Cluster Headache Frequency Follows a Long-Tail Distribution

[Warning: Disturbing content ahead. Why talk about it? This is an ethically very serious topic and it deserves more attention. But please beware that thinking about this might be bad for one’s mental health.]


One of the key insights that shows why Effective Altruism is so important is that the positive effect on the world that results from donating to various charities follows a long-tail distribution:

health interventionsCost-effectiveness of health interventions as found in the Disease Controls Priorities Project 2. See “The moral imperative towards cost-effectiveness in global health” by Toby Ord for more explanation. [Taken from: The world’s biggest problems and why they’re not what first comes to mind]

It is for this, among other, reasons why focusing on the best interventions really pays off. Where else can we expect long-tails to appear?


In Get-Out-Of-Hell-Free Necklace we discussed how introducing a new metric into the Effective Altruist ecosystem could shed light on neglected cost-effective interventions. We presented the Hell-Index:

A country’s Hell-Index could be defined as the yearly total of people-seconds in pain and suffering that are at or above 20 in the McGill Pain Index (or equivalent)*. This index captures the intuition that intense suffering can be in some ways qualitatively different and more serious than lesser suffering in a way that isn’t really captured by a linear pain scale.

In a future article we will discuss how the quality of suffering as a function of different medical and psychological conditions very likely follows a long-tail distribution. That is, some conditions such as Cluster Headaches (which affect about 1 in 1000 people worldwide) produce pain that is orders of magnitude worse than the pain experienced in other kinds of medical conditions, such as migraines (which are themselves already described as orders of magnitude worse than tension headaches). In other words, a 0-10 pain-scale is better thought of as a logarithmic compression of the true levels of pain rather than a linear scale. So concentrating on the worst conditions could really pay off for reducing suffering in bulk amounts.

Now: the long-tailed nature of suffering may extend beyond the quality of suffering, and show up also in its quantity. That is, the frequency with which people experience episodes of intense suffering, even among those who experience the same kind of suffering, is unlikely to be normally distributed.

Intuitively, one may think that how much suffering people endure on a given year follows a normal distribution. This intuition says that if the median number of hell-seconds people endure in a year is, say, 1,000, then people who are at the 90% percentile of hell-seconds experienced per year will be experiencing something like 1,500 or at most 2,000. If suffering follows a long-tail distribution, in reality the 90% percentile might be experiencing something more akin to 10,000 hell-seconds per year, the 99% percentile something akin to 100,000, and the 99.9% something akin to 1,000,000. If true, such a heavy skew of the distribution would suggest that we should concentrate our energies on addressing the problems of the people who are unlucky to be on the upper ranges, rather than be overly concerned with “the typical person”*.

Unfortunately, I come to share the bad news that suffering probably follows a very long-tail distribution:

It is generally acknowledged that Cluster Headaches are some of the most painful experiences that people endure. Having a single Cluster Headache, lasting anywhere between 15 minutes to 4 hours, is already an ethically unacceptable situation that should never happen to begin with. It is disheartening to know that 1 in 1,000 people experience such extreme pain. But the truth of the matter is yet much worse than we intuitively think…

We recently analyzed a survey** of Cluster Headache patients that was conducted with the intention of determining the reasons why sufferers do or do not use psychedelics to relieve their pain. As it turns out, LSD, psilocybin, and DMT all get rid of Cluster Headaches in a majority of sufferers. Given the safety profile of these agents, it is insane to think that there are millions of people suffering needlessly from this condition who could be nearly-instantly cured with something as simple as growing and eating some magic mushrooms.

We will get back to this in more depth in later articles, but for the time being what we want to highlight is the responses to the question “About how many cluster headaches do you get in a typical year?”.

After cleaning the data***, we end up with 270 participants. We then ranked the values from smallest to largest, and visualize them:

270_ranked

Honestly I am a bit suspicious of the very top numbers (I do not know how you can fit 25,000 Cluster Headaches in a year, so perhaps the participant interpreted the question as “lifetime number of Cluster Headaches”). So, just to be safe, we cut the top 20 highest numbers and visualize the bottom 250 values:

first_250_

This is clearly a long-tail distribution. And since many people online do claim to have 3 or more Cluster Headaches a day, I am inclined to believe this curve. To zoom in on some parts of the distribution, here are some additional histograms that focus on the lower percentiles:

If we take the logarithm of the number of yearly Cluster Headaches, the distribution looks remarkably normal:

log_of_estimated_total_half_bins_till_12

Natural log of the responses to the question “About how many cluster headaches do you get in a typical year?”

Using a Shapiro-Wilk normalcy test does not rule out a Gaussian distribution (p >0.05). Although this in no way shows that that the distribution is log-normal (which would require more specialized statistical analysis), it is at least suggestive of it.

I should also point out that the distribution is really close to the 80/20 Pareto principle – we see that the top 20% of the participants contain about 83% of the CH incidents per year. Below you will find the percent of the total number of incidents accounted for by the bottom x% of the respondents:

  1. The bottom 10% accounts for .06% of incidents
  2. The bottom 20% accounts for 0.36% of incidents
  3. The bottom 30% accounts for .95% of incidents
  4. The bottom 40% accounts for 1.82% of incidents
  5. The bottom 50% accounts for 3.17% of incidents
  6. The bottom 60% accounts for 5.54% of incidents
  7. The bottom 70% accounts for 9.56% of incidents
  8. The bottom 80% accounts for 17% of incidents
  9. The bottom 90% accounts for 30% of incidents
  10. The bottom 95% accounts for 43% of incidents

Below we also include the number of yearly Cluster Headaches experiences at different percentiles:

  1. 10% percentile experiences 5 CH/year
  2. 20% percentile experiences 17 CH/year
  3. 30% percentile experiences 30 CH/year
  4. 40% percentile experiences 45 CH/year
  5. 50% percentile experiences 70 CH/year
  6. 60% percentile experiences 105 CH/year
  7. 70% percentile experiences 200 CH/year
  8. 80% percentile experiences 365 CH/year
  9. 90% percentile experiences 730 CH/year
  10. 95% percentile experiences 1095 CH/year
  11. 98% percentile experiences 2190 CH/year

I believe that this information is crucial to consider when assessing cost-effective interventions to help people who endure intense suffering.


Here are some additional results from the survey.

cluster_headache_tryptamine_use

The following graphs are about the beliefs and attitudes of Cluster Headache sufferers who do not use tryptamines (LSD, psilocybin, DMT, etc.) to treat their condition:

 

I think it is fair to say that the survey shows that one of the biggest barriers preventing CH patients from using tryptamines to treat their condition is simply the difficulty of acquiring them. Since a number of interviews we’ve conducted have shown that even sub-hallucinogenic doses of DMT can abort cluster headaches (writeup coming soon), more education could easily address the barrier of being concerned about hallucinogenic side effects. The social stigma seems like a minor problem, and the legal implications (the hardest to change, perhaps), are a big concern to about half of the participants (ratings of 4 or 5/5). Hence the importance of passing new laws allowing people with this condition to use them without repercussions.

Do CH sufferers who do not use tryptamines think they would work?

no_use_cluster_headache_belief_in_effectiveness

And do they work? Here is what the CH sufferers who do use them say:

use_cluster_headache_effective

Effectiveness

use_cluster_headache_kind

Tryptamines used

If we interpret a 2 or 3 in the 0 to 5 scale as an equivalent to a “maybe”, and a 4 or 5 as a “yes” to the question “do they work?” we see a big difference between non-users beliefs in their effectiveness and their reported effectiveness by users. 24% of people who use tryptamines to treat their CHs report that “They have completely eliminated the cluster headaches” and in total 68% mark it as either a 4 or a 5 in the scale (which we can interpret as “working” even if not “completely eliminating them”). This is compared to only 30% of non-users who believe the tryptamines would work. This large discrepancy also suggests that outreach and education could help sufferers give this approach a try.

Finally, we also looked at whether the users and non-users had different number of incidents per year (reasoning that perhaps those who experience more incidents would be more desperate to try legally and socially risky treatments). We notices that there is a very slight difference in the mean (and mean-log) for the number of CH incidents a year between the 20% of sufferers who treat their CHs with tryptamines and those who don’t. I won’t report the difference in the mean because the skew of the distribution makes such a metric deceptive, but the log-mean of yearly incidents of tryptamine users is 4.73 whereas for all the rest it is 4.10 (which reaches statistical significance of p < 0.05 based on a t-test). That said, we don’t think this is a very practically relevant difference. The distributions look roughly the same:

tryptamine_vs_non_tryptamine_users

The similarity between these two distributions also suggests that there is a long way to go to make sure that those who are the worse off get prompt access to tryptamines.

The End.


See also https://clusterbusters.org/, which is an organization that aims to make psychedelics legally available to people who suffer from this condition. Please consider donating to them to help this very important cause. Also consider donating to MAPS which is championing the use of psychedelics for mental health applications. Finally, consider also donating to organizations that care and strategize about how to reduce intense suffering, such as: QRI, FRIOPIS, and The Neuroethics Foundation.


*There are instrumental considerations here – if experiencing more than, say, 5,000 hell-seconds in a year is very likely to make you depressed and ineffective, then it might pay-off to also spend resources on keeping as many people as possible below that level. In particular, to be an effective Effective Altruist it pays off not to be heavily depressed and nihilistic.

**Thanks to Harlan Stewart for taking the initiative to conduct this survey. He advertised it on the Facebook groups and subreddits of Cluster Headache sufferers and got 371 responses.

***Some people provided numerical answers, which we used directly. Some other people provided ranges, in which case we used the middle point between the values provided (e.g. “200 to 300” was coded as “250”). Some people provided lower bounds, in which case we simply used such lower bound (e.g. “500+” was coded as “500”). We discarded the data of people who didn’t provide an answer in any of those formats – which left 270 participants. A more strict analysis that uses *only* the numerical responses results in the same observations listed above (e.g. the distribution is equally long-tailed and it appears to be log-normal).


[Cross-posted in Effective Altruism Forum]

Coffee Saves Lives

[July 18 2019 addendum: This assumes that coffee has a causal- rather than merely correlational- influence on longevity. See comment section for more details.]


The T-shirt in the featured image was probably designed as a joke, but I take it very seriously.

Indeed, I think there is a strong case to be made that subsidizing coffee could be seen as an Effective Altruist priority. You see, you can save a life with coffee for as little as $50k. This makes coffee an intervention that is on par with some of the top charities in the world, and it is an outlier when it comes to the cost-benefit ratio of medical interventions. Consider how, e.g. this article on QALY states that:

“The UK’s recommendations, for example, are about £20,000 to £30,000 ($30,000 to $45,000) for each additional year of good health, once it has been adjusted to take into account the quality of life. So a drug that achieved 0.5 on the QALY measure would only merit £10,000-15,000 ($15,000 to $22,500).”

Assuming a QALY-adjusted average life-span of about 60 years per person, coffee is about 30 to 50 times more cost-effective than the types of medical interventions the UK is willing to subsidize to extend people’s lives. And that’s not even considering what people themselves are willing to pay to extend their own lives, which is, of course, a lot more than what a government would.

Relative to GiveWell‘s top charities this is still not the best intervention out there (with some of the ultra-effective charities saving a life for about 2,000 dollars). I would nonetheless point out that the ultra-effective charities out there are all effective because they address populations where very basic human needs are not typically met. In Malaria-ridden, war-torn areas, a little can go a long way. But what’s different about coffee is that it is as effective everywhere in the world. Sure, you can save a life with $50k in many African countries. But can you do so in Sweden?! With coffee you can!

Anyhow, how did I arrive at these numbers? Well consider that you can get about 380 doses of coffee for as little as 10 dollars.*

So this means you can have a cup of coffee for as little as 2.63 cents(!). In turn, we know from a lot of research that each cup of coffee up to 4 cups a day prevents about 1/2 micromorts (interestingly, it is just as cost-effective to encourage people who don’t drink coffee to drink 1 cup as it would be to encourage people who drink 3 to go ahead and drink 4).

Given those numbers, we have that the cost of a full life-span worth of micromorts is about $52,631.58.

Why are we not funding this?!


*With: Example 48 oz brand. (we could do even better buying in bulk – I reached out to a delivery company to get a quota and will update when I know more).

Against Fetishizing Cortical Neurons: Prioritizing Humans As Instrumentally Rational

In response to: [Partially Retracted] Cortical Neuron Number Matches Intuitive Perceptions Of Moral Value Across Animals (see also: 1, 2), and The Cognitive Chain of Being: A New Approach to Animal Rights


Some errors are ethically catastrophic. Prioritizing the prevention of suffering based on the number of cortical neurons of the brains that would generate such suffering might be one of them.

We should avoid jumping to conclusions. It is possible that moral significance will ultimately be revealed to be based on capacity to suffer and experience joy, which is related to the limbic system, pleasure centers, and thalamus rather than the capacity to verbalize and cogitate, which is related to number of cortical neurons. People’s perceptions and intuitions are likely to be biased towards over-valuing intelligence because that’s something that got ingrained into our perception of value due to sexual and kin selection.

If QRI’s Symmetry Theory of Valence is correct, most intense and (dis)valuable experiences will turn out to be very simple in structure (even if very high energy-wise). Complexity of neural architecture is correlated with potential for intelligence and complex states. But it is not necessary for emotionally powerful experiences. The cortex, after all, plays majorly an inhibitory role in the brain. Emotion centers, on the other hand, are excitatory, evolutionarily ancient and phylogenetically preserved across the animal kingdom (e.g. even octopodes enjoy MDMA). Based on this, uninhibited base emotions are likely to feel roughly the same (or close to the same) in human and nonhuman animals alike.

What about an animals’ capacity to inhibit base emotions? As John Lilly’s studies indicate, the thickness of an animal’s cortex is correlated with its emotional control. A macaque in panic is more impulsive and violent than a chimpanzee in panic, which in turn is more impulsive and violent than a human in panic. The same goes for humans with different cortical sizes. Hence, sadly, there is a good chance that pigs, dogs, birds, and cows experience emotions more- rather than less- intensely. Their emotions may not be as ‘subtle’ and multilayered, but why would that matter for ethics? Raw panic is worse than subtle poetic melancholia and other ‘valued (i.e. fetishized) human emotions’. Again, we overvalue such subtle emotions as a side effect of the specific sexual selection pressures experienced in our recent evolutionary history, rather than for good well-thought-out reasons.

In this age of ethical emergencies (aka. the Darwinian age), I would like to offer the suggestion of enforcing pleasure center activation in factory farm animals as a precondition for having them raised for meat or dairy. Likewise, such should be done in nonhuman animal studies that focus on things other than the brain. Why not wirehead rats who are being studied for kidney failure? It won’t matter for that area of research… but it will certainly matter for the subjective wellbeing of the rats in question.

A relevant side note here would concern another human bias in addition to the fetishization of cortical neurons. Namely, our positive bias towards cute animals due to mirror neuron activation. Cuteness and neoteny are attractive to humans for good evolutionary reasons, but this is a perceptual bias rather than the result of careful moral reasoning. The fact that humans perceive pandas as cute hardly justifies letting millions of sentient beings suffer in exchange for “saving the panda” (cf. Should We Let Pandas Go Extinct?*).

Really what we need is what Mike Johnson has pointed at in his blog for ages: objective measures of species’ specific valence landscapes.

My dark hunch: the life of some animals is simply not worth living no matter their environmental conditions. Crickets- the consciousnesses science of 2050 could reveal- are 100% driven by dissonance and never experience pleasure. If so, let’s fix them or phase them out.

Finally, also consider: Cluster headaches are 10,000sX more painful than other medical conditions. Given this extreme outlier in humans, we could infer that there are good odds that there are other kinds of ultra-high-intensity suffering lurking in species’ specific diseases. Morally, it ought to be key to identify these cases and treat them as our priority. Focusing on cortical neurons instead would be a- possibly ethically catastrophic- red herring.


* This is not to say that it is desirable for the panda to go extinct. It is a question of opportunity cost. It might make sense to put efforts instead in sequencing the DNA of the entire panda population and consider rebooting it sometime in the future.

Cause X – What Will the New Shiny Effective Altruist Cause Be?

The Qualia Research Institute hosted an interesting event a couple of weeks ago. Here is how the event was advertised:

Description

Event NameQRI & Friends: “Cause X” – what will the new shiny EA cause be?
Time: Saturday, January 19, 2019 at 4 PM – 1 AM
Description: This event will consist of 4-minute presentations from attendees about what the “new EA cause area should be” (from 4pm to 6pm) followed by a casual and chill hangout for the rest of the evening.
There are 10 slots for the presentations, and we encourage you to sign up for one before they run out. If you want to give a presentation please fill out this form: [deleted link]
If you want to see people’s presentations please show up before 4:15pm (we will start the presentations at 4:30 sharp). Each participant will be given 4 minutes to present and 1 minute for Q&A. We will be strict on time. You should come prepared to defend your cause with logic, data, etc.
Everyone who sees the presentations will get to vote* at the end for the following three categories:
  1. Most likely to prevent as much suffering as possible with 1 million dollars of funding
  2. Most fun to think about
  3. Most likely to be the plan of a super-villain
There will be real prizes for each of these three categories!!!**
If you just want to come and hang out for the evening please show up from 6:30pm onwards. Vegetarian/vegan food and drinks will be served at around 7:30pm. Feel free to bring vegan/vegetarian food/drinks too.
As usual, feel free to invite people who are curious about consciousness and EA (but please let me know in advance so I can make a head-count for the event).

*Voting was carried out with Approval Voting (where every person can vote for as many presentations as they want and the ones with the highest number of votes win). This was chosen based on the assumption that some presentations might be similar, which would lead to an unfair penalty on similar presentations based on the spoiler effect. Additionally, voters who are undecided between more than one presentation can communicate their uncertainty via this type of voting rather than having that useful information be discarded.
**Prizes were announced the day of the event. For category (1) the prizes were “a fully-equipped first-aid kit plus a 16-bottle essential oils kit”. The winner of category (2) received a prize consisting of “a 3D Mirascope and an Ivy Cube“. And category (3) had as its prize an “Apollo Tools 39 piece general tool set (DT9706)“. These prizes were, of course, highly symbolic of their respective categories.

Winners

With the permission of the participants, here is what each of the winners presented:

For (1) two presenters tied in first place:

– Natália Mendonça presented about “Using smartphones to improve well-being measures in order to aid cause prioritization research” (link to presentation). She argued that the experience sampling paradigms that made waves in the 2000s and early 2010s happened at a time when relatively few people had smartphones. Since today smartphone adoption in developing countries has exploded we could use an experience sampling app to determine the major causes of suffering throughout the world in a way that wasn’t possible before. She specifically mentioned “comparing how bad different illnesses feel” in order to help us guide policy decision for cause prioritization.
– An anonymous attendee presented about “Psychedelic Drug Decriminalization“. Some of the core ideas involved taking a look at the effect sizes of the benefits of MDMA, LSD, psilocybin, etc. on various mental illnesses and comparing them against current alternatives. Also looking at the potential downsides they estimated that these only account for about 10% of the benefit, so cost-benefit wise it is very positive. They didn’t cover the entire presentation due to time – more details and a contact email can be found at https://enthea.net.

For (2) the winner was:

– Matthew Barnet who presented about “Timeloop Concept as Cause X” (link – slides don’t have much content; they were used just to keep the presentation on track). Matthew looked at the recent Qualia Computing article about the “Pseudo-Time Arrow” and wondered whether the importance of agents from an ethical point of view should be weighted at least in part based on their subjective time-structure. It’s true that 99% of experiences are experienced as having a linear causal time arrow, but this is not the case for the general space of possible experiences (e.g. including “moments of eternity”, “time loops”, “atemporal states”, etc. common on altered states of consciousness). He posited that perhaps time loop experiences have a much bigger moral importance because from the inside it feels like they never end. A discussion about infinite ethics and the quantification of consciousness ensued.

For (3) the winner was:

– Yev Barkalov, who proposed that rather than trying to endlessly battle in favor of digital privacy… how about we “just give up” and instead refocus the absence of digital privacy for social good. He mentioned China’s social credit score as a possible bad implementation of what he had in mind (“they have poisoned the well of the no-privacy camp by doing it so poorly”). Part of his argument was that technologies such as adblockers, crypto tokens, and the dark net further arms races in which advertisers, financial institutions, and governments become more clever at displaying ads, making you sign up for credit cards, and forcing citizens to abide by the law. Since arms races are dangerous and may lead to draconian systems while also being a waste of resources (due to their zero-sum nature), he suggested that we at least consider the alternative of seeing how a privacy-less world could work in practice. He posited that this could allow people to find quality collaborators more easily thanks to enhanced “people search” capabilities made available to the general population.

For completeness, the remaining presentations included:
Open Individualism as a new foundation for ethics
– Collective internet identities to replace countries
– The researching of possible Cause Xs as itself Cause X
– Automatic Truth Discovery neo-Wikipedia: like the current Wikipedia but with meta-analytic tools embedded into it, which provide confidence intervals for each claim based on the statistical robustness of the empirical findings that support it. And…
– A critique of utilitarianism that was more of a rant than a specific proposal (???)

Finally, I would like to add here some additional possible Causes X that I have thought about. These did not participate in the event because the organizers were not allowed to present (due to fairness and also because I didn’t want to “win a prize” that I bought myself):

  1. Subsidizing/sponsoring the use of HEPA filters in every house
  2. Distributing DMT vape pens that dispense in 4mg doses to deal with unexpected cluster headaches (this deserves an article of its own; cf. “Hell Must Be Destroyed“)
  3. Building a model that takes in genetic data and returns hedonic set point (and/or tells you which recreational drugs you are most likely to respond positively to).

In brief, (1) above might be a highly effective way of improving the health-span of a country’s population in a cost-effective fashion. As Robin Hanson has argued over the years, if we truly cared about the health of people, we would be spending more resources on the top 4 drivers of health (diet, exercise, sleep, and clean air) rather than on extravagant medical interventions designed to convince us that “an attempt was made.” Clean air, in particular, seems easy to influence at a rather minimal cost. HEPA filters capable of providing clean air to entire apartments (reducing by 10X the PM2.5 concentrations in the apartment) can cost as little as $70, with an upkeep of about $30 a year for renewing filters, and about $20 a year for electricity. Fermi calculation would indicate this would cut the average person’s daily PM2.5 exposure by half. I haven’t worked out the math concerning the amount of micromorts prevented per dollar this way, but the numbers seem extremely promising.

For (2) the rationale is that inhaling tiny doses of DMT aborts a cluster headache within about 3 seconds. Given the fact that about 0.1% of people will suffer from a cluster headache at least once in their lifetimes, and the fact that they are considered one of the most painful experiences possible, having a DMT vape pen within reach at all times as an insurance against spontaneous hellish levels of pain might be perfectly justified. A dedicated article about this specific topic will be posted soon.

And finally, (3) was recently argued in a Qualia Computing article: Triple S Genetic Counseling: Predicting Hedonic-Set Point with Commercial-Grade DNA Testing as an Effective Altruist Project. This may very well be a defensible Cause X on the basis that building such a model is already possible with the data available to commercial DNA testing companies like 23andMe, and that it might course-correct the reproductive strategy of millions of prospective parents within a few years, preventing untold amounts of suffering at a relatively small cost.

Why don’t more effective altruists work on the Hedonistic Imperative?

By David Pearce (in response to a Quora question)

 

Life could be wonderful. Genetically phasing out suffering in favour of hardwired happiness ought to be mainstream. Today, it’s a fringe view. It’s worth asking why.

Perhaps the first scientifically-literate blueprint for a world without suffering was written by Lewis Mancini. “Brain stimulation and the genetic engineering of a world without pain” was published in the journal Medical Hypotheses in 1990. As far as I can tell, the paper sunk almost without a trace. Ignorant of Mancini’s work, I wrote The Hedonistic Imperative (HI) in 1995. I’ve plugged away at the theme ever since. Currently, a small, scattered minority of researchers believe that replacing the biology of suffering with gradients of genetically preprogrammed well-being is not just ethical but obviously so.

Alas, perceptions of obviousness vary. Technically, at least, the abolitionist project can no longer easily be dismissed as science fiction. The twenty-first century has already witnessed the decoding of the human genome, the development and imminent commercialisation of in vitro meat, the dawn of CRISPR genome-editing and the promise of synthetic gene drives. Identification of alleles and allelic combinations governing everything from pain-sensitivity to hedonic range and hedonic set-points is complementing traditional twin studies. The high genetic loading of subjective well-being and mental ill-health is being deciphered. The purely technical arguments against the genetic feasibility of creating a happy living world are shrinking. But genetic status quo bias is deeply entrenched. The sociopolitical obstacles to reprogramming the biosphere are daunting.

You ask specifically about effective altruists (EAs). Some effective altruists (cfEffective Altruism: How Can We Best Help Others? by Magnus Vinding) do explore biological-genetic solutions to complement socio-economic reform and other environmental interventions. Most don’t. Indeed, a significant minority of EAs expressly urge a nonbiological focus for EA. For example, see Why I Don’t Focus On The Hedonistic Imperative by the influential EA Brian Tomasik. I can’t offer a complete explanation, but I think these facts are relevant:

1) Timescales. Lewis Mancini reckons that completion of the abolitionist project will take thousands of years. HI predicts that the world’s last unpleasant experience will occur a few centuries hence, perhaps in some obscure marine invertebrate. If, fancifully, consensus existed for a global species-project, then 100 – 150 years (?) might be a credible forecast. Alas, such a timescale is wildly unrealistic. No such consensus exists or is plausibly in prospect. For sure, ask people a question framed on the lines of “Do you agree with Gautama Buddha, ‘May all that have life be delivered from suffering’?” and assent might be quite high. Some kind of quantified, cross-cultural study of radical Buddhist or Benthamite abolitionism would be interesting. Yet most people balk at what the scientific implementation of such a vision practically entails – if they reflect on abolitionist bioethics at all. “That’s just Brave New World” is a common response among educated Westerners to the idea of engineering “unnatural” well-being. Typically, EAs are focused on measurable results in foreseeable timeframes in areas where consensus is broad and deep, for instance the elimination of vector-borne disease. Almost everyone agrees that eliminating malaria will make the world a better place. Malaria can be eradicated this century.

2) The Hedonic Treadmill. In recent decades, popular awareness of the hedonic treadmill has grown. Sadly, most nonbiological interventions to improve well-being may not have the dramatic long-term impact we naïvely hope. However, awareness of the genetic underpinnings of the hedonic treadmill is sketchy. Knowledge of specific interventions we can plan to subvert its negative feedback mechanisms is sketchier still. Compared to more gross and visible ills, talk of “low hedonic set-points” (etc) is nebulous. Be honest, which would you personally choose if offered: a vast national lottery win (cfHow Winning The Lottery Affects Happiness) or a modestly higher hedonic set-point? Likewise, the prospect of making everyone on Earth prosperous sounds more effectively altruistic (cfCan “effective altruism” maximise the bang for each charitable buck?) than raising their hedonic defaults – even if push-button hedonic uplift were now feasible, which it isn’t, or at least not without socially unacceptable consequences.

3) The Spectre of Eugenics. Any confusion between the racial hygiene policies of the Third Reich and the project of genetically phasing out suffering in all sentient beings ought to be laughable. Nonetheless, many people recoil at the prospect of “designer babies”. Sooner or later, the ”e”-word crops up in discussions of genetic remediation and enhancement. If we assume that bioconservative attitudes to baby-making will prevail worldwide indefinitely, and the reproductive revolution extends at best only to a minority of prospective parents, then the abolitionist project will never happen. What we call the Cambrian Explosion might alternatively be classified as the Suffering Explosion. If we don’t tackle the biological-genetic roots of suffering at source – “eugenics”, if you will – then pain and suffering will proliferate until Doomsday. Without eugenics, the world’s last unpleasant experience may occur millions or even billions of years hence.

4) Core Values. Self-identified effective altruists range from ardent life loversfocused on existential risks, AGI and the hypothetical Intelligence Explosion to radical anti-natalists and negative utilitarians committed to suffering-focused ethics (cfWhat are the main differences between the anti-natalism/efilism community and the negative utilitarian/”suffering-focused ethics” wing of the effective altruism community?). There’s no inherent conflict with HI at either extreme. On the one hand, phasing out the biology of suffering can potentially minimise existential risk. Crudely, the more we love life, the more we want to preserve it. On the opposite wing of EA, radical anti-natalists oppose reproduction because they care about suffering, not because of opposition to new babies per se. Technically speaking, CRISPR babies could be little bundles of joy – as distinct from today’s tragic genetic experiments. In practice, however, life-loving EAs are suspicious of (notionally) button-pressing negative utilitarians, whereas radical anti-natalists view worldwide genetic engineering as even more improbable than their preferred option of voluntary human extinction.

5) Organisation and Leadership. Both secular and religious organizations exist whose tenets include the outright abolition of suffering. EAs can and do join such groups. However, sadly, I don’t know of a single organisation dedicated to biological-genetic solutions to the problem of suffering. Among transhumanists, for instance, radical life-extension and the prospect of posthuman superintelligence loom larger than biohappiness – though article 7 of the Transhumanist Declaration is admirably forthright: a commitment to the well-being of all sentience. Also, I think we need star power: the blessing of some charismatic billionaire or larger-than-life media celebrity. “Bill Gates says let’s use biotechnology to phase out the genetic basis of suffering” would be a breakthrough. Or even Justin Bieber.

For my part, I’m just a writer/researcher. We have our place! My guess is that this century will see more blueprints and manifestos and grandiose philosophical proposals together with concrete, incremental progress from real scientists. The genetic basis of suffering will eventually be eradicated across the tree of life, not in the name of anything “hedonistic” or gradients of intelligent bliss, and certainly not in the name of negative utilitarianism, but perhaps under the label of the World Health Organisation’s definition of health (cfConstitution of WHO: principles). Taken literally, the constitution of the WHO enshrines the most daringly ambitious vision of the future of sentience ever conceived. Lifelong good health (“complete physical, mental and social well-being”) for all sentient beings is a noble aspiration. Regardless of race or species, all of us deserve good health as so defined. A biology of information-sensitive gradients of physical, mental and social well-being (HI) is more modest and workable thanks to biotech. Optimistically, life on Earth has only a few more centuries of misery and malaise to go.

Mental Health as an EA Cause: Key Questions

Michale Johnosn and I will be hanging out at the EA Global (SF) 2017 conference this weekend representing the Qualia Research Institute. If you see us and want to chat, please feel free to approach us. This is what we look like:

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At EAGlobal 2016 at Berkeley

I will be handing out the following flyer:


Mental Health as an EA Cause Area: Key Questions

  1. What makes a state of consciousness feel good or bad?
  2. What percentage of worldwide suffering is directly caused by mental illness and/or the hedonic treadmill rather than by external circumstances?
  3. Is there a way to “sabotage the hedonic treadmill”?
  4. Can benevolent and intelligent sentient beings be fully animated by gradients of bliss (offloading nociception to insentient mechanism)?
  5. Can we uproot the fundamental causes of suffering by tweaking our brain structure without compromising our critical thinking?
  6. Can consciousness technologies play a part in making the world a high-trust super-organism?

symmetries

Wallpaper symmetry chart with 5 different notations (slightly different diagram in handout)

If these questions intrigue you, you are likely to find the following readings valuable:

  1. Principia Qualia
  2. Qualia Computing So Far
  3. Quantifying Bliss: Talk Summary
  4. The Tyranny of the Intentional Object
  5. Algorithmic Reduction of Psychedelic States
  6. How to secretly communicate with people on LSD
  7. ELI5 “The Hyperbolic Geometry of DMT Experiences”
  8. Peaceful Qualia: The Manhattan Project of Consciousness
  9. Symmetry Theory of Valence “Explain Like I’m 5” edition
  10. Generalized Wada Test and the Total Order of Consciousness
  11. Wireheading Done Right: Stay Positive Without Going Insane
  12. Why we seek out pleasure: the Symmetry Theory of Homeostatic Regulation
  13. The Hyperbolic Geometry of DMT Experiences: Symmetries, Sheets, and Saddled Scenes

Who we are:
Qualia Research Institute (Michael Johnson & Andrés Gómez Emilsson)
Qualia Computing (this website; Andrés Gómez Emilsson)
Open Theory (Michael Johnson)

Printable version:

mental_health_as_ea_cause