What's The Point?

Macaskill points out people often decide how they make an impact "based on assumptions and emotions rather than facts." Macaskill encourages people to apply utilitarian thinking to make a positive social impact. He discusses how people can apply social impact oriented utilitarianism to the charities they donate to, causes they support, the consumption choices they make, and the careers they choose.

Bullet Summary

• Introduction - Macaskill tells a story about PlayPumps, a non-profit trying to supply families in developing countries with water. PlayPumps installed merry go rounds that children could play on. The contraptions would pump water from the ground, instead of a parent having to go to wells to do so. However, the PlayPump proved less efficient than a parent going to a well, and it made children responsible for labor in some communities. Additionally, the contraptions were not safe. Many users got physically impaired by the merry go rounds. After funding on the order of millions, from the Clintons, Bushes, and Case Foundation, the project's net-negative impact was exposed, demonstrating how people should back good intentions with objective data-driven execution. Macaskill also tells the story of the Deworm the World Initiative. Kremer, one of its founders, wanted to use a science concept, "randomized controlled trials" to see if giving out books, uniforms, and teaching supplies to schools in developing neighborhoods would make a difference in student attendance and test scores. It turned out this intervention showed no evidence that it made a significant difference between the schools that did receive the support and those that didn't. However, they started searching for alternative solutions. They tried increasing the number of teachers and a few other techniques but none of them had shown any difference in the statistics they were tracking. At one point they tried deworming. It turns out that many students do not attend school in developing countries because they are sick from intestinal worms; they are not deadly, but deworming someone sick with them significantly improves the quality of life and decreases the pain they live with. Deworming proved super effective in randomized control trial experiments, and 20 years after these experiments those who got dewormed worked 3.4 hours longer and had 20% extra income than those who did not. Using these two stories, Macaskill sets the stage for his case on effective altruism, doing good with a utilitarian approach. The goal of effective altruism is to make the largest imporvement in an objective measure of the quality of life for the greatest number of people.
• Chapter 1 - Macaskill points out that anyone reading his book probably is in the 1% income bracket of the world population. He does this by showing how the U.S. poverty line of $28,000 is already in the top 5% income bracket. He says that he has adjusted for inflation, and that basic needs are not cheaper in other countries where they seem to be; they are just lower quality. He then uses these statistics to point out how those in the top 1% have a "tremendous opportunity" to help the bottom 50%. A dollar for someone in the bottom 50% can provide 100x more value relative to the quality of life they currently have than someone in the top 5%.
• Chapter 2 (How many people benefit, by how much?) - Macaskill spotlights a doctor who chose to help out during the heat of the Rwandan genocide. The doctor had to choose amongst helping people immediately dying, in pain, or irretrievable. He chose to focus on people immediately dying, followed by in pain, and then lastly those that seemed irretrievable. Macaskill discusses how making rational choices on who to help must have emotionally challenged the doctor, but might have been the most effective way to help in his situation and certainly did more than nothing at all. Macaskill argues that people in everyday situations have such choices to make, especially in how they commit their time and money. They can choose to help out in a variety of ways, and they should attempt to choose the most efective ones. He then introduces a unit of measure (quality-adjusted life year (QALY) - 1 QALY equivalent to a person having perfect health for 1 year). He offers this metric as a way in which people should evaluate the effectiveness of an action with the aim of social impact. The goal of actions should be to maximize QALYs, either by extending life or making life more livable. He uses this evaluative standard throughout the rest of the book. He encourages us not to let emotions drive our decisions in the causes we choose to support but rather rationality. He suggests that just because a connection supports a cause or struggles with the focus of a cause does not mean support of this cause is the most effective way to give. Instead, people should strive to give in the most effective (QALY maximizing) ways possible.
• Chapter 3 (Is this the most effective thing you can do?) - Macaskill debunks views of foreign aid skeptics, as the overall spending of countries overshadows the amount of spent on aid, and the quality of life of the bottom 50% have dramatically increased despite the relatively weak economies in which they live. He admits that this improvement doesn't imply foreign aid caused it, but then he shows examples of where it has. One example is the smallpox vaccine, saving 60 million to 120 million lives since 1973 (saving 5 times as many lives as world peace would have done). The vaccine allows Macaskill to prove that saving a life through foreign aid is done for 1/150th the cost, at worst, the United States spends on its own citizens. Macaskill goes on to discuss again the tail distributed nature of income. He then describes how much impact a sum of money has depending on the initiative supported by the money. Eg. deworming is 695x more effective on the QALY measure than cash transfers to girls. Mosquito bed nets are 500x more effective on the QALY measure that a surgery, Kaposi's sarcoma. He uses these statistics to show how we can save lives, just by carefully investing money in the correct charities and causes. We don't need to do heroic acts, like running into a burning building to save a child, to save lives.
• Chapter 4 (Is this area neglected?) - Macaskill argues that ethical career paths, emblazoned by culture and media, are not necessarily the most effective career paths. For example, being a doctor alone does not guarantee that a person makes the biggest difference they can. He asks us to think about the question "is this area neglected?" For example, donating to disaster relief charity may not be the most effective (Macaskill defines effectiveness in utilitarian terms, what gives people the most QALYs) donation, if the charity focuses on widely covered disasters that already have a large humanitarian effort behind it. He encourages the reader to think of how many more people die from health diseases than natural disasters. Going back to being a doctor, practicing the work of a doctor in the United States, where there already exists a large healthcare infrastructure, has a far lower impact than doing the same work in a developing country, where people struggle with a scarcity of healthcare.
• Chapter 5 (What would have happened otherwise) - Macaskill discusses how people should choose causes and initiatives to support, by asking what would happen if these causes or initiatives did not exist. He gives an example through the smallpox vaccine. The person who received most of the credit for the vaccine, rode the research of a scientist in the Soviet Union. If we look at what would have happened otherwise, the smallpox vaccine could have likely been eradicated without D. A. Henderson, the person who received credit for its eradication, getting involved. Macaskill then writes about a television program, Scared Straight, that takes delinquents to see life in jail to scare them from ever going to jail. It turns out evidence exists that this program has an adverse impact; children on the television show might have a higher chance of ending up in jail if they take away that inmates do not live as bad a life as previously imagined. Macaskill then argues that people should not feel shameful taking up high paying jobs in favor of ethical lower paying ones, if they aim to earn to give. By earning to give and donating to the correct charities and causes, Macaskill argues that one can have a high impact in QALYs. He does not diminish the value someone can bring by taking up an ethical career.
• Chapter 6 (What are the chances of success, and how good would success be?) - Macaskill applies the math concept, expected value, to choosing how to make an impact. The expected value of a decision is the probability of each outcome given a decision times the value of that outcome added together. Let us apply the concept to voting in a swing state. A person has a high probability that their vote will not make a difference (let us say 0.9999). The value of such an outcome is 0. But that person has a 0.0001 probability that their vote will tip the election. The value of that can be 1 million QALYs, esp. if the vote reflects a decision a powerful position, like the president of the United States. So even though voting does not likely make a difference; in terms of expected value, it creates (0.0001 * 1,00,000 + 0.9999 * 0) = 100 QALYs, which means it still has a significant difference. Macaskill argues that we should think in terms of maximizing expected value when making decisions. Macaskill applies this idea to someone considering a career in politics. Statistics show that the chance the person he considers in this example can get a high ranking position in politics is low, although not so low relatively, but the financial influence she gains by getting such a job overrides this low probability. He applies this reasoning to thinking about whether or not to prioritize solving climate change; there exists a small percentage, less than 3 (likely smaller since the writing of this book) percent, of the scientific community who do not believe human intervention is the primary cause of climate change. But the fact that there exists a high probability that it is, and that there could be a drastic decrease in QALYs for future generations, even if the probability that this descrease happens is small, demonstrates that people should care about it, if they want to maximize expected value. He uses this reasoning to explain why people should think about mitigating expected disasters (eg. nuclear apocalypse and Artificial Intelligence takeover), even if they believe that such disasters most likely would not happen.
• Chapter 7 (What charities make the most difference?) - Macaskill goes through an example of choosing to donate amongst multiple charities. One charity gives book to school children in Africa, another promotes health awareness through media in developing countries, and another creates the infrastructure to make cash transfers to the "poorest of people in Kenya and Uganda" who can then use the money however they want. First, he recommends looking at the charities' financial information; the breakdown of what percent of resources get spent on administrative overhead versus their programs can help identify how efficient a charity is. The cash transfer charity does not rate so well on this metric. He next looks at the evidence behind of the programs' goals. It turns out that giving books to children in developing countries has little evidence of success without teacher training, making this charity look the least effective. He also reviews how well each charity implements their programs. He also checks whether or not the charity needs more money. This goes back to the disaster relief discussion. If many already donate to help recovery from a widely publicized natural disaster, donations might go further elsewhere. For example, the health awareness promoting charity Macaskill discusses at the beginning of this Chapter will not need to spend money beyond a threshold; they were ranked highly in a charity evaluation website in an annual review and raised far above that threshold and thus the charity evaluation website did not recommend donations to them the next year. The rest of the chapter, Macaskill talks about charities to donate to; the list has become outdated, but this website —https://www.givewell.org/charities/top-charities — offers an up to date one which he would support.
• Chapter 8 (How can consumers make the most difference?) - Macaskill discusses ethical consumerism. He first focuses on sweatshops. He argues that we choose non-sweatshop clothing with the "noblest of intentions"; however, working in sweatshops with relatively (compared to developed neighborhoods) low income labor does not necessarily harm the people who work there. "In developing countries, sweatshop jobs are the good jobs." When people in developed countries "boycott" sweatshop made goods, they make the people in these jobs lose them. In fact, people in these jobs move to less regulated, unregistered operations that have far worse conditions than a job in a factory for a transnational corporation. Macaskill moves on to another form of ethical consumerism, fair trade. Most fair trade goods come from wealthier countries (eg. Costa Rica and Mexico rather than a country like Ehiopia), as meeting requirements for fair trade certification has high costs. Additionally, little of the extra money from higher prices for fair trade goods actually reaches workers; middlemen take most profits. Macaskill then shifts to green living. He talks about how, even if a person choses to turn off their lights, put devices on stand by, and use less plastic bags, the impact of these decisions on their carbon footprint is minor compared to choosing not to drive, lessening the use of an AC or heater, and taking less flights and warm showers. He also points out that most of the carbon footprint of consumption depends on the type of good rather than its shipping. For example, a person makes a much better choice for the environment by not consuming red meat and dairy than choosing local over international produce. Macaskill claims that carbon offsets offer one of the most effective ways to reduce footprint. He concedes to an argument saying that carbon offseting programs do not always prove effective; however, he points out that effective charities do exist, and donating to them gives people a chance to dramatically reduce or even make their footprint carbon negative. Additionally, with the logic of expected value, carbon offsets make even more sense. He also briefly discusses vegetarianism. He admits vegetarianism is effective, discounting carbon offsets, but with carbon offsets, the environmental argument may be weak as offsets do so much more. However, Macaskill believes in terms of animal suffering (if a person cares about animal QALYs, even at a fractional value of human QALYs), the argument for vegetarianism still works, because the way farmers mass produce some livestock forces the livestock to go through painful conditions.
• Chapter 9 (Which careers make the most difference?) Macaskill goes through different ways people can make maximize the impact they make with their career. Macaskill has cofounded a non-profit, 80,000 hours to help people choose work that makes the greatest impact. Macaskill develops a framework which he recommends people use to choose work. The first part of that framework is personal fit. Personal fit does not mean follow your passion. Follow your passion can be bad advice, because a) what most people are passionate about (eg. sports and games) are highly competitive job fields with low impact b) people's interests change over time, and c) the best predictors of job satisfaction have to do with certain characteristics of work. These characteristics include "independence," "sense of completion/ownership," "variety" in work, "feedback," and "contribution" (or impact on other people). Other factors that matter include a sense of achievement, support from peers, and logistical matters like not having a long commute. Macaskill urges people to search outwards, by gathering information through interviews, content, and simulations (tests or short stints). People should try to reduce the uncertainty in this search, asking themselves "what is the most important piece of information for a career decision and what they can do to get that information." Macaskill claims that a sizable group of people feel passionate about their jobs because they believe certain life events related to their job will make them happy. Events that people believe will make them happy do not always do so; for example, professors with tenure report less happiness than they predicted they would have prior to tenure. The next part of Macaskill's framework for choosing a job focuses on how much impact a job makes. He admits that the social sector offers obvious ways to make an impact, but these opportunities shoul get the same treatement of caution as other options as not all charities (eg. PlayPumps) and socially oriented projects (eg. Scared Straight) result in a positive difference. He also mentions, even if a person goes into social work, they need to bring valuable skills and resources to the table. Macaskill argues that it is more important to build these skills and make connections at the beginning of a career than it is to directly make an impact, as it makes one more capable of impact in the future. This brings the reader to the next aspect one should look for in a job, impact later in life. Choosing careers that offer credentials, connections, and learning opportunities early in life benefit impact later in life. For example, going through what it takes to get a PhD gives people the chance to apply many rigorously tested skills later. Or getting a job at McKinsey or Google offers credentials that allow people to more easily get their foot into doorsteps or high impact careers later. He also encourages exploration early in life, as it allows people have more information to identify how they can make the most impact later in life. He states that people should think about their careers like entrepreneurs and scientists, making hypotheses and consistently shift their goals based on the results of experiments (eg. their jobs or information from interviews with people in the jobs they consider), rather than seeing career goals as a rigid plan. Macaskill also addresses earning to give. He says that earning to give can make a significant impact, but the caveat is figuring out how to get into a high paying job. High paying jobs include finance and doctors, but those careers are highly competitive and challenging. He also recommends software engineering, sales and marketing, and accounting as lower barrier to entry work. He concedes to a counter argument to this approach that a person can risk losing their values in some jobs in these fields. However, he states there exist ways to keep in touch with values while working in such jobs - he recommends joining the effective altruism community and pubically stating one's will to donate. He also discusses jobs with low probability of success, but high possibility of breakout impact if success happens. These careers include entrepreneurship, research, and politics and advocacy (eg. journalism). With entrepreneurship, he encourages us to first understand why the problem hasn't been solved. If society has not solved just because it is a difficult problem, it might not offer the most effective work a person can do. In some cases, a void exists as the market, state, and/or philanthropy would not address it with the objectives they have, the people they addrress, and way they operate. Macaskill also recommends for profit entrepreneurship as a way to earn to give. Moving onto research, Macaskill advises that people think more about impact than usual, as academic research often focuses on theoretically interesting problems rather than socially important ones. Additionally, achievements in research only come from a few, so when pursuing a PhD, people should feel like they excel or have the ability to excel in the field they choose. He also recommends combining fields while in research as a way to have more transferrable skills to the world outside of research later in a career. Macaskill sees politics and advocacy as amongst careers that have the highest impact, but he also sees them as amongst the most difficult, because they follow a "winner takes all" system, where only the elected and a few thought leaders command most of the attention. Thus, Macaskill believes people should only go into politics and advocacy if they feel like they have an unusually good chance of success. Macaskill briefly writes about volunteering as well. Traditional volunteering usually costs more for the non-profit organization, but benefits the volunteer by reaffirming and defining values for them. Thus, it may help in allowing people to have an impact later in life, but a person should not choose to volunteer with the objective of helping out an organization short term. He briefly discusses late career moves, suggesting if a person has built up many skills throughout their career they should apply their skills directly for a social cause; otherwise, earning to give presents a high impact alternative.
• Chapter 10 (What causes are most important?) Macaskill shows how many people see climate change as the most important cause of our time. Then, he segways into how people should prioritize causes. He develops a framework where people should assess a cause by the scale of its impact (long and short term), solvability, neglectedness, and personal fit (can a person bring insights, connections, skills, and experience to the table). Thinking about scale keeps people from choosing problems to solve that only "persist in the short term," and focues their attention on areas that have many opportunities. People should consider solvability because jumping into an intractable area especially without the right expertise (eg. doing cancer research) could end up offering little value, as there might be little that can be done to solve the problem. Looking at neglectedness allows people to consider an area that might not have been addressed otherwise. Better personal fit makes a person more capable of having an impact in the area they choose. Macaskill then goes through a list of causes using this framework, but the information about these causes may be outdated and contain value judgements. Updated information based on Macaskill's views can be found at: https://80000hours.org/problem-profiles/
• Conclusion - Macaskill encourages people to earn to give, join the Effective Altruism community, and tell others about effective altruism. He also encourages the reader to incorporate effective altruism into their life by writing down how they will get information to make the next steps in their career, to whom and when they will start giving, and how they will change what they buy.

Notable Quotes

"Sometimes we look at the size of the problems in the world and think, 'Anything I do would be just a drop in the bucket. So why bother?' But in light of the research shown in these graphs [graphs about the tail distributed nature of income], that reasoning doesn't make any sense. It's the size of the drop that matters, not the size of the bucket, and if we choose, we can create an enormous drop"

"Donating to a charity is not nearly as glamorous as kicking down the door of a burning building, but...Through the simple act of donating to the most effective charities, we have the power to save dozens of lives. That's pretty amazing."

"By the time Henderson was hired, the political will to eradicate smallpox already existed...This isn't to say he didn't rise to the challenge or that he wasn't a hero, but if he had never existed, someone else would have been in his shoes and eradicated smallpox eventually"