Meaning, medicine, and merit

Andreas Mogensen (Global Priorities Institute, Oxford University)

GPI Working Paper No. 3-2019, published in Utilitas

Given the inevitability of scarcity, should public institutions ration healthcare resources so as to prioritize those who contribute more to society? Intuitively, we may feel that this would be somehow inegalitarian. I argue that the egalitarian objection to prioritizing treatment on the basis of patients’ usefulness to others is best thought of as semiotic: i.e. as having to do with what this practice would mean, convey, or express about a person’s standing. I explore the implications of this conclusion when taken in conjunction with the observation that semiotic objections are generally flimsy, failing to identify anything wrong with a practice as such and having limited capacity to generalize beyond particular contexts.

Other working papers

Is Existential Risk Mitigation Uniquely Cost-Effective? Not in Standard Population Models – Gustav Alexandrie (Global Priorities Institute, University of Oxford) and Maya Eden (Brandeis University)

What socially beneficial causes should philanthropists prioritize if they give equal ethical weight to the welfare of current and future generations? Many have argued that, because human extinction would result in a permanent loss of all future generations, extinction risk mitigation should be the top priority given this impartial stance. Using standard models of population dynamics, we challenge this conclusion. We first introduce a theoretical framework for quantifying undiscounted cost-effectiveness over…

Estimating long-term treatment effects without long-term outcome data – David Rhys Bernard (Rethink Priorities), Jojo Lee and Victor Yaneng Wang (Global Priorities Institute, University of Oxford)

The surrogate index method allows policymakers to estimate long-run treatment effects before long-run outcomes are observable. We meta-analyse this approach over nine long-run RCTs in development economics, comparing surrogate estimates to estimates from actual long-run RCT outcomes. We introduce the M-lasso algorithm for constructing the surrogate approach’s first-stage predictive model and compare its performance with other surrogate estimation methods. …

Should longtermists recommend hastening extinction rather than delaying it? – Richard Pettigrew (University of Bristol)

Longtermism is the view that the most urgent global priorities, and those to which we should devote the largest portion of our current resources, are those that focus on ensuring a long future for humanity, and perhaps sentient or intelligent life more generally, and improving the quality of those lives in that long future. The central argument for this conclusion is that, given a fixed amount of are source that we are able to devote to global priorities, the longtermist’s favoured interventions have…