“How much should we value averting a Day Lived in Extreme Suffering (DLES)?” by Alfredo Parra 🔸

Warning: Discussions of extreme pain and suffering. In the US, one QALY is valued at around $100,000–$150,000 [1]. In the UK, a WELLBY is valued at £13,000 [2]. Such thresholds help governments and philanthropists decide whether interventions are cost-effective and worth implementing. However, these metrics (plus the DALY) are largely insensitive to instances of extreme suffering (at least in their current form), so if we want to perform cost-effectiveness analyses of interventions aimed at reducing extreme suffering, we need either to supplement these metrics or introduce new ones. This post explores some considerations relevant to deciding how much we should value averting instances of extreme suffering. In particular, we’re interested in strategies to estimate the dollar value of averting a “Day Lived in Extreme Suffering” (DLES), defined as a day spent in “the most urgent suffering at the level of approximately 9/10 and above.” [3] However, I won’t attempt [...] ---Outline:(02:31) Reasoning about a Day Lived in Extreme Suffering(06:23) Extreme psychological suffering(09:44) Improving existing metrics vs developing new metrics(12:07) Challenges in quantifying extreme suffering(20:34) Potential approaches(20:48) Governmental approaches(21:23) 1. Willingness-to-pay methods(24:22) 2. Precedent methods(25:51) 3. Opportunity cost methods(26:55) 4. GDP-based methods(27:33) Multi-criteria decision analysis (MCDA)(30:23) Philanthropic approaches(31:51) Discussion(34:19) Conclusion(35:15) References--- First published: July 26th, 2025 Source: https://forum.effectivealtruism.org/posts/z4Hb8tZsuRCXmy3mM/how-much-should-we-value-averting-a-day-lived-in-extreme --- Narrated by TYPE III AUDIO.