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How Many Lives Should I Save?

by Julian Savulescu

Toby Ord is a brilliant young Oxford post doc. He has established Giving What We Can. On the website, you can calculate how many lives you could save by giving to the most effective charities he has evaluated. He calculates that even a person on the median salary could save 1350 lives. Here is an example of how Toby calculates the number of lives which could be saved.

Let’s focus on a young adult earning the median income, but really trying to save lives, so prepared to live their life like a grad student (i.e. better than many working class people, but worse than middle class) and not having children.

£18,500 is the UK median personal income

keep £9,000 (= £8,000 after tax)

thus give £9,500 per year * 40 years in work force (a low estimate) = £380,000 = $610,000 USD

divided by 3.41 dollars per DALY (Disease Control Priorities Project, DCP2, page 476) = 180,000 DALYs

divided by 30 DALYs per 'life saved' (a standard conversion) = 6,000 'lives saved'

or more directly $610,000 divided by $450 per death averted (DCP2 midpoint estimate) = 1,350 lives saved

Children cost about £200,000 on average in the UK, so £100,000 per parent (and a family *trying* to keep costs down could do so). If the person had a child, that would lower their overall income by a quarter, lowering the lives saved by a quarter. If they had two children, that would halve the lives saved.

You could compare this with Oskar Schindler who saved just under 1,200 lives.

What Toby argues is that if a person on just the median salary lived a life better than the average person in the working class, he or she could save 1350 lives by donating £9500 per year. For those on higher incomes, the impact on their quality of life would be even less.

Toby has set a compelling challenging that I believe all of us must respond to. Practical Ethics is not about accepting someone else’s reasons or arguments and doing what they think is right. It is about thinking for yourself about their arguments and forming your own judgements of what is right. Toby has a wealth of arguments on his website. I urge you to consider them.

I don’t have any especially good responses to his arguments, at least for people on higher incomes. I myself have existing commitments which I believe I should fulfil. I undertake to commit a minimum of £10 000 per year to Giving What We Can when my commitments to my existing children are complete.

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19 Comment on this post

  1. I suppose the only real question is how much do we have to give? After, all we could give up all of our money that we spent on our education to charity. If we have plenty of money, and live comfortably, with my charity, why shouldn’t I give even more, to the point where I’m living like a graduate student? And why shouldn’t I give even more than that and live like a person who has been recently unemployed and counting every cent?

    At what point does our giving to charity become supererogatory?

  2. Uncomfortable reading for some of us with extravagant lifestyles. The most compelling question to me, and one that has been causing me a lot of worry in recent years, is not “how much should I give?” but “how (ie, to whom) should I give?”. I had a quick skim through some of the sections in DCPP and while there is a lot of detailed analysis and some common-sense conclusions, there do not seem to be any easy answers. Some simple rules of thumb would seem to be:
    Give to areas of the world where average income is lowest as your money goes furthest;
    Avoid governmental bodies unless they have impeccable records of efficiency and integrity;
    Target NGOs with low overhead and streamlined management, with local rather than Western staff on the ground;
    Maximise your Gift Aid contribution by giving to charities that qualify.
    Beyond that, though, I struggle. It is extremely hard to tell, without embarking on misery tourism, whether donations are really having the intended effect, or whether intervening factors such as war, corruption or resistant local cultures are neutralising the input.
    If anyone has a pet charity that they can persuade me is truly effective, I have a trust that is looking to make disbursements, and can be contacted via Julian.

  3. There is of course a heated debate over the (actual, sustained, long term) efficacy of most any kind of foreign aid, development or humanitarian. For anyone unfamiliar with the polemics, just check out, for instance, some contrasting work by Jeffrey Sachs at Columbia University, on the one hand, and William Easterly at New York University, on the other hand.

    Leif Wenar at King’s College London provides an accessible introduction to the relevant issues in a paper titled, “Poverty is No Pond: Challenges for the Affluent” in a forthcoming anthology from OUP edited by Patricia Illingworth, Thomas Pogge, and Wenar. You can download a PDF copy of this paper by Wenar from his main website (wenar.info). (I recommend all work by Wenar and Pogge on these and related matters, by the way. I might, and perhaps soon will, also recommend Illingworth’s work, though I have not yet read/studied/taught it.)

    Nicole Hassoun at Carnegie Mellon University has some particularly good, and perhaps more optimistic, papers on relevant topics available from her website.

    I strongly agree with David Shipley’s remark (in his comment above) about local people on the ground. Many if not most attempts to help from the outside either fail or are not nearly as effective as empowering local grassroots organizations already doing the necessary work (from the inside) but without sufficient resources. Samuel Martínez at the University of Connecticut, for instance, has some excellent work discussing examples of these matters through his anthropological field studies.

    Similar sentiments lead me towards various forms of microcredit and microfinance generally, following the work of Muhammad Yunus, for instance. Interested readers might want to check out kiva.org, Grameen Bank (grameen-info.org), grameenfoundation.org, and Yunus’ website (muhammadyunus.com).

  4. For examples of the kind of local, grassroots organizations that I advocate in my comment above, please see my website post on moral heroes:
    http://sites.google.com/site/davidslutsky/home/moral-heroes

    Bogaletch and Fikirte Gebre (two sisters) founded a remarkable organization called KMG Ethiopia (formerly called Kembatta Women’s Self-Help Center – Ethiopia) in their village region of Kembatta-Tembaro. The aims, goals, and activities of this organization have achieved great success and are spreading to several other regions. Their accomplishments are extraordinary and represent ways of reducing if not eliminating forms of oppression and suffering that are both very effective and not susceptible to charges of cultural imperialism, cultural chauvinism, and/or ethnocentric bias. Reading through their entire website (and perhaps the accompanying news story) is well worth your time.

    Another moral hero, Wangari Maathai founded a remarkable organization called the Green Belt Movement (GBM Kenya) around 1977. It is also expanding afar under the heading of the Green Belt Movement International. As with KMG Ethiopia in the paragraph above, I will not try to do justice with my own words here to the aims, goals, activities, and accomplishments of this organization. I encourage interested readers to read through the websites provided at the link above (perhaps along with the two linked news stories associated with each organization that include incredible interviews with the founders of these two organizations).

    Both organizations accept donations.

  5. It seems like charity and aid is helping…. 20 million children died of poverty related illness or malnutrition in 1960, less than 10 million in 2007. So things are getting better.

    I’m always a bit suspicious in microcredit/microfinancing helping the poor. No doubt it helps some individuals, but usually individuals who are not literally dying from their poverty. But then again, without our assistance with microcredit, their children and they themselves might become those we’re aiming to save…

    Its a multifaceted problem, that needs a multifaceted solution I suppose.

  6. On being worried about aid effectiveness – Giving What We Can has a similar attitude. The members of GWWC are concerned not just to give more, but also to give more cost-effectively. Indeed, while the benefit to the global poor would be 10x greater if one chooses to give 10x the amount one would otherwise have given, the benefit to the poor can easily be 100x greater, depending on the choice of charity – even among excellent charities that work within the developing world.

    Total aid-scepticism seems unwarranted, however. For example, the eradication of smallpox cost only $1.4 billion, yet has so far saved 122 million lives (and counting). Even if all the money spent on aid (around $4tr) had done no good other than eradicating smallpox, aid would still have saved one life for every $30 000 spent. In comparison, the UK’s National Institute of Clinical Excellence will fund new drugs if they provide one year of (high quality) life for $30 000.

    It seems likely that other programs might also be exceptionally cost-effective, and so we want to find them. Of course, that’s difficult to do. So Toby, I, and a few others from GWWC, spent a substantial amount of time drawing on the latest research from health and development economics in order to find out some answers. Our conclusions so far are available at http://www.givingwhatwecan.org/resources/recommended-charities.php (as well as under the ‘charity comparisons’ section).

    Wayne: It’s great that you are already familiar with the DCPP. If you’d like to talk further about Giving What We Can’s cost-effectiveness research, you can e-mail me on firstname.lastname@philosophy.ox.ac.uk.

  7. An apparent problem in the GWWC is that 10% of the income is not “what we can”. Depending our income, it is very few or very much (Julian puts the problem of raising children, for example).
    Singer in his recent book (The life you can save) and in his very similar website (www.thelifeyoucansave.com) has suggested around 5%, but asking more if higher is the income (5% to 33,3%!) or less (from 1% to 5% if the donnor lives in an developing country). There is a pledge in the site too.
    I do not know exactly why I do not give more, if it is because weakness of will (weakness of morality), or if it is because I had three children and live in a developing country (our welfare state is not good and we spend money in education, private helth system, etc) or if it is because there are some theorical (social problems should be treated by our public sector, our national States and politics, for example) and practical problems (corruption, uneffectiveness) with the idea of humanitarian tenth. Probably all these answers…
    This – to end the world poverty – should be the principal target of our ethical reflections and practices, but I do not know if the consensus in the comments is so good as it seems.

  8. Thanks for these constructive comments and thanks David for promoting it with Leiter. Toby is very attune to the issue of cost-effectiveness. He says it is more important where you give, rather than whether you give. So I have some faith in his ability to identify cost-effective charities. My entree into this was not highly rational. I asked Toby to calculate how many lives the average person could save. He gave me the calculation I included. 1350 lives for about 10k per year. I thought, “Wow (or thoughts to that effect) that is nearly exactly how much I pay in maintenance for one child per year. I thought when one of those children leaves school, I could easily transfer the support to effective charity. (Not very rational, I know.) I won’t save the Schindler number, but it will save some lives. I think the most important thing is that you have an answer that you can defend to yourself.

  9. If I could just reiterate the central figures before I make my point:
    a lifetime’s income is around 1200k, a lifetime’s donation to charity could be 600k, and raising a child comes at a cost of 200k. a lifetime’s donation to charity could save over a thousand lives.

    The obvious conclusion is that raising a child is a tremendous waste of money. But that depends, surely, on how charitable a child you intend on raising. If, to take an extreme situation, you raise the next Bill Gates, then to have done so will be your greatest moral achievement, and arguably, one of the greatest moral achievements of all time.

    So, to take a more realistic scenario, what if you believe you can raise a child who earns ten times the average income. And furthermore, suppose that you give yourself a ten percent chance of successfully raising a child to be as inclined to give to effective charity as yourself. The maths is not too tricky, you’re creating a person who will save more than one thousand lives, for a cost of 100k. Should you have spent the money donating directly to charity, you would be less cost-effective by a third!

    So if you believe you can raise kids to be both rich and more inclined to philanthropy than yourself, then it’s a good idea to give birth to them after all!

  10. Marco Antonio Oliveira de Azevedo

    Let me offer a rather different view on the matter. I recognize that, concerning the issue of humanitarian aid, some people think that NGOs, not Governments, are the proper and adequate institutions for civil actions in favor of the unfortunate people, be them within or outside the limits of the agent’s own nation. People can think this way because, for example, they suspect that Governments (all of them or at least some of them) are not reliable institutions. Other moderate view is that both NGOs AND governments are good and proper institutions for a correct distributive benevolent civil action. The view is that NGOs supplement governmental actions, especially in emergencies and in the most serious situations.
    But I prefer to see the problem with another view-point. I agree that severe poverty is an enormous endemic human disaster. Affluent people have not only good reasons for looking the best way of giving aid; they have preeminent reasons for doing that. Nevertheless, I don’t think they are properly obliged to. They don’t have a “moral obligation”, but a strong and preeminent reason for action. We have, by the same token, reasons for criticizing them if they don’t make efforts in that direction. Nevertheless, their inaction is not a subject for proper indignation (it would not be a suitable reactive attitude). Rich people’s inaction estimule our scorn; but I don’t see their omissions as “acts” of injustices.
    Anyway, affluent people can be criticized if they don’t spend their money in benevolent enterprises. In some sense, our contempt is a “moral contempt”. But I don’t think my inaction could be criticized by the same reasons. As a matter of fact, I’m not rich or affluent. I am at most sufficiently flush (sse Harry Frankfurt topic on sufficiency). Anyway, that is the regular situation of most of us that think seriously about these serious problems. But that does not mean that I am, or you are, not worried about these serious human misfortunes and predicaments. My conclusion is that I am already doing what I must and actually can do. Besides that, we have also our own lives to live, and it is reasonable that we look for a good, healthy and a pleasurable life, with good and sufficient wealth for spending in things related to our choices, plans and personal preferences, with aims also related to the well being and happiness of our relatives and friends. Individually, this is the most important part of all individual life decisions. A good politically organized common form of life is a form of living that permits to its citizens the possibility of looking for their own well-being and happiness, and, not less important, also for their relatives and close friends (see Hume). If we keep ourselves away from those particular ends, we keep ourselves away from happiness. Nietzsche was right about that. Being sympathetic beings, we could not have peace of mind if the charge of relieving all the pain and suffering in the world would be within our personal responsibility; the consequence would be to deviate ourselves from our own lives with the danger of compromising the happiness of the persons we love, and care for, the most.
    My point, hence, is that governments have the proper (political) obligation of doing something for eliminating severe poverty and famine in the world. The best civil action is to push Governments on taking more urgent, effective measures for the sake of eradicating famine and severe poverty in the entire world. Aiding NGOs can be a good step, but it can be also ineffective and even unproductive (as we know, aid contributions may sometimes “lead to some poor people being made worse off than they would have been”, as Leif Wenar has commented in his reflective thoughts on Singer arguments – http://wenar.info/WenarPovertyNoPond8-09.pdf – thanks for David Slutsky reading suggestion above). We can suspect that it is true concerning Governments; but the difference is that Goverments have a duty of doing something, and urgently.

  11. Dear Marco, in our world, living well, inluding living flush, without giving to the poorest is not only unnecessary luxury, but immoral. For practical reasons, Singer and Ord ask only a little help, from 1% to 10%, not only to NGO, and not only necessarily with money (it could be with our time for NGO or Governments or Public/Political institutions, since it is for fighting agaisnt exterme poverty). I do not think that in moral discourses “obligation” or “duties” are different from “special and preeminent reasons” because I do not think that we can to maintain the distinction between actions and omissions.

  12. Marco: you are simply assuming a sharp moral distinction between doing harm and allowing harm and claim that the latter is to no degree obligatory and that no negative reaction is fitting for any agent that allow harms. That calls, nay screams at a high pitched voice, for defence. Show us the argument. Also, there seems to be obvious counterexamples, like Singer’s original Shallow Pond Case. What is your take on that case? Surely, the agent who leaves the child to die acts morally wrong.

  13. Ryan:

    First, I wouldn’t say that the take-home message is that having children is a tremendous waste of money. More interesting and important, I think, is the message: one can live a very comfortable life, have at least one child (or more depending on one’s income level), pursue the career that one wants, and yet still do huge amounts of good – just by spending some of one’s money in the right way. That’s an eye-catching message.

    On the other hand, I’m not sure that your argument works. Certainly, it’s plausible that having a child and bringing him/her up to make the world as good a place as possible is an action with net positive consequences. But it seems to be strictly dominated by using the money that one would spend on child-rearing on influencing students or other young people: one could plausibly convince many more than one person to, e.g., earn lots of money and give it to the most cost-effective causes. In which case one would have done more good than if one had focused on influencing only one person (your child).

    Marco:

    On how ‘affluent’ or merely ‘flush’ one is, one might want to look at GWWC’s ‘‘How rich are you?’ calculator’: http://www.givingwhatwecan.org/resources/how-rich-you-are.php

    On the argument that Toby/Julian originally presented: one does not even need to use moral language in order to make a strong argument for giving to cost-effective development charities. For most of us, at least, one of the things we care most deeply about is helping other people: think how great you would feel if you rescued someone from a burning building – you’d be a hero! What GWWC shows is that each one of us can be that hero 100 times over – simply in virtue of having been born into an affluent nation.

    Just taking people’s fundamental values for granted – and not even asking if those values are right or wrong – it seems that the best way for many people to fulfil their values is to spend a proportion of their income helping thousands of people in the developing world. For these people, therefore, unless you can provide arguments that they ought actively not to be giving, then the question of whether there is a obligation to give is beside the point. Most of us want to make the world a better place: GWWC is suggesting that cost-effective giving is one of the best ways to do this.

  14. Marco Antonio Oliveira de Azevedo

    “Most of us want to make the world a better place: GWWC is suggesting that cost-effective giving is one of the best ways to do this”. We want a better world; but I’m not sure that donation represents the best way for attaining that. Certainly, cost-effective giving is not the best way for making the world a better place (for living and flourishing). It is at best only a plausibly good cost-effective way for relieving extreme poverty, but it is not a plausibly effective way for eliminating poverty, even extreme poverty. It is not also an effective way for promoting human development. And certainly it is not a cost-effective way for *saving lives*. The point of giving aid is not “to save lives” but to relieve extreme suffering and, in some cases, to contribute for reducing some risks of morbidity and high mortality rates from some diseases (note that the first three highly recommended charities following GWWC are related to disease control). For having a better world, we need global economic and political achievements. We need global human development; charity is not a cost-effective way for improving global human development.

  15. Jonah, Julian, etc. You say that those living in luxury and “allowing” others to suffer is as morally objectionable as acts of commission against those same people. I think I disagree.

    Would the only difference between a “rich” guy “allowing” poverty/suffering and a “less rich” guy allowing the same, be the ease with which the “rich” guy can help? Then isn’t it also the moral obligation of the “less rich” guy to get rich so that he can help others? Is morality measured by the amount of good you do or the amount of sacrifice you must endure to provide that good?

    If a rich guy helps 10 poor people but it’s easy for him and a less rich guy helps 5 poor people but at great sacrifice to himself, would you rather have more rich guys or more less rich guys in the world? I’d take more rich guys.

    My understanding of economics is that most people (not all), at least in free societies, get rich BY helping others (providing them with something that they are willing to trade for, whether it’s goods, services, employment or even baseball skills). So I’d add that even without giving to the poor, the rich guy is likely to have provided the world with more than the less rich guy anyway, so he’s better on two fronts.

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