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When Is Altruism Effective?

(The names of people in this post have been changed)

In a small room in a care centre in Changsha, China, a young girl is struggling to swallow her food. Jiajia has cerebral palsy, which has twisted her limbs and made it impossible for her to speak. Intellectually, she can understand language but finds it difficult to learn basic concepts. The woman who is patiently feeding Jiajia is a paid caregiver. It costs several thousand dollars a year to meet the costs associated with Jiajia’s care, and many times that to care for the other girls in the building where she lives.

None of them will ever be able to hold a job, contribute to society or live on their own. Jiajia’s caregiver, Mrs. Chen, loves the girls in her care, and during the pandemic chose to be locked down with them for weeks on end, separated from her family.

Not far away, a single mother is caring for a child who was born with multiple disabilities, including an intellectual disability. Her husband left the family and the child’s grandparents are unable to help out. Living on the fourth floor of a building with no elevator, the young mother struggles to care for her son and pay her bills. She could have abandoned the boy when he was a baby—it was common back then—but she chose not to. Now, she relies on support from an international charity.

The money to support these children comes from donors scattered around the world. Their compassion is prompted by the stories of struggle, hardship and perseverance that the non-governmental organizations (NGOs) send to them on a regular basis.

Are these donors wasting their money?

Perhaps they should direct their donations to organizations whose efforts are based on effective altruism. Effective altruism, simply put, aims to provide the most effective solutions to humanitarian situations, by undertaking projects that benefit the most people while providing quantifiable results. “Most effective” is generally assumed to mean “bang for the buck”: achieving the most impact cost-effectively.

Examples of this approach include widespread de-worming projects and the provision of malaria nets. Many thousands of people can be helped through the donation of just a few thousand dollars. 

So why spend that amount of money on Jiajia when the same amount could benefit many more children? Isn’t it more effective to direct your money where it can benefit the most people?

I believe this approach ignores the value of the individual and replaces it with a simplistic mentality that focuses on statistics and generalizations.

I have known people in the Philippines who went blind because they couldn’t afford the few dollars required to pay for the necessary medicine, and men who succumbed to tuberculosis for the same reason. These are individuals facing heart-rending challenges. They are not part of a grand calculation.

A study in 2015 calculated that the “best buys” in development aid could be expected to save a life for around $3,400. Viewed in this light, Jiajia is not a “best buy.”

There is no doubt that the provision of anti-malarial bed nets and deworming medicine are valuable programs. But when it comes to assessing the effectiveness of these programs, advocates of effective altruism often throw in concepts like future productivity—as if the mere fact that lives were being saved wasn’t quite enough, and some kind of economic or productivity metric was necessary to show how valid the programs are.

This approach demeans the essential value of what these programs are doing: they are saving lives. Additionally, it ignores the complex realities that most aid recipients confront daily. In most regions where these programs are in place, families face many more challenges than just mosquitos or worms: they face intractable problems like entrenched poverty, discrimination and broken governments. Those are problems that are not so easily solved by a simple program that dispenses a product or drills a well.

But that’s not part of the effective altruism sales pitch. When making recommendations on where donors should effectively allocate their donations, there is the ‘feel good’ factor that a donor is not only helping solve a crisis, but also being smart with their money. They can be satisfied that their donations were used where they were most effective, and therefore they have done the right/best thing with their money.

Then what happens to Jiajia when donors decide that helping her isn’t cost effective? Advocates of effective altruism must answer the question of what they would do if a family member or loved one was stricken with an incapacitating malady and they didn’t have the money to provide for them. What if they lived in a country with insufficient health care? This person has immense value to them, but under the dictates of effective altruism, asking donors to direct funds to their care doesn’t make sense.

Advocates of effective altruism like to say that their approach prioritizes the use of evidence and reason in search of the best ways of doing good.I suggest that donors should contribute to projects that have widespread, measurable impacts. That’s great. But they should also remember that Jiajia has value, and assisting her is true altruism. Those who prioritize statistics over individual lives—and call it “the best approach”— are disregarding this important reality.