Artificial organs: “good guys” finish last to technology

It is hardly a keen insight to note that there are a lot of problems in the world today, and that there are also lots of suggested solutions. Often these can be classified under three different labels:

  • “Good guy” solutions which rely on changing individual people’s attitudes and behaviours.
  • Institutional solutions which rely on designing good institutions to address the problem.
  • Technological solutions which count on technology to resolve the problem.

In this view, it is tremendously good news that scientists are getting closer to producing artificial organs. If this goal is achieved, it will be a technological solution to the problem of transplant organ shortages – and technological solutions tend to be better than institutional solutions, which are generally much better than “good guy” solutions. The “good guy” solution to organ donation was to count on people to volunteer to donate when they died. Better institutions (such as an opt-out system where you have to make a special effort not to be a donor, rather than a special effort to be a donor) have resulted in much improved donation rates. But cheap artificial organs would really be the ultimate solution.

Of course I don’t denigrate the use of getting people on your side, nor the motivations of those who sincerely want to change things. But changes to people’s attitudes only tend to stick around as long term solutions if this is translated into actual institutional or technological changes.

Take slavery, for instance. Thomas Clarkson and William Wilberforce certainly changed many minds with their campaigns, but this in itself didn’t end slavery. They marshalled their efforts into targeting the most powerful institution around, the British parliament. It slowly came over to their side, banned slavery, and eventually sent its massive fleet to enforce the slave-trade ban. Some have argued that technological change – the shift away from agricultural to urban workforces – played a role, but this was incidental: the technology was not designed specifically to reduce slavery, this was simply a fortunate by-product.

The catalytic converter is an example of a problem that has come full circle. First, it was realised that cars emitted poisonous gases – carbon monoxide, unburnt hydrocarbons and oxides of nitrogen. Efforts to get people to volunteer to drive less, if these were even attempted, were certainly doomed to failure. Then an institution, the EPA, got in on the act, mandating and enforcing cleaner cars. This created a market for the catalytic converter, which essentially solved that problem (though this lead to other issues).

Similarly, pious individual actions to reduce CO2 emissions have achieved little. The European Union’s trading scheme, beset by difficulties as it has been, seems to have at least halted the growth of EU carbon emissions, if not reversed the trend. However, there is no doubt that if someone was to event a cheap and effective CO2 scrubber that could remove carbon from the atmosphere on a global scale, this would solve global warming at a stroke.

This points to the great weakness of the technological solution: the tech just may not be there at all. Welfare and care for the poor used to be in the hands of churches and private donors. The situation was very much improved (from the point of view of the welfare recipients) when this shifted to state-run programs. Of course, the ideal would be a technological solution involving… well, we’re not really sure. What would a poverty-solving tech look like?

Even capitalism has followed that cycle to a certain extent. Early efforts were in getting merchants to behave better, to burnish their reputations for probity or out of moral goodness. But capitalism really took off when states institutionalised the market economies and the regulations that backed them up. And now, with companies like Ebay around, we may be on the verge of a technological solution to the age old problem of whether you can trade in safety. Or maybe we aren’t – no one knows what Ebay would look like if there were no institutional infrastructure behind it.

Yes, technology often has side effects, can entrench elites, and hoping for a technological solution may just be wishful thinking, distracting us from solving the problems here and now. But, for all that, when you hear that a new technology has been developed, it is likely a cause for minor celebration: it is possible that a long-intractable problem may be on the verge of being solved.

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5 Responses to Artificial organs: “good guys” finish last to technology

  • Dave Frame says:

    Nice post, Stuart. There are lots of interesting issues in this space, but I think two of the main ones are (1) the cheap Samaritan** thing; (2) social mandates.

    On (1), in a world of multiple ethical and policy objectives, limited resources and open questions about just how much worthiness we’re obliged to undertake, it makes sense to be a cheap Samaritan, ie to act for the good of others “where the benefit to the receiver is substantial and the cost to the altruist low.”** You could argue – I think Toby Ord, Will Crouch etc do argue*** – that we actually have an obligation, on efficiency grounds to be as cheap a Samaritan as possible. [Maybe a little unfair… maybe they’d prefer “efficient Samaritan”.] But I think that’s actually how progress gets made.

    Technology changes the relative prices of things, and that sometimes lowers the costs of doing the right thing. Sometimes it gets low enough that some evil can be stopped: look at the patterns of railway networks and free (ie waged, ie non-slave, non-serf) labour in both Europe and North America in the 19th Century. Where you get lots of trains, you don’t get slaves, to a pretty good approximation. There’s a chicken and egg aspect to the causality, of course, since labour costs and technology are presumably reinforcing each other, but the point is that among other things, improvements in technology can help people move away from morally horible, but hitherto ubiquitous, “peculiar institutions”. Prior to the industrial age, pretty much any large empire had to obtain its kilowatt hours by coercion (I think I’m right if I assert that in pre-industrial socieities most tax was, in effect, levied via labour..?).

    In our age, we extract our kWhr unsustainably from the ground, which is huge progress, but still not where we ultimately want to be. I have every hope that our next moves towards where we want to be (cheap and sustainable energy) will follow the same broad pattern of development – technology and self-interest combining to reduce the costs of moving away from reliance on fossil fuels. On the other hand, I have very little faith that William Wilberforce and co would have got anywhere without the invisible but invaluable aid of James Watt & co. And that’s one of my issues with the “change behaviour” crowd in climate change. Unless they can get their hobby horse into the arena where the costs to the altruist are low, they’re always going to be trumped by other moral issues in the real world since action in those other areas does more good than does action on the low carbon front.

    On (2) I think cheap Samaritan arguments play well in democracies, since people (a) like to do good and (b) dislike burdens. Stuart’s distinctions are relevant here: technology gets adopted if there’s a market, which turns on private behaviour – people buy into a technology if they see benefits, but the choice is basically theirs. Institutional reform can happen or not, but people get some say in it and a chance to publicly negotiate over the nature and distributions of burdens (at least in our sorts of society). But private “behaviour change” lacks an obvious mandate and usually lacks the wiggle room that social negotiation over institutional reform provides. People can get into something (vegetarianism, low carbon whatever, morality crusades) or not. But you can’t force people to become vegetarian or low carbon, and you can’t tell them how to think or feel, either. If anything, I think those sorts of pious initiatives actually breed a fair bit of reaction, since no one likes being morally hectored. And I think this is one reason for technology’s success – it tends to sail with the tailwind of public support, just because it provides new ways to be cheap Samaritans, which is the only sort most of us ever aspire to be.

    *The wonderful phrase comes from Charles Kindleberger, International Public Goods without International Government, The American Economic Review, Vol. 76, No. 1 (Mar., 1986), pp. 1-13. Most of the article is about other stuff, and his use of the phrase is somewhat throwaway – he also uses “minimal altruist” which i find too prescriptive, since I think “cheap” provides a lot more wiggle room/felxibility than “minimal”.
    **Kindleberger, p3.
    ***eg, from “As individuals, we are not able to help everyone in need and so we must make difficult decisions about where we use our resources. One way of making such a decision might be to favour people who live locally, as we may be especially well placed to attend to their needs. However, any advantage this may bring is dwarfed by the relative expense of helping people in developed countries compared to those in developing countries.” This clearly makes the case that the cost-effectiveness of charity/giving is (for them) a primary determinant of its goodness.

  • Anders Sandberg says:

    Great post and comment, thanks Stuart and Dave!

    I wonder how often exhortations actually produce desirable and self-sustaining changes in behaviour? Maybe there are good examples, but most cases that come to my mind seem to lead to reactance or mere lip-service. At the same time this is a popular strategy. Maybe it is because the idealists or paternalists behind it think they are doing God’s work and get internal rewards for doing it, or they are (consciously or not) enticed by the social signalling or institutional rewards. One can make a good living in a quango, after all.

    Similarly there are ineffective technological solutions (besides technological fixes) that try to address a problem but fall short of actually solving it. My favourite example is cleverly designed clip-on gadgets to monitor appliance energy consumption in the hope that consumers will be influenced to waste less energy. I suspect the savings would be far greater had the designers and engineers tried to reduce waste in other parts of the energy network. But you rarely get invited to design awards for your work on optimizing coal power plants, even if those savings are far greater than anything achievable by a monitoring gadget.

    Maybe we should regard the persuasive and engineering capital expended on ineffective exhortation and ineffective solution technologies as waste or misallocation: it could be used for something better.

  • Dave Frame says:

    Thanks Anders. I’m sure you’re right that there’s lots of wasted intellectual (and physical) capital in both ineffective technologies and ideas for living differently. But I’m not sure we can identify these very successfully a priori. Hence the patchy returns to venture capital. As for the ideas market… probably even patchier returns. But all the ideas for do-goodery do at least two useful things: (1) is cheap, so can explore lots of Millian possibilities for living at mercifully low cost; (2) keeps them off the streets.

  • elisa freschi says:

    Thank you for this interesting post. However, technology is not neutral. One has started trying to produce artificial organ because of the pressure of “good guys” thinking that it would be good to take care of those who need an organ and succeeding to persuade institutions to finance this kind of research. I agree with your implicit idea of a circle, not with the explicit position of independent factors.

  • Dave Frame says:

    Elisa wrote: “One has started trying to produce artificial organ because of the pressure of “good guys” thinking that it would be good to take care of those who need an organ and succeeding to persuade institutions to finance this kind of research.”

    This is a good point, but not a generic one about technology. Watt didn’t build the steam engine to free indentured/slave labour. He built it (1) because it was cool; (2) because it might be useful. Probably in that order. The fact it, and the technology tree descending from it, effectively undercut the price of human labour was one of a number of side-effects.


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