by instead donating to the most cost-effective charities.

I’m not saying that no other causes besides those that save the most lives can ever be worthwhile. My point is simply that we have an ethical obligation to be aware of what we could be doing with our resources, and what we are giving up when we donate to charities other than the most cost-effective. Furthermore, if we really care about doing the most good, we ought to demand very good arguments and very strong evidence that alternate causes will lead to more good than can be done by saving a life for $2,000. In my view, charitable endeavours that can meet this challenge are few and far between.

But can’t we do both? Can’t we donate, say, to deworming as well as to cancer research, or Greenpeace, or whatever else? Alas, no, we can’t. At least, not in any meaningful sense. Billionaires aside, our funds and abilities are very limited compared to the capacities of the charitable organisations in question. This means that every dollar we don’t give to the most cost-effective charities is failing to have as much impact as it could. We can’t just pretend that the opportunity cost somehow magically disappears just because we have donated some money to the more effective charity. That alternative still exists for every single dollar we give away. I’m not saying that the ‘some other cause’ option is never the better choice, but I am calling attention to the fact that this is always the real alternative that we face.

My argument here does not extend only to our charitable donations. It also can (and I think ought to) be applied to every purchase decision we make. Here is the brute fact: every dollar we spend on anything is one less dollar that could have been donated to the most effective charities. Thus, every single purchase we make is a moral act. Every time we hand over money for anything, we are handing over some part of a chance to save a life. How much does a car cost? Several thousand dollars at least. That’s a few lives right there. How much does it cost to attend a music concert? A hundred dollars? Several of those in a year equates to maybe a fifth of a life. How much does a cup of coffee cost? A few dollars? How often would you buy one? Every other day? That’s some non-trivial fraction of a life. How much does an overseas holiday cost? Several thousand dollars? Another few lives. How much do we spend on jewellery? Alcohol? Eating out? Electronics? DVDs? How much do we spend in things that we do not need to get by? How many lives could we have saved, but did not?

Do I live up to my own standards here? I do try, but of course I only partly succeed. There are still numerous luxuries I allow myself that I don’t really need. But, however much of a hypocrite I may be, I don’t think this in any way diminishes our ethical obligation to do better. We simply must do better. Many, many lives depend on it.