Life, the Universe, and Everything

What We Owe the Future

Posted by Peter on September 23, 2022
Posted in: Artificial Intelligence, Book Reviews, Life, the Universe, and Everything. Tagged: , . Leave a Comment

Book review: What We Owe the Future, by William MacAskill.

WWOTF is a mostly good book that can’t quite decide whether it’s part of an activist movement, or aimed at a small niche of philosophy.

MacAskill wants to move us closer to utilitarianism, particularly in the sense of evaluating the effects of our actions on people who live in the distant future. Future people are real, and we have some sort of obligation to them.

WWOTF describes humanity’s current behavior as reckless, like an imprudent teenager. MacAskill almost killed himself as a teen, by taking a poorly thought out risk. Humanity is taking similar thoughtless risks.

MacAskill carefully avoids endorsing the aspect of utilitarianism that says everyone must be valued equally. That saves him from a number of conclusions that make utilitarianism unpopular. E.g. it allows him to be uncertain about how much to care about animal welfare. It allows him to ignore the difficult arguments about the morally correct discount rate.

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Reward the Non-use of Medicine

Posted by Peter on April 21, 2022
Posted in: Health. 2 comments

Problem

The US, and to a lesser extent much of the developed world, has concentrated interest groups (e.g. big pharma), which have incentives to increase medical spending. The main check on pro-expense interest groups used to be patients’ desire to spend less of their money. We’ve carefully eliminated that incentive for most patients. That leaves us with a situation in which spending increases to absorb much of the increase in disposable income.

I originally started writing this post in reaction to Aduhelm’s conspicuously bloated price. But it now seems that the system has enough sanity to avoid major waste there.

I’m also interested in the situation with statins. There’s reasonably good evidence that they saves the lives of a small fraction of people who take statins, but also some reason to doubt that cholesterol best describes what problem they fix (I don’t have a good link for these doubts. Here are some mediocre ones: 1, 2, 3).

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New Dementia Trial Results

Posted by Peter on July 1, 2021
Posted in: Health. Tagged: , .

There’s a new clinical trial result showing that Bredesen’s approach is able to at least partially cure common forms of Alzheimer-like dementia. (Press release here). It has not received as much attention as it deserves.

The 9 month study seemed a bit less impressive than what I’d hoped for, but the outcomes still support the claim that common forms of dementia are partly curable.

Out of 25 patients, 21 or 19 improved their cognition compared to the start of the trial, depending on which measure I look at, and 2 or 3 declined.

Side effects included occasional improvements in hypertension and diabetes, enough to allow patients to stop taking medications for those conditions.

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Functional Medicine

Posted by Peter on March 10, 2021
Posted in: Health. Tagged: .

Mainstream medicine has become increasingly standardized over the past few decades.

Standardization has some benefits: reduced inequality, improved procedures for minimizing mistakes, and increased predictability. Those attributes are often easier to verify than health effects.

Standardization is not so great for promoting innovation (standardizing a few building blocks may promote innovation, but that’s not what medicine has done). Yet medicine is an area where we have a relatively high need for more innovation.

It would be nice if one system of medicine provided everything that I want from medicine. Just like it would be nice if one company could provide all my transportation needs, or every type of food that I want, or an operating system with all the software that I want to use.

Alas, none of those seem close to being feasible this decade. Yet I get the impression that many more people expect it of medicine than is the case for food or transportation.

I’ve reached an age when it’s valuable to ask a good deal from medicine. So in addition to a standard doctor, I’ve engaged with a competing “brand” of medicine.

Specifically, the functional medicine practitioners at Chris Kresser’s Adapt180.

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The End of Alzheimer’s Program

Posted by Peter on December 26, 2020
Posted in: Book Reviews, Health. Tagged: , .

Book review: The End of Alzheimer’s Program, by Dale Bredesen.

This sequel to The End of Alzheimer’s is an attempt at a complete guide to a healthy lifestyle.

Alas, science is still too primitive to enable an impressive version of that. So what we end up with is this guide that would overwhelm anyone who tries to follow it thoroughly, while still lacking the kind of evidence that would convince a skeptic.

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I Lose My COVID Bet

Posted by Peter on December 20, 2020
Posted in: Health, U.S. Politics. Tagged: .

Last month, I conceded defeat in my bet (with Robin Hanson) that US COVID-19 deaths would be less than 250,000.

My biggest mistake was thinking voters would care about results, and unite against a common enemy as they did in WWII. I should have been more aware of the tendency to treat natural deaths as more acceptable than deaths due to a hostile agent. Robin clearly did better at evaluating this.

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The Precipice

Posted by Peter on November 3, 2020
Posted in: Artificial Intelligence, Book Reviews, Life, the Universe, and Everything. Tagged: , .

Book review: The Precipice, by Toby Ord.

No, this isn’t about elections. This is about risks of much bigger disasters. It includes the risks of pandemics, but not the kind that are as survivable as COVID-19.

The ideas in this book have mostly been covered before, e.g. in Global Catastrophic Risks (Bostrom and Cirkovic, editors). Ord packages the ideas in a more organized and readable form than prior discussions.

See the Slate Star Codex review of The Precipice for an eloquent summary of the book’s main ideas.

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Medical Certainty and Prestige

Posted by Peter on October 30, 2020
Posted in: Health, U.S. Politics. Tagged: , .

From The problem with rapid Covid testing, Mayank Gupta writes:

The absolute number of false positives would rise dramatically under slightly inaccurate, broad surveillance testing. At least initially, the number of people going to the doctor to ask what to do would also rise. One can imagine if doctors truly flubbed and didn’t know how to advise patients accurately, a lot of individual patients would lose trust in the medical system (testing, doctors, or both). The consequence of this would be more resistance to health public policy measures in the future.

For a reminder of why rapid testing is valuable, see Alex Tabarrok. Note also the evidence from the NBA that people who need useful tests can be more innovative than the medical system.

This seems like the tip of an important iceberg.

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