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Author Topic: Doctor and nurse build custom dialysis machine to save a baby girl
kmbboots
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And the hours you are spending not helping Africans? Honestly, KoM, is this really an issue for you or are you just being a jerk? If the former, go do something useful. If the latter, go do something useful anyway.
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ClaudiaTherese
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And we come back around full circle, to the perennially unanswered question:

So what have you done to save the world, King of Man? Or is this just about internet points, sturm and drang and easy-to-say-but-not-gonna-do-it-myself, no, you go and do it?

---

Edited to add: Uh, what kmboots said. [Smile]

Look, I don't think one has to be perfect before entering criticism of or input to the broader world. I do think there is just as much hypocrisy in adopting an air of self-serving sanctimoniousness when criticizing (but not doing, or not doing much) as there is in doing a little (but not all possible effort). Well, more, actually, come to think of it.

PS: Would be delighted to learn that you are an African neonatologist, BTW. Have no objection to eating crow because you are speaking from a position of solid and evidenced commitment to those principles advocated, yourself.

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fugu13
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The city with the highest dirtiness is not necessarily the city where a trash collector's time will result in the largest marginal decrease in dirtiness. You aren't using marginal arguments correctly.

edit: also, a doctor treating patients where he is doesn't require he values those patients more than those elsewhere who might have a larger marginal benefit. He might have other reasons for remaining in one location, and given residence in a particular location, the highest marginal benefit for others is almost certainly going to be to treat people in that location.

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ClaudiaTherese
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For the record, just to be clear: I do think we ought to be talking more about global inequalities and human tragedies in places less visible to us. Thinking, talking, and doing. That can be done without sanctimony.
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Dagonee
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quote:
That can be done without sanctimony.
But where's the fun in that?
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Puffy Treat
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My problem is, saying a doctor did a good thing by helping save the life of a little girl who would have died otherwise is a completely different thing from saying: "I don't care about poor people in Africa. They can just be sick and die!"

Why keep trying to force a connection between those two things? It's nonsensical, and distracts me from any valid point that can be made regarding what personal resources one can and should send towards those in need world-wide.

It's not a valid discussion technique, it's shock jock tactics.

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King of Men
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quote:
Originally posted by fugu13:
The city with the highest dirtiness is not necessarily the city where a trash collector's time will result in the largest marginal decrease in dirtiness. You aren't using marginal arguments correctly.

Substitute "where the trash collector will do the most good", by all means. That's what I was using 'dirtiest' as shorthand for.

quote:
edit: also, a doctor treating patients where he is doesn't require he values those patients more than those elsewhere who might have a larger marginal benefit. He might have other reasons for remaining in one location, and given residence in a particular location, the highest marginal benefit for others is almost certainly going to be to treat people in that location.
Which is indeed what I'm saying. As a society, we just don't care about those outside our own continent to anywhere near the extent we say we do. What reason do you suppose this doctor would like to give for not moving, if you showed him pictures of a child with worms in her eyes? I would bet a reasonable sum he would not defend the decision from first moral principles. But if you asked him why he became a doctor, he would be very likely to say something on the order of "helping others" or "making sick children better". So, why this child and not those children?

quote:
And the hours you are spending not helping Africans?
Tu quoque is not an argument, it is a way to not think about the problem. Let me be clear: I don't actually give a damn about any Africans. But you do. Or at least, you say you do.
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katharina
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All horse and no cattle, then.
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Dagonee
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So KoM is taking others to task because they don't interpret a moral precept he doesn't hold in the way he would interpret it if he did hold it.

This makes sense why, exactly?

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King of Men
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quote:
My problem is, saying a doctor did a good thing by helping save the life of a little girl who would have died otherwise is a completely different thing from saying: "I don't care about poor people in Africa. They can just be sick and die!"
It is not different. It is precisely the same. Actions have consequences. This particular act has the consequence of saving one life; that is good. Notwithstanding that good thing, it is nevertheless true that it also has the consequence of not helping any number of other children, whose need is just as great and easier to meet. If you help the one, you cannot help the others. This is just a fact of physics. It is good to keep your eye on all the consequences of your acts, even the ones you don't like. How else are you going to know what actions to take?
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ClaudiaTherese
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quote:
Originally posted by King of Men:
Let me be clear: I don't actually give a damn about any Africans. But you do. Or at least, you say you do.

Where?

Specifically, where are people claiming this while also claiming that there are no other competing and valid claims of obligation in the world?

I think you came into this farm looking for a fight, and you yourself are the one that raised up a strawman for fisticuffs. [Confused]

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Puffy Treat
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So, it was just another bout of pointless trolling, Gotcha.
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kmbboots
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Ah...so the latter, then. I was afraid of that. I don't know why I keep hoping for some substance from you, KoM.
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fugu13
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Not only that, but even were there someone who wanted to do the most good, it isn't at all clear Africa would be the place. If we only looked at immediate improvement in health, yes, but there are significant complicating factors. Even significant work to treat specific diseases in Africa wouldn't necessarily reduce the child mortality rate very much, so it isn't at all clear there's the highest marginal benefit to treating African children.

This is before we even get into the other things people could be doing.

But yes, where has someone said they view their obligations to African children exactly as highly as their obligations to everything else in the world (not just other children)? More specifically, where has the doctor in the article said anything of the like?

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ClaudiaTherese
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quote:
Originally posted by King of Men:
Notwithstanding that good thing, it is nevertheless true that it also has the consequence of not helping any number of other children, whose need is just as great and easier to meet.

I wouldn't argue with the broad point here, although I don't think it is the same argument that has been made throughout.

But "easier to meet?" Have you ever tried to go on a medical mission to Africa? I have helped coordinate these. The last one my group went on, the planning fell through on the Ugandan end, there was political fallout, and they were shuttled to a school to teach, not see patients. This after all of the prophylaxis and shots, and all that entails, and thousands of dollars out of pocket for each ticket, and updated passports, and 3 people back home to field paperwork and political issues that arose ... a dialysis unit in someone's garage from scraps? Not so much a problem.

Doing medicine in Africa as an outsider is not straightforward, open arms, just get here and we will find a use for you. It's paperwork and hoops and power plays and restricted access and a lot of hassle. It is getting affiliated with the local medical schools and bringing the right gifts. Worth doing, but not at all what it seems to me you are implying.

---------------------------------

PS: And getting licensed to practice long term in another country, other than the one you trained in? Trust me, not easy. There is politics and turf protection everywhere, and need does not change that. Not when it is an issue of positions of power.

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King of Men
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quote:
But "easier to meet?" Have you ever tried to go on a medical mission to Africa? I have helped coordinate these.
Ok, this is a reasonable objection. If the benefit per unit cost isn't really greater, that's something else again. Let's say "would be easier to meet in the absence of artificial barriers". But I note that several people here (kq, for example) have objected to making this kind of calculation even in principle.

I have no beef with anyone who is willing to straightforwardly admit "I value African children less than Western children". I do that, too. But again: Several of the objections raised in this thread have been to the idea that such a valuation exists; for example:

quote:
(Synesthesia)I don't see why you can't do both. Help kids in Africa and help kids here.
quote:
(Squicky)You seem to be presenting these as if they are mutually exclusive things.
quote:
(kq)But the concept of triage doesn't apply when resources ARE available to save a patient immediately available vs. putting the same time, talent, and money toward people on another continent.

(...)

KOM, just because people need doctors in Africa does not mean people in wealthier countries don't need them, too. If all the doctors went to Africa to give vaccinations and treat parasites, malaria, and AIDS, there would be too many doctors in Africa and not enough elsewhere (and I should add that there are shortages of doctors in some specialties in parts of the developed world already.)

(...)

And that's the rub, KOM-- I don't think that such a comparison should (or possibly can ethically) be made.

quote:
(Mrs M)Every NICU in the US needs every single neonatologist it has, if not more.

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ClaudiaTherese
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quote:
Originally posted by fugu13:
Not only that, but even were there someone who wanted to do the most good, it isn't at all clear Africa would be the place. If we only looked at immediate improvement in health, yes, but there are significant complicating factors.

Not always even this. For Canadian physicians, bang-for-the-buck medicine is treating Native populations far north without access, not Africans. No licensing issues, no passport concerns, no additional vaccinations, infrastructure in place, heavy infant mortality and shortened lifespans. Close to home work wins there, and not enough is being done.

Bang-for-the-buck overall in the world isn't medicine at all, but sanitation (as noted above). Clean water is the foremost problem.

Theory is simple and streamlined and aesthecially satisfying. Practice is warty and bumpy and not nearly as much fun as ascetic contemplation. Often that is why we who are further removed do not understand why the solutions that look so simple to us are not being put in place by others.

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ClaudiaTherese
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quote:
Originally posted by King of Men:
Let's say "would be easier to meet in the absence of artificial barriers"

Yeah. Shame that there is no accessible world without those sorts of barriers. The world of imagination is much more clean and asthetically pleasing, and it would be nice if we could all live there instead.
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kmbboots
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quote:
Originally posted by King of Men:
I have no beef with anyone who is willing to straightforwardly admit "I value African children less than Western children".

But it isn't just the children in the balances. You are making it sound like there are no factors involved in the decision other than the ethnicity of the children. A doctor isn't just a doctor. He or she is also a person with their own aspirations, family obligations, home, life, interests, friends. Also, practicing medicine in Africa is not without actual danger. You also need to weigh all that in the scale.

You might say with somewhat more validity, that people value the lives of western children and their own lives, family, friends, and so forth, more than African children.

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King of Men
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Those are all costs to the doctor of moving to Africa. They can reasonably go into a cost/benefit calculation. They do not affect the quesiton of whether such a calculation can be or should be made. And again, this is also a decision we make as taxpayers and voters, when we do not pay for high stipends for charity work in other continents, and do not impose effective sanctions on corrupt regimes.
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fugu13
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Yes, we make such decisions, based on what little, imperfect, intuitive evidence we can scrape tother. You seem to be asserting that you do not because you do not value the lives of African children, but that is a decision in itself.
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kmbboots
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KoM,

Right. And that is different than "You value Western children more than African children."

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King of Men
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Well, yes, I'm also making the assertion that even after all these factors have been accounted for, nonetheless there would be a greater benefit per cost in sending resources to Africa. If you don't like doctors, how about poodle stylists?
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Threads
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quote:
Originally posted by King of Men:
It is good to keep your eye on all the consequences of your acts, even the ones you don't like. How else are you going to know what actions to take?

This is a strawman. Who here is arguing that we shouldn't look at the consequences of our actions?

quote:
Originally posted by King of Men:
quote:
A basic epistemological precept that you should have learned in undergrad is "Absence of evidence is not evidence of absence."
I'm glad I went to a good university, then, because absence of evidence is evidence of absence. In some cases not bery strong evidence, but evidence nonetheless.
This isn't true at all unless you are using an odd definition of evidence. Using a Bayesian definition, something can be considered evidence if it causes the posterior probability of an event to change from the prior probability.

quote:
Originally posted by King of Men:
I have no beef with anyone who is willing to straightforwardly admit "I value African children less than Western children".

I think kmbboots hit the nail on the head with her response. Your argument is flawed because you are only viewing the problem in one dimension. I had meant to mention this in my post last night but I kind of ran out of steam and it was late. Nobody's goal is "only" to save children so it does not follow that people are being inconsistent with their actions if they do something that saves only one children instead of two.
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MrSquicky
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quote:
Originally posted by Threads:
quote:
Originally posted by King of Men:
quote:
A basic epistemological precept that you should have learned in undergrad is "Absence of evidence is not evidence of absence."
I'm glad I went to a good university, then, because absence of evidence is evidence of absence. In some cases not bery strong evidence, but evidence nonetheless.
This isn't true at all unless you are using an odd definition of evidence. Using a Bayesian definition, something can be considered evidence if it causes the posterior probability of an event to change from the prior probability.
Which, as I noted, can be the case in a situation where there can be an expectation of observing some sign if the condition existed. However, right here we're talking about two people that we know nothing about before this article and your (KOM's) assertion that because you have no evidence that they send money to Africa, you can treat the situation as if they don't send money to Africa.

That would be foolish even without you explicitly stating that them sending money to Africa would not get them any recognition.

I've never seen an indication that you went to a good university, KOM. Maybe your conception of what constitutes good there is as shaky as your grasp of basic concepts in epistemology.

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King of Men
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quote:
This is a strawman. Who here is arguing that we shouldn't look at the consequences of our actions?
ketchupqueen, for one; see my quote of her previously.

quote:
Which, as I noted, can be the case in a situation where there can be an expectation of observing some sign if the condition existed.
But this is always the case, even though the probability may be small. Consider: There is a small, but finite, probability that the article will mention "Dr Whosis is also a contributor to charity X, and spends his free time making balloon animals for victims of left-handed drunk drivers", if those things are true. (And a smaller probability that the article will include this if they aren't true.) Therefore, the absence of this sentence is weak evidence for the absence of such activities. And this is true for any finite probability, however small. You can't ignore it just because your personal "never-happen threshold" lies around 3% or so. Events with 3% probability happen around one time in 33, in spite of the binary intuition that tells us otherwise.
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MrSquicky
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quote:
There is a small, but finite, probability that the article will mention "Dr Whosis is also a contributor to charity X, and spends his free time making balloon animals for victims of left-handed drunk drivers", if those things are true.
And that would be relevant if not for another epistemological error you are making.

There is a finite probability that the article will mention that the people involved do not do these things that is at the very least on close order of them mentioning that they do do it.

You're making baby Francis Bacon cry.

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Threads
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quote:
Originally posted by King of Men:
quote:
Which, as I noted, can be the case in a situation where there can be an expectation of observing some sign if the condition existed.
But this is always the case, even though the probability may be small. Consider: There is a small, but finite, probability that the article will mention "Dr Whosis is also a contributor to charity X, and spends his free time making balloon animals for victims of left-handed drunk drivers", if those things are true. (And a smaller probability that the article will include this if they aren't true.) Therefore, the absence of this sentence is weak evidence for the absence of such activities. And this is true for any finite probability, however small. You can't ignore it just because your personal "never-happen threshold" lies around 3% or so. Events with 3% probability happen around one time in 33, in spite of the binary intuition that tells us otherwise.
It depends on what you mean by "ignore". I don't see why such an omission would change the probability by an appreciable amount and therefore the slightly increased probability that the doctor does not help African kids does not noticeably change any of my judgments. Clearly you've determined that there is a large enough probability that this doctor doesn't help African kids to make a character attack on him. How do you justify that?
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fugu13
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Not only that, but the attack on his character is only valid if the doctor shares a position on equality of value that many people clearly do not.

Btw, nothing in your quotation by kq says she views all lives as exactly equal. I happen to disagree with her that a comparison can be made, and in fact she makes a comparison: in her value system, the doctors in places in the US are needed. That tells us something about her value system right there, and it doesn't look like the one you are asserting she has.

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King of Men
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quote:
Originally posted by MrSquicky:
quote:
There is a small, but finite, probability that the article will mention "Dr Whosis is also a contributor to charity X, and spends his free time making balloon animals for victims of left-handed drunk drivers", if those things are true.
And that would be relevant if not for another epistemological error you are making.

There is a finite probability that the article will mention that the people involved do not do these things that is at the very least on close order of them mentioning that they do do it.

You are mistaken. The chances of the doctor's charitable contributions being mentioned, if they exist, are at least 0.1%; journalists like that kind of thing. Who is going to write "The doctor doesn't contribute to charity" in a feel-good fluff piece? Even if it is true? I would put this probability much lower.
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MrSquicky
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Do you not understand what close order means?
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ClaudiaTherese
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Of note, most physicians I know who donate to charity do not tend to speak freely of it. Those that do charitable work outside the country do speak of it, presumably because people will notice they are gone for weeks at a time, and coverage must be arranged But pro bono work and straight donations, not so much.

Why assume the journalist would know about it, even if he or she asked? Especially given that this is an article not about charity, but about the technology?

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King of Men
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quote:
Originally posted by MrSquicky:
Do you not understand what close order means?

It means "of the same order of magnitude".
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MrSquicky
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I'm not talking about in straight mathematics. I'm talking about comparing two probabilities. Do you know what saying that they are on close order means?

---

edit: Putting it another way - and leaving aside that you're just making up numbers without any solid basis - the probabilities here can't really be expressed as any thing as clear cut as a single number. Because of the various sources of error and the large number of unaccounted variables, what we're really dealing with is two fuzzy clouds that cover pretty much the same area. Thus, in any sort of valid analysis, the probabilities can only be treated as essentially equivilent.

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King of Men
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Apparently not. Why don't you enlighten me?

Edit: I disagree. I admit to making up numbers, but I don't see how

"The probability of a charitable contribution being mentioned, given that it exists"

is anywhere near

"The probability of the nonexistence of such contributions being mentioned, given that they don't".

I put the former around 0.1%, the latter in the millionths, and the uncertainties small enough that there is no overlap.

[ August 06, 2008, 03:04 PM: Message edited by: King of Men ]

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Dan_raven
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It has been my experience that heroes and villains are treated strangely in our society.


villains are expected to eternally live down to their lowest moments. If they do not, and who can be eternally evil, we treat each moment of their greater than vileness as a sign of redemption and heroic temperament.

Heroes are expected to eternally live up to their greatest moments. If they do not, and who can be eternally perfect, we treat each moment of their less the perfection as an insult and cause to vilify the hero.

Darth Vader kills a room full of children, then goes on to a life of darkness and destruction, but the moment he tries to save the life of his grown son, all is forgiven and he goes to Jedi heaven.

Here, a team of doctors and nurses go to good lengths to save the life of one child. Yet KoM wants to deny their heroic name because they didn't give their lives to the ill in Africa.

It is only by applauding doctors and nurses who go that extra mile that we will teach the next doctors that such extra work is worth while.

KoM's criticisms will only result in doctors who say, "Why bother. Nothing is good enough."

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King of Men
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Please note that I also harshly criticize people who did give their entire time to helping the poor, such as Mother Theresa, when they don't do it the right way.
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Threads
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quote:
Originally posted by King of Men:
Apparently not. Why don't you enlighten me?

Edit: I disagree. I admit to making up numbers, but I don't see how

"The probability of a charitable contribution being mentioned, given that it exists"

is anywhere near

"The probability of the nonexistence of such contributions being mentioned, given that they don't".

I put the former around 0.1%, the latter in the millionths, and the uncertainties small enough that there is no overlap.

I think Squicky was talking about the probability of a charitable contribution being mentioned versus the probability that such a contribution would not be mentioned.
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MrSquicky
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quote:
I put the former around 0.1%, the latter in the millionths, and the uncertainties small enough that there is no overlap.
As long as you're talking about a world that doesn't actually have to correspond to reality, I'm fine with that statement.

When I do probablistic analyses, I have to deal with the real world - the rules of which make it so that there is no evidence that these people don't send money to charities in Africa, so I don't think your way of doing things will work for me. But man, that would make research so much easier.

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ketchupqueen
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quote:
He might have other reasons for remaining in one location, and given residence in a particular location, the highest marginal benefit for others is almost certainly going to be to treat people in that location.
That is exactly what I tried to say last night but much clearer. Thanks.

As for the rest of it, I tried to express several ideas, none of which I got through very clearly.

I think I'm going to bow out for right now, since it seems rather fruitless when others are expressing myself better than I could. [Wink]

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ElJay
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I would have put the period after "fruitless", myself.
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Wendybird
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Thank goodness Dr. Salk decided to stay here in rich America spending all those resources developing the vaccine for polio and pioneering the science of vaccines so we actually have something to take to the poor African children we want to save.

Hmmm, thank goodness this British doctor spent his own time and resources coming up with a machine that could eventually be produced on a mass scale and allow doctors in every country to save the lives of babies that previously couldn't be saved - perhaps someday in Africa too.

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