EA - To WELLBY or not to WELLBY? Measuring non-health, non-pecuniary benefits using subjective wellbeing by JoelMcGuire

Link to original articleWelcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: To WELLBY or not to WELLBY? Measuring non-health, non-pecuniary benefits using subjective wellbeing, published by JoelMcGuire on August 11, 2022 on The Effective Altruism Forum. This essay was written for the Worldview Investigations category of Open Philanthropy’s Cause Exploration Prizes by staff at the Happier Lives Institute Summary Open Philanthropy recognises the need to measure benefits beyond health and income. We think that subjective wellbeing is the best tool for the task. Subjective wellbeing (SWB) is measured by asking people to rate how they think or feel about their lives. We propose the wellbeing-adjusted life year (WELLBY), the SWB equivalent of the DALY or QALY, as the obvious framework to do cost-effectiveness analyses of non-health, non-pecuniary benefits. As our previous work has shown that using WELLBYs can change funding priorities by giving more weight to improving mental health, compared to DALYs or income measures; and they may reveal different priorities in other areas too. The advantages of SWB over alternatives are fourfold. (1) SWB captures and integrates the overall benefit to the individual from all of the instrumental goods provided by an intervention. This avoids the challenging problem of assigning moral weights to different goods, makes spillover effects easier to estimate, and clarifies the importance of philosophy. (2) SWB is based on self-reports by the affected individuals whereas Q/DALYs rely on flawed predictions about how good or bad we think a malady will be for ourselves or others. (3) Using SWB will reveal previously under-captured benefits, such as it has already done for psychotherapy. (4) Measures of subjective wellbeing already exist, are easy to collect, and widely (and increasingly) used in academia and policymaking across an extensive array of circumstances and populations of interest. Furthermore, subjective wellbeing measures are reliable and valid instruments and the existing evidence supports consistent use across people. Having said that, SWB is not without its disadvantages. (1) There is little research on the comparability between SWB scales across people. (2) We don’t know where the ‘neutral point’ lies on SWB scales. (3) We’re unsure how to choose the best measure of SWB (e.g., life satisfaction or happiness) or how to convert between them. (4) There are very few cost-effectiveness analyses using WELLBYs. Fortunately, we think these issues can be resolved and we are actively working towards doing so. 1. The problem and a solution Open Philanthropy’s mission is to help others as much as possible. Its human-focused Global Health and Wellbeing grantmaking aims to save lives, improve health, and increase incomes. However, Open Philanthropy recognises that measuring changes to health or income does not capture all the benefits experienced by the recipients. So, they ask, how should they account for the effects of injustice, discrimination, empowerment, and freedom? To that list, we could also add crime, loneliness, and corruption. Whilst the standardised health metrics, QALYs and DALYs, make it easier to compare different health states in the same units, the broader challenge is to find a common currency that allows sensible trade-offs between health, wealth, and non-health, non-wealth outcomes. How could this be done? We take it that Open Philanthropy is interested in funding interventions that improve wellbeing. Therefore, reducing discrimination (or injustice, etc.) is good mostly because it increases wellbeing, any other reason is secondary. But what is ‘wellbeing’? Philosophers have three main theories: (1) positive experiences, (2) satisfied desires, and (3) a multi-item ‘objective list’ that includes ‘objective’ goods such as knowledge, achievement, and love. Conspicuously absent from this list are wealt...