Valuing lives instrumentally leads to uncomfortable conclusions

It's indisputable that some lives are more instrumentally valuable (to save) than others.  So if you hold that all lives are equally intrinsically valuable, it follows that some lives are all-things-considered more valuable to save than others (due to having the same intrinsic value, but more instrumental value).

To avoid that "uncomfortable"-sounding conclusion, you would need to reject the second premise (that all lives are equally intrinsically valuable).  That is, you would have to claim that some lives are intrinsically more valuable than others.  And that is surely a much more uncomfortable conclusion!

I think we should conclude from this that there's actually nothing remotely morally objectionably about saying that some lives are more valuable to save for purely instrumental reasons.  The thing to avoid is to claim that some lives are intrinsically more important.  It "sounds bad" to say "some lives are more valuable to save than others" because it sounds like you're claiming that some lives are inherently more valuable than others.  So it's important to explicitly cancel the implicature by adding the "for purely instrumental reasons" clause.

But once clarified, it's a perfectly innocuous claim.  Anyone who still thinks it sounds bad at that point needs to think more clearly.

It seems a little strange to call this a repugnant conclusion, given that this priority has been shared by the vast majority of people both historically and today. As far as I can see, almost no-one thinks that we should be completely indifferent between which person we save. I don't think really anyone believes it is equally important to save e.g. a terminally ill pedophile as it is to save a happy and healthy doctor who has many freind's and helps many people.

One point on instrumentally valuing life is that this is essentially what happens under triage. I think a large portion of the reason we can value equality is because right now, our societies are stable and prosperous, and hopefully won't have a crisis. But if we do and the crisis is an GCR or X-risk, then certain people really are more valuable.

I think the reverse could be argued as well, that is, a rich person's life costs the rest of society and the globe more in terms of resources and suffering, and the rich are more likely to spend their time in idle diversions, therefore, saving a life of someone in a developing country is more valuable than saving a life of someone in an industrialized country. Either way you argue, though, you miss another perspective.

Another perspective is, and a plausible comparison would be, how much people value their own lives. By that standard, people in each country, rich or poor, value their own lives equally as far as I know. Accordingly, since their interest in saving their own lives is equal, the moral value of serving each's interests is equal as well.

Deciding who to save is always an uncomfortable decision because it positions us in front of someone who will die because of our choice. But not taking the decision at all is even worse because then both will die. Therefore, we have triage systems that help us to take the decision consistently to our moral principles.

Whenever we can increase the number of QALYs using the same resources the decision is simple. Whenever we can get the same amount of QALYs with less resources the decision is also simple. Things get complicated when the ratio QALY/$ is the same. I don’t know what the next criteria are to be used then. To me it also seems very problematic to use the economic position of the affected persons. One could argue that the better positioned person will (potentially) get more welfare and therefore choosing her/him to maximize the absolute welfare, but one could alternatively argue that the person who will (potentially) do the most efficient transformation of our common resources into personal welfare is the right choice. I develop the example in the rest of the reply, without taking a stance on which choice is best.

[Update: I edited this reply to include the introduction above this line, as it provides more context]

What is the cost of saving a life? In my view the resources to be counted are the sum of:

1. Resources needed to save the life in a given point of time
2. Resources needed to keep the person alive with the expected level of welfare during the rest of her/his life

Even in a hypothetic scenario where saving a life (1) of a rich person costs the same as saving the life of a poor person, we would still have to consider how much resources will the rich person consume (2) compared to the poor.

The life of the average person in Luxembourg takes 15 times more resources than the life of the average person in Gambia [1], therefore the life expectancy should be almost 15 times longer in order to generate a similar level of welfare per resources used. But it is not.

Taking finite resources such as fossil fuels or easily accessible minerals will reduce the resources available for future beings’ welfare, so we as humanity should make an effective use of them to generate effectively welfare and HQALYs. In this respect, an alternative uncomfortable conclusion seems to favor increasing the number of lives with a low ecological footprint compared to the number of lives with higher impact.

Whether somebody is aligned with this alternative uncomfortable conclusion will depend heavily on how she/he sees the availability of resources. Let’s take these two extremes:

1. If you believe we will soon overcome our planet limits and face significant difficulties as described by Corentin Biteau in “The great energy descent (short version) - An important thing EA might have missed”
2. If you believe we still have a lot of room for growth and human ingenuity will find ways to make more people richer before overshooting Earth’s ecosystems’ capacity, and this is very positive for welfare creation as described in “Growth and the case against randomista development” by Hauke Hillebrandt and John G. Halstead

In case of (A - planet limits coming soon) then the uncomfortable conclusion is that it is way much better to let the richest people die instead of the poor one in your uncomfortable example. A less uncomfortable conclusion would be to heavily limit their capacity to exhaust resources and impact ecosystems by setting limits on personal ecological footprint and/or huge taxes, but in case someone needs to die the choice seems evident.

In case of (B - room for positive growth) then the smart thing to do might be to open the borders completely. As it is described in the post “Global economic inequality” the life expectancy and many other welfare factors depend almost completely on where are you from. If we could for example increase 15 years the life expectancy of 100 million of sub-Saharan Africans by letting them come into Europe this would mean 1.500 millions HQALYs generated within a generation time. If we don’t think it is possible to extend the European way of life to so many additional people, then (B) is not completely true and we should go back to (A) and reduce the consumption per capita of the rich people to let more room for the poor people to develop their welfare.

“C1: A person in a poor country whose life is saved experiences less welfare than a person in a rich country whose life is saved”

(Asking a dumb question here, but,) is this true? Ie, does an increase in material wealth actually increase psychological wellbeing?

I have an intuition that psychological well-being is mostly affected by how wealthy you are compared to your peer group.

Maybe you’re talking about individuals poor countries who are below the poverty line (in which case, I agree that they would experience much less psychology wellbeing).

But I would be surprised if individuals in rich countries are actually happier than individuals in poor countries (who have all their basic needs met).