On Thursday, I will donate one of my kidneys to someone I’ve never met. Most people think this sounds like an over-the-top personal sacrifice. But the procedure is safe and relatively painless. I will spend three days in the hospital and return to work within a month. I am 21, but even for someone decades older, the risk of death during surgery is about 1 in 3,000. My remaining kidney will grow to take up the slack of the one that has been removed, so I’ll be able do everything I can do now. And I’ll have given someone, on average, 10 more years of life, years free of the painful and debilitating burden of dialysis.
To be sure, even if the numbers didn't fall the way I'm about to present them, I wouldn't be donating one of my kidneys. Though I make more of an effort than most people to think rationally about such matters, I have such a strong instinctive repulsion to the idea of having one of my kidneys taken out that I would always find some rationalisation to avoid undergoing that operation.
But two statistics presented by Berger in the excerpt above are not impressive to me. He sacrificed a month of work for giving an expectation of 10 years of life. Now, GiveWell's top-rated charity is currently the Against Malaria Foundation, and GiveWell estimates that a statistical life is saved for every $2000 or so donated to AMF. The lives saved are mostly those of children under five, and the life expectancy in the countries where AMF's bednets are distributed is typically in the low 50's.
If we value the lives of Malawians as much as those of Americans or Australians, or even if we discount the former by a factor of (say) 4, then we can do more good with the month's salary than with the donated kidney.
Of course, if in your job you accumulate four weeks' leave a year, then you could time the kidney operation so that you don't forego any salary. But we see from the above reasoning that a failure to donate a kidney is as morally bad as the failure to donate an extra thousand or so dollars to AMF. And furthermore, you can only donate a kidney once! A kidney donation is only a small part of the high-impact giving opportunities I will have in my lifetime, and selfishly keeping my two kidneys is about as selfish as my subscription to a bunch of TV sports channels. My conscience isn't complaining about the cricket that's on in the background as I type this, and so it's also not complaining that I still have two kidneys.
