Volume 7, Issue 1 Being Good In A World Of Need 1 Being Good in a World of Need: Some Empirical Worries and an Uncomfortable Philosophical Possibility LARRY S. TEMKIN Rutgers University ABSTRACT In this article, I present some worries about the possible impact of global efforts to aid the needy in some of the world's most desperate regions. Among the worries I address are possible unintended negative consequences that may occur elsewhere in a society when aid agencies hire highly qualified local people to promote their agendas; the possibility that foreign interests and priorities may have undue influence on a country's direction and priorities, negatively impacting local authority and autonomy; and the related problem of outside interventions undermining the responsiveness of local and national governments to their citizens. Another issue I discuss is the possibility that efforts to aid the needy may involve an Each-We Dilemma, in which case conflicts may arise between what is individually rational or moral, and what is collectively rational or moral. Unfortunately, it is possible that if each of us does what we have most reason to do, morally, in aiding the needy, we together will bring about an outcome which is worse, morally, in terms of its overall impact on the global needy. The article ends by briefly noting a number of claims and arguments that I made in my 2017 Uehiro Lectures regarding how good people should respond in a world of need. As I have long argued, I have no doubt that those who are well off are open to serious moral criticism if they ignore the plight of the needy. Unfortunately, however, for a host of both empirical and philosophical reasons, what one should do in light of that truth is much more complex, and murky, than most people have realized. Journal of Practical Ethics LARRY S. TEMKIN2 PART I. INTRODUCTION. For most of my life, I have been deeply concerned about the problems of the global needy, and for many years, I have published and lectured on the topic (Temkin 1999, 2004a, 2004b). Along with Peter Singer, I helped launch the University of Manchester chapter of the Effective Altruist organization, Giving What We Can and, along with Jeffrey Sachs, I helped launch the Princeton University chapter of that organization. In my lectures and writings, I have long contended that most of those in the developed world are open to serious moral criticism, when they basically ignore, as most of us do, the plight of the world's needy. I continue to think that. Nevertheless, philosophers are required to subject even their deepest and most longstanding commitments to critical scrutiny, and to follow the arguments wherever they lead. And in recent years, I have become increasingly worried about possible negative impacts of global efforts to aid the needy in some of the world's most desperate regions. In this article, I raise some of those worries. The article contains four main parts. In Part II, I address some worries about certain marketplace distortions that can arise as a result of aid efforts on behalf of the needy in some of the world's poorest countries. In particular, I note some possible unintended negative consequences that may occur elsewhere in a society when aid agencies hire highly qualified local people to promote their agendas. In Part III, I discuss the possibility that foreign interests and priorities may have undue influence on a country's direction and priorities, negatively impacting local authority and autonomy; and the related problem of outside interventions undermining the responsiveness of local and national governments to their citizens. In Part IV, I discuss the possibility that efforts to aid the needy may involve an Each-We Dilemma, in which case conflicts may arise between what is individually rational or moral, and what is collectively rational or moral. Drawing on results from my book, Rethinking the Good (2012), I argue that it is possible that if each of us does what we have most reason to do, morally, in aiding the needy, we together will bring about an outcome which is worse, morally, in terms of its overall impact on the global needy. In Part V, I respond to the view that we shouldn't provide direct aid to people in the world's poorest countries, Volume 7, Issue 1 Being Good In A World Of Need 3 because doing so contributes to poor governance within such countries. In Part VI, I end by offering a few claims that I made in my 2017 Uehiro Lectures regarding how good people should respond in a world of need. Unfortunately, in this article I must be content to merely offer those claims, without further argument. I am acutely aware that this article, which is based on the third of my three 2017 Uehiro Lectures, is only a preliminary treatment of the issues explored. Equally important, there are a host of other crucial issues related to the topic of how good people should respond in a world of need that this article doesn't even broach. But no one article can address every important issue, and I believe the issues I am addressing here are deserving of much more attention than they have typically been given, at least in the philosophical literature. I hope to give a much fuller treatment of this important topic in a book tentatively titled Being Good in a World of Need to be published as part of the Uehiro Lectures Book Series. Because this article mainly raises worries about the possible negative effects of efforts to aid the needy in some of the world's poorest countries, let me emphasize, at the outset, that I remain as committed, as ever, to the view that those of us in a position to do so-which includes almost everyone in the so-called developed world- have a strong moral imperative to find ways of effectively helping our world's worstoff members. Unfortunately, however, for a host of both empirical and philosophical reasons, it is much less clear to me now, than it once was, what we should actually do in light of that truth. PART II. MARKET PLACE DISTORTIONS. One common worry regarding global aid, concerns the possibility of corruption, and ways in which aid efforts may benefit evil agents, and give rise to perverse incentives and indirect, negative effects (Easterly 2006, Moyo 2010, Wenar 2011, Deaton 2013, and Temkin 2017b). Unfortunately, aid efforts can also give rise to indirect, negative effects when no corruption or evil actions are involved. Moreover, these negative effects are easily overlooked and difficult to quantify. I start with a point familiar to global health experts. International aid groups promote many worthy projects. They might improve the water supply, build new schools, bring electricity to villages, construct medical clinics, and so on. As a result, they may hire many local workers: managers, engineers, principals, teachers, doctors, nurses, administrative staff, drivers, road pavers, well diggers, wire stringers, and Journal of Practical Ethics LARRY S. TEMKIN4 so on. Naturally, the most effective aid groups seek to hire the best people they can for these positions. Ideally, they will hire personable people with good leadership, managerial, and communication skills, who work well with others, and are dedicated, trustworthy, hardworking, reliable, and so on. Aid groups will be in competition with each other for such people and, thanks to their donors, will be able to offer higher pay, fewer hours, and better working conditions than the local standard. Accordingly, highly qualified people from across the region will seek these jobs. As described, so far, this sounds like a win/win/win situation. Hiring such talented people will be great for the needy, the workers themselves, and the aid groups, enabling them to truthfully show their donors how they have effectively achieved their goals. Unfortunately, left out of this rosy account is what happens elsewhere in the system as a result of the successful, well-intentioned, aid efforts. In particular, one needs to worry about the indirect effects of hiring such people away from whatever jobs they might otherwise occupy (Leif Wenar also recognizes this worry, see 2011). Governments in poor countries desperately need talented engineers, accountants, lawyers, teachers, doctors, nurses, managers, and civil servants working on behalf of the general public. Unfortunately, however, most poor governments cannot match the pay scale or working conditions that many aid groups offer. This may result in an internal "brain and character drain" away from public sector jobs, which may have a significantly deleterious effect on the efficiency and success of the government, the economy, and public projects. Moreover, depending on the disparities between salaries and working conditions, one might see highly trained professionals leaving jobs that require all of their talents, for jobs for which they are overqualified. Thus, due to marketplace distortions that well-funded aid groups may inadvertently create, some outstanding teachers, engineers, accountants, lawyers, doctors, nurses, and civil servants may happily give up their posts to become administrators, clerks, drivers, or manual laborers. If that happens, the overall costs their society bears, when such people are no longer performing jobs befitting their talents, may substantially outweigh the relative gains their society gets due to their successfully fulfilling their new positions. Here is a related problem. Highly talented, hard-working people of great character will always be in demand. Such people may well get used to an aid group's pay scale and high quality working conditions. Moreover, such people may receive special training or make connections with well-placed aid officials which enable them Volume 7, Issue 1 Being Good In A World Of Need 5 to compete for comparable positions outside of their countries. So, what will happen when an aid group shuts down its local operation? Its highly talented workforce might return to the low pay and poor working conditions of their previous places of employment, where their skills might be desperately needed. Or, they might seek better prospects in the developed world where the need for their talents is much less great, but the personal rewards are far greater. There is an old question: "how do you keep people down on the farm once they have seen the lights of the big city?" There is a kernel of truth embedded in that question which underlies my worry here. No one can blame aid groups for hiring highly talented people to efficiently promote their important goals. Nor can one blame such people for bettering themselves and their families. Yet, together, these perfectly understandable and laudable goals may contribute to both internal and external "brain and character drains" that can be deeply problematic for the world's poorest countries (though, importantly, so-called brain "drains" can also have positive effects on poor countries when accompanied by remittances that overseas workers send back to their home countries). Thus, an aid group's gains, which are often readily identified and quantified, may be offset by indirect losses elsewhere in the system in ways that are easily overlooked and difficult to quantify. This can result in a distorted picture of the overall good that an aid group is doing. I am not claiming that the net effect of such tradeoffs will necessarily be negative, though in some cases it may be. But merely that the desirability of supporting an aid group must take full account of the opportunity costs of doing so, including not only where else I might spend my money, but also what else an aid group's local workers would be doing, if they weren't working for the aid group. Unfortunately, given the countless aid groups that operate in some of the world's poorest regions, the cumulative impact of the negative effects that I have been describing may be substantial. PART III. RESPONSIVENESS AND THE IMPORTANCE OF GOOD GOVERNANCE. Let me turn next to a worry raised by Angus Deaton, a leading international development expert and the 2015 Nobel Prize Winner in Economics. Deaton is deeply concerned about the world's needy, but after analyzing data about economic development in the world's poorest regions, and searching for correlations between how Journal of Practical Ethics LARRY S. TEMKIN6 much international aid a poor country receives and its level of social and economic development, Deaton has arrived at a striking conclusion: people like Peter Singer are doing more harm than good! Specifically, Deaton believes that if we genuinely want to aid the world's needy, we must find some route to do so other than by contributing to aid groups that work directly in the world's poorest regions to ameliorate their desperate conditions (see Deaton 2013, Chapter Seven). Deaton knows that his conclusion is at odds with what most people think. It is, after all, deeply counterintuitive to believe that if external funding pours into a region of great need, explicitly earmarked to address those needs, that, overall, the result should prove fruitless, at best, or harmful, at worst. Deaton also recognizes that fully explaining his findings is not easy. Still, Deaton suggests several factors that might help account for his findings and support his counterintuitive conclusion. Consider first, The Paradox of Aid: in countries where the need is greatest, aid won't help; while in countries where aid would help most, it isn't needed. If there is a kernel of truth to this Paradox, as many development economists believe, it reflects the crucial role that governments play in their countries' social and economic progress. The basic thought is that good governments find a way to take care of their people's basic needs; while poor governments are either unable, or unwilling, to do so. Even worse, poor governments tend to obstruct aid efforts, so that any gains will be short term, at best. On this view, substantial and long-lasting social and economic gains require a well-functioning government which can formulate and effectively implement plans to develop infrastructure, energy, food production, schools, the health system, etc. Aid groups, no matter how well-intentioned or wellfunded, cannot accomplish this on their own. What makes a government well-functioning? Deaton believes the key component of a well-functioning government is that it be responsive to its citizens' needs, interests, and will. With that in mind, Deaton suggests that what primarily accounts for the counterproductiveness of international aid efforts in the world's poorest regions is that they tend to undermine the governments' responsiveness to their citizens. But, to repeat, on Deaton's view, it is precisely such responsiveness that is necessary for any poor country's long-term social and economic development. The mechanisms by which international aid may undermine governments' reVolume 7, Issue 1 Being Good In A World Of Need 7 sponsiveness to their people include the following. First, corrupt governments may find ways of capturing aid resources for their own purposes. They may impose licensing fees that fill their coffers; tax or demand kickbacks from aid beneficiaries; extort bribes in return for government cooperation; insist that aid groups employ their supporters; require aid groups to supply them with food, medicine, or other supplies; and so on. In sum, there are many ways in which corrupt governments can divert aid resources to strengthen their positions and advance their agendas. This can enable such governments to be indifferent and unresponsive to their citizens' needs, interests, and will, and to put their own interests, and those of their supporters, ahead of their general populations'. Second, in many of the world's poorest regions many outside aid groups operate. Some address hunger; others poverty; others rape or victims of sectarian violence; others victims of particular illnesses, such as malaria, tuberculosis, diarrhea, or AIDs; others pre-natal, post-natal, and maternal health care; others health care more generally; others education; others female empowerment; others infrastructure; and so on. Of course, some agencies will address multiple concerns. This all sounds desirable. But if so many aid groups are helping in so many ways, how come the problems of the needy continue to persist in the world's poorest regions? Is it merely because not enough aid groups have been involved? Or not enough resources efficiently spent to eradicate the problems? Deaton has another hypothesis. He believes that with so many aid groups working to help the needy, local governments can abdicate their responsibilities to provide for their citizens' basic needs, and leave that task to the aid groups. The local governments can then shift the blame for any unmet needs to the aid groups, who have failed to fully deliver on their promises to help the needy! In other words, the well-intentioned interventions by aid groups can undermine the local governments' responsiveness to their citizens' needs, interests, and will. But, of course, if Deaton is correct, such responsiveness is a key characteristic of good governance, without which there can be no hope of a lasting solution to the social and economic woes of the world's poorest nations. The preceding points are intimately related to a third point. Generally, effective governments depend on taxing their citizens in order to generate revenue to provide for their citizens' needs, to pay for basic government functions, and to advance their political agendas. However, the relation between a government and its taxpaying citizens is special. Taxpaying citizens expect a return on their "hard earned dollars." They Journal of Practical Ethics LARRY S. TEMKIN8 want a say in how their money is spent, and they want their government to provide for their basic needs, to protect and promote their interests, and to reflect their will. In other words, there will always be pressure for a government that taxes its citizens to be responsive to them. If it is not, it risks the citizens bucking the government, avoiding their taxes and, if the situation is dire, replacing the government with a more responsive one. However, in countries where substantial aid resources flow into the government's coffers, those governments can pursue their agendas without taxing their citizens to the same degree that they otherwise would. Correspondingly, citizens may feel less entitled to demand more from their government, as they can't insist on having more of a say in how "their" money is spent, if it isn't actually their money that is being spent. Moreover, in a nation where the government is receiving little tax money from its citizens, and where its citizens most pressing needs are being addressed by outside aid groups, the government can always claim (whether truthfully or not!) that it lacks the resources to do more to help its citizens and that it has established relations with external groups to provide for its citizens' needs. So, again, if the citizens' basic needs are unmet, the government can claim that the fault lies with the aid groups from the world's richest countries, not with its own inadequacies. In this way, too, aid efforts can undermine a government's responsiveness to its citizens' needs, interests, and will. It does this, in part, by shifting the responsibility for the countries' needy from the governments to outside groups. As importantly, it does this by upsetting the normal relationship between a government and its taxpayers; in virtue of which taxpaying citizens expect to have a say in their government's direction and priorities, since they are paying for them. (There is a similar problem in many resource-rich countries, in the Middle East and elsewhere, where state control of a country's rich resources enables royal families or ruling elites to push their social and political agendas without depending heavily on taxation to fund those agendas. This, in turn, often enables such governments to be unresponsive to the will of their citizens (Wenar, 2016)). Finally, consider the old adage, "he who pays the piper, calls the tune." This adage suggests that in poor countries where much of a government's income is derived from external groups, rather than internal taxes, the governments of those countries will have strong reason to be responsive to the outside groups, and much less reason to be responsive to their own citizens. There are two problems with this. First, each aid group will have its own agenda, Volume 7, Issue 1 Being Good In A World Of Need 9 and its own view about the best way of fostering its agenda "on behalf of the needy." Unsurprisingly, there will often be a gap between what the outsiders would like to accomplish, and how they want to accomplish it, and what the needy themselves would like done, and how they would like it done. This raises many troubling questions about paternalism, autonomy, and respect for local people, their values, and their ways of life. Unfortunately, I cannot pursue these here, however these questions will be addressed further in my book, Being Good in a World of Need. The second worry is that even if the aid groups are accomplishing great good, so that there are good reasons for the government to support their efforts, it remains true that being responsive to the benevolent and paternalistic aims of outside aid groups is not the same as being directly responsive to one's citizens. But it is the latter that is the mark of good governance, not the former. In sum, Deaton believes that good governance is necessary for substantial and lasting social and economic progress in the world's poorest countries, and that good governance requires a government's being responsive to its people. Unfortunately, however, international aid efforts in many of the world's poorest nations can undermine the responsiveness of those nations' governments to their citizens. According to Deaton, this helps account for the empirical evidence, showing little substantial and lasting social and economic progress in many poor countries that have received great amounts of outside aid. Further, this helps explain Deaton's counterintuitive claim that, despite their best intentions, aid groups and their donors may actually be doing more harm than good. Deaton sums up his position as follows: Aid and aid-funded projects have undoubtedly done much good; the roads, dams, and clinics exist and would not have existed otherwise. But the negative forces are always present; even in good environments aid compromises institutions, it contaminates local politics, and it undermines democracy. If poverty and underdevelopment are primarily consequences of poor institutions, then by weakening those institutions or stunting their development, large aid flows do exactly the opposite of what they are intended to do. It is hardly surprising then that, in spite of the direct effects of aid that are often positive, the record of aid show no evidence of any overall beneficial effect (2013, pp. 305-306). There are many possible responses to Deaton's view. One of the most natural Journal of Practical Ethics LARRY S. TEMKIN10 responses raises some especially important, and troubling, issues. Let me turn to that next. PART IV. THE PROBLEM OF INDIVIDUAL VERSUS COLLECTIVE RATIONALITY AND MORALITY. Many are unconvinced by Deaton's worries. They see his critique as supporting Effective Altruism. Now in fact, Effective Altruism is a somewhat amorphous philosophical and social movement whose members share a common commitment to using reason and evidence to determine the most efficient morally permissible way of promoting one or more of the following goals: aiding non-human animals, existential risks to sentient life on Earth, promoting the Effective Altruism movement itself, researching the most efficient way of promoting good, and aiding the world's needy. However, in this article, when I refer to Effective Altruism, I am referring to that portion of Effective Altruism which is concerned with identifying and supporting as efficiently as possible the international relief and development organizations that most effectively aid those people in the world's poorest countries facing premature death or severely debilitating conditions as a result of poverty, famine, war, tyranny, ignorance, or disease. In particular, in response to Deaton, many would argue as follows. Given that many people are in great need, and that many others could help them at little cost to themselves, it is crucial to identify and support the most effective aid groups. Obviously, we shouldn't be supporting aid groups doing more harm than good, but equally obviously, it seems, there must be some aid groups doing more good than harm, and we should be supporting the most effective of those groups. Deaton, himself, seems to offer support for this position. He grants that there have been some successful health initiatives-for example, early vaccination programs for smallpox or polio-where the costs associated with those initiatives may have been worth bearing (Deaton 2013, pp. 308-309). Given this, doesn't it make sense to identify other programs where the costs Deaton worries about are worth bearing given the amount of good to be achieved? Why can't Deaton simply support Effective Altruism? Instead of claiming that we shouldn't be supporting international aid groups operating directly in the world's poorest regions, why shouldn't Deaton contend, more modestly, that we must be very careful about which aid groups we support, to make sure that they are, indeed, doing more good than harm? Volume 7, Issue 1 Being Good In A World Of Need 11 I believe the key to answering these questions lies in an important, and troubling, fact about practical reasoning; namely, that conflicts that can arise between individual and collective rationality and morality. Parfit has referred to such conflicts as Each-We Dilemmas (Parfit 1984, Part One). Each-We Dilemmas arise when if each of a number of individuals does what is best, individually, by the lights of a given theory, they, collectively, do worse by the lights of that theory. The most famous examples of Each-We Dilemmas are Prisoners Dilemmas.1 The original Prisoners Dilemma, discussed by game theorists, is a two person dilemma, where if each of two prisoners does what is genuinely best for himself, according to the standard self-interest theory of individual rationality, they, together, will end up serving a large number of years in prison, say twenty years-ten years each!-rather than a much smaller number of years in prison, say, four years-only two years each! What makes the Prisoner's Dilemma paradoxical is that each prisoner is fully aware of the predicament they are in, but there is no individually rational way of arriving at the outcome where each only spends two years in jail, rather than ten. Here, we have a conflict between the individually rational choice and the collectively rational choice. From the standpoint of what would be individually best for each of them, it is clear that each should act one way. However, from the standpoint of what would be collectively best for the two of them, together, it is clear that they should act another way. Two person Prisoners Dilemmas are rare in the real world. However, Many-Person Prisoner's Dilemmas frequently arise (Parfit 1984, Section 23, pp. 56-62). Unfortunately, it is often true that if each of a large group does what is best for herself in self-interested terms, they, together, will be much worse off than they would have been if they had instead done what was best for the group as a whole. So, for example: each farmer is better off, in self-interested terms, bringing as many crops to market as possible, no matter what the other farmers do-but, together, the farmers would be better off if they brought fewer crops to market, since too many will collapse the crop's price; similarly, each fisherman would better off, in self-interested terms, harvesting as many fish as possible, no matter what the other fishermen decide to do-but, together, the fishermen would be better off if they harvested fewer fish, since harvesting too many will collapse the stocks and undermine their livelihoods; likewise, each taxpayer would be better off avoiding her taxes, whatever anyone else does-but, together, taxpayers will be worse off if they don't pay their taxes than if they do, since a large tax base is 1. There is a massive literature on Prisoner's Dilemmas, too massive to cite here. The Stanford Encyclopedia of Philosophy contains a nice article with a useful bibliography on the topic, available online. Journal of Practical Ethics LARRY S. TEMKIN12 necessary for the provision of crucial government services and public goods; and so on. In Reasons and Persons, Parfit showed that analogous Each-We Dilemmas can arise for deontological moralities (Parfit 1984, Section 36, 95-98). Specifically, Parfit showed that on deontological theories, people can be in the troubling position where if each of them does, individually, what she ought morally to do, they, together, will be doing something which, collectively, they ought not to do. Parfit's result was fascinating and worrisome. In Rethinking the Good, I argued that consequentialist theories can face similar worries (Temkin 2012, Section 3.5, pp. 85-95). In particular, I argued that if one accepts certain anti-additive-aggregationist principles for comparing certain outcomes-as most people do-then even on consequentialist theories people can be in the troubling position where if each of them does, individually, what she ought, morally, to do, then they, together, will be bringing about an outcome which, collectively, they ought not to bring about. One such principle, which most people find plausible, is the following: The Disperse Additional Burdens View: In general, if additional burdens are dispersed among different people, it is better for a given total burden to be dispersed among a vastly larger number of people, so that the additional burden any single person has to bear within her life is "relatively small," than for a smaller total burden to fall on just a few, such that their additional burden is substantial (Temkin 2012, pp. 67-68). Here is an example. Suppose an aid group could provide farming equipment to a village, which would relieve hunger in that village for 1,000 people for fifty years, or they could provide grain to 4,000,000 people, relieving their hunger for a single week. In accordance with the Disperse Additional Burdens View, many people hold that the outcome in which 1000 people had their hunger relieved for fifty years would be better than the outcome in which 4,000,000 people had their hunger relieved for a week, even though in the former case there would "only" be 2.6 million weeks of hunger relief. This is because relieving someone's hunger for fifty years has a significant impact on her life, while relieving someone's hunger for only one week has relatively little impact on the overall quality of her life. Not everyone accepts anti-additive-aggregationist principles. Notoriously, they Volume 7, Issue 1 Being Good In A World Of Need 13 are rejected by total utilitarians. But consider the following case (from Temkin 2012, see pp. 34-38, and also 42, 259-264, 339, and 484-488): Lollipops for Life: In outcome A, countless people live very long lives, and they all have enormously satisfying lives along every important dimension of human life, along with, more trivially, lots of licks of many different lollipops over the course of their lives; unfortunately, however, A also involves one innocent person suffering unbearable agony for eighty straight years, before dying a slow, lonely, torturous death. By contrast, outcome B involves the same countless people living the same enormously satisfying lives, except that they each receive one less lick of a lollipop over the course of their very long lives; however, in B, the innocent person would be spared the agony and painful death, and would instead live a full rich life. Total utilitarians are committed to the view that if only there were enough people each enjoying a tiny amount of pleasure from the one extra lick of a lollipop, then A would be better than B. Most people, including most consequentialists, reject the total utilitarian's judgment about my Lollipops for Life case. For certain comparisons, at least, they reject total utilitarianism's simple additive-aggregationist approach in favor of the anti-additive-aggregationist approach of principles like the Disperse Additional Burdens View. For most people, then, the Disperse Additional Burdens View seems deeply compelling. However, it can give rise to consequentialist Each-We Dilemmas. To see this, consider the following example: The Reservoir, the Drowning Child, and the Toxic Watch Battery: Uhuru is walking by a reservoir where a child is drowning. If she pauses to remove her watch before diving in, the child will suffer severe brain damage. If she doesn't remove her watch, its battery will leach toxic chemicals into the reservoir, increasing its pollution level by a very small amount. The reservoir is the main source of water for the region's animal life and 1,000,000 people. What should Uhuru do? Uhuru might plausibly reason as follows. If she removes her watch first, this will significantly impact the child. If she doesn't, this may have a very small negative impact on each of the many people and animals who depend on Journal of Practical Ethics LARRY S. TEMKIN14 the reservoir for their water. Since there are so many sentient beings using the water, we may suppose that the total amount of negative effects will be larger if she doesn't remove her watch than if she does. Still, the distribution of those effects is very different. If she removes her watch, all of the negative effects will be borne by one child. If she leaves her watch on, the negative effects will be dispersed across a vast number of sentient beings so that each of their lives would be barely impacted. Given this, Uhuru might conclude, in accordance with the Disperse Additional Burdens View, that if she wants to produce the best possible outcome, she should dive in immediately and spare the child severe brain damage. Suppose that Uhuru is right about this. She would then be acting rightly in consequentialist terms. Notice, however, that Uhuru might not be the only person facing such a decision. Suppose that 30,000 others were in a similar predicament. No matter what anyone else did, each might act as Uhuru did, and for the same reasons. In so doing, each would produce the best of her available outcomes, and so be acting rightly, as individuals, in consequentialist terms. Still, the cumulative impact of 30,000 toxic batteries might be very bad. In particular, while the individual negative impact on each sentient being from the increased pollution level of a single watch battery might be very small, the collective negative impact of 30,000 batteries might be quite significant. Thus, it might well be that, together, the quite significant negative impact on millions of sentient beings would be worse than the negative impact of brain damage on 30,000 children. If so, Uhuru and her peers would be facing a consequentialist Each-We Dilemma. If, in accordance with the anti-additive-aggregationist reasoning of the Disperse Additional Burdens View, each individual does what is best in consequentialist terms, they, together, end up producing an outcome which is worse in consequentialist terms. We can now see why Deaton might grant that some aid groups do more good than harm, and yet resist the Effective Altruist's view that we should identify and support those groups. For Deaton, the issue isn't whether aid groups are doing more good than harm at the individual level. His concern is with the collective impact of such groups. If the preceding is correct, then it could be that even if each of us, individually, only supports effective aid groups that are doing more good than harm, it could still be the case that, collectively, we are doing more harm than good. I believe these considerations help illuminate Deaton's position, as well as most people's reactions to it. Deaton urges us not to support aid groups operating in some of the world's poorest countries, largely on the grounds that doing so weakens the Volume 7, Issue 1 Being Good In A World Of Need 15 local governments' responsiveness to their citizens. But most people find this line of reasoning unbelievable. As individuals, each thinks of the great good that her particular contribution might do. She might, after all, save a life! By contrast, she thinks that the extent to which her individual contribution will weaken a government's responsiveness to its citizens will be ludicrously small. Thus, the negative impact that her contribution will have on each of the country's many citizens will be so small as to not even be measurable. Therefore, in accordance with the Disperse Additional Burdens View, her individual contributions will be doing more good than harm, contrary to what Deaton seems to be suggesting. This reasoning is cogent, so far as it goes. But I believe it misses Deaton's point. Deaton isn't taking the ground-level perspective of what each individual donation is, or is not, accomplishing. Deaton is taking the 30,000 foot view of things. He is looking at the net impact of vast numbers of individual acts on behalf of the needy. And what he sees, from that perspective, is that the collective negative impact of those vast numbers of individual acts is quite substantial. Thus, while I, individually, may have virtually no impact on a government's responsiveness to its citizens; we, together, can have a substantial impact on its responsiveness. And, of course, Deaton believes that, ultimately, a government's responsiveness to its citizens is the crucial component for substantial and lasting social and economic progress. This is why Deaton urges us not to support aid groups. His contention needn't be that each of us, individually, is doing more harm than good. It is, rather, that we, collectively, are doing more harm than good. As we have seen, if principles like the Disperse Additional Burdens View are correct, the latter can be true, even if the former is not. In his famous article, "Famine, Affluence, and Morality," Singer implied that people of good conscience may have to do more than they otherwise would to aid the needy, given that not enough other people who are able to help actually do so (Singer 1972, pp. 232-233). Ironically, Deaton's view is almost the opposite. He believes that people of good conscience may have to do less than they otherwise would to aid the needy, given that so many other people are doing the same thing! Underlying Deaton's view is the conviction that, collectively, the direct, indirect, and interaction effects of such efforts do more harm than good. Conflicts between individual and collective rationality and morality are profoundly troubling. Arguably, they lie at the root of many of our most pressing social and political problems, and they can be particularly intractable. Indeed, climate Journal of Practical Ethics LARRY S. TEMKIN16 change, global warming, pollution, destruction or depletion of natural resources, protectionist economic policies, refugee crises, sky rocketing medical and insurance costs, restricted immigration policies, and the proliferation of weapons of mass destruction can all be seen as manifestations of such conflicts among people and/or nations. Unfortunately, the domain of obligations to the needy is no exception to this. Effective Altruists may be right that many effective aid groups are doing more good than harm. Given this, perhaps each of us, individually, ought morally to support such groups. Yet, despite this, it is possible that, collectively, we ought not to support such groups since, if we do, we, together, may do more harm than good. If that is our real-world predicament, then it may be very clear what each individual should do, and also very clear what we, together, should do; but what would remain painfully unclear is how one could defensibly reconcile the two perspectives. PART V. A RESPONSE TO DEATON. In this section, I want to briefly reconsider Deaton's view that we shouldn't provide direct aid to people in the world's poorest countries, because doing so contributes to poor governance within such countries. Importantly, Deaton offers numerous suggestions for how we might try to indirectly help people in the world's poorest countries (Deaton 2013, pp. 312-324). In doing this, he quotes favorably the economist Jagdish Bhagwati, who claimed that "it is hard to think of substantial increases in aid being spent effectively in Africa. But it is not so hard to think of more aid being spent productively elsewhere for Africa" (Deaton 2013, pp. 318-319). However, it is worth noting that many of the concrete suggestions that Deaton offers for how we might help people in some of the world's poorest countries would only help badly-off people at some time in the future, not those whose current desperate plight cries out for immediate amelioration. Recall the so-called Paradox of Poverty, which holds that aid is unnecessary in countries with good governance, and unhelpful in countries with bad governance. If this is right, then there is already poor governance in those countries where so many desperate people need help. So, it isn't as if withholding aid will prevent there from being poor governments in such countries. They are already there, with or without our interventions! Hence, it appears that our choices are between letting needy people suffer, while they are ruled by unresponsive governments; or helping them out, while they are ruled by unresponsive governments! If, in fact, those are our choices, it may Volume 7, Issue 1 Being Good In A World Of Need 17 seem plain that we ought to do the latter, notwithstanding the ways in which outside aid can undermine a government's responsiveness. Deaton seems to be suggesting that we should let people suffer now, on the chance that doing so may lead to long-term changes in their government's responsiveness, which, in turn, may eventually lead to substantial long-term social and economic progress. Perhaps Deaton thinks that if poor governments couldn't count on outside resources to fund their agendas, and take care of their needy, they would have to adopt policies that would generate tax revenues to enable them to advance their agendas, remain in power, and deal with their countries' problems. Presumably, the most sustainable way to do this would involve adopting policies that would eventually transform their societies' neediest members from being drains on their societies' resources, to being contributors to their societies' tax bases. Such an approach has some intuitive plausibility. Still, one might think it is a pretty cold-hearted and risky approach-as it abandons the present needy to their cruel fate, with no guarantees that doing so will lead to the necessary changes in government responsiveness that Deaton champions. Notice, it could turn out that the expected harms of letting many needy suffer now, might be outweighed by the expected benefits of far more people not being needy for decades to come, even if the expected harms are a virtual certainty, while the expected benefits are less likely to be realized than not. In that case, Deaton's somber advice would be endorsed by Effective Altruism. Even so, we might balk at following it. Consider the standard deontological views that I ought to save my mom, rather than five strangers; or that I ought not to break my promise, to stop five others from breaking their promises; or even that I ought not to break my promise to you today, even if that is the only way of my keeping five other promises in the future. Similarly, consider the almost universal appeal of heroic rescues. There is something uplifting, noble, and morally compelling about searching through the rubble days after a major earthquake on the off chance of finding someone still alive, even though the price of doing so would almost never be justified on cost-effectiveness grounds. These observations remind us there is much more to morality, and to being a good person, than doing the most good that we can. A thoroughly decent person will be virtuous, and will also give weight to deontological considerations at odds with maximizing the good. This is why many of us may feel queasy about Deaton's recommendations, even if we accept that they might be supported by long-term, impartial, cost-effectiveness calculations. When we learn of people suffering from the Journal of Practical Ethics LARRY S. TEMKIN18 ravages of war, illness, or natural disasters, many morally relevant factors move us to ease their plight. Perhaps we could do more total good by pursuing other, more costeffective, long-term goals. However, for many of us, we are not prepared to sacrifice the current needy on the altar of need minimization. We would be fools, or worse, to ignore Deaton's important considerations. However, we must balance those considerations against all of the other considerations relevant to how a decent person responds to the plight of the needy (Temkin 2017a and forthcoming). PART VI. CONCLUSION. Some people will be frustrated or even angered by this article. Here I sit, comfortably speculating about various possible negative effects that aid groups may produce. In doing this, I provide ammo for all those who selfishly pursue materialistic lifestyles of wasteful consumption, and do nothing to aid the needy. Worse, I haven't offered empirical evidence to support the concerns that I have raised. Meanwhile, millions of flesh and blood innocents are dying or suffering from easily preventable hunger or disease. Don't I know that even raising these worries may contribute to needless suffering? I understand such reactions. Indeed, I have lain awake many nights with the same concerns. My hope is that if my worries can be laid to rest, that will be shown quickly, and if they cannot, people will rethink their assumptions and proceed along a safer, sounder path. As for gathering and assessing empirical data, I must leave that to the social scientists. My job, as a philosopher, is to help identify both empirical and normative issues relevant to our obligations to the needy, which I have done. Also while I deeply worry that this article may do more harm than good, I also worry that Deaton may be right, and that my previous one-sided approach to thinking about the needy may have been doing more harm than good. There are practical dangers in taking up any complex, morally important topic, but also practical dangers in failing to take up such topics, and letting society's dominant social mores shape people's views about them. The philosopher's job is to carefully and honestly examine such topics, and see where the arguments lead. This article engages in that enterprise, even if only partially. Unfortunately, I have had to leave so many pertinent empirical and normative questions open for now, that I cannot offer too much concrete advice here. However, let me conclude this article with various considerations to bear in mind, and paths Volume 7, Issue 1 Being Good In A World Of Need 19 that still need to be explored, in thinking about how a good person should respond in a world of great need. What I offer, here, are mostly assertions, the arguments for which have been offered elsewhere, or must await another occasion (see Temkin 2004, pp. 349-395 and 409-458). First, in 1996, the World Health Organization adopted the DALY-disabilityadjusted life year-as its standard measure for assessing the negative impact of conditions of ill-health (The World Health Organization "Metrics"). Ever since then, many global health experts, and many Effective Altruists, have shared the common approach of measuring the effectiveness of interventions on behalf of the needy in term of the minimization of DALYs. Though understandable, given the importance of health to human wellbeing, our concern for the needy must encompass much more than just health-related goals. Specifically, we must pay attention to deontological-, virtue-, egalitarian-, fairness-, and justice-based reasons for aiding the needy, as well as the consequentialist-based reasons embodied by DALYs. Second, we must take seriously the fact that to some extent we may be directly or indirectly responsible for the plight of at least some of the world's needy, and this may be true both individually and collectively. This raises a host of complex issues about individual and collective responsibility, and how to trade-off between helping those whose plight we may be partially responsible for, and others whose plight is wholly independent of us, but who may be every bit as needy or more, and whom we may be able to benefit to an even greater extent with equal or fewer resources. Third, we must face the fact that what each of us, individually, has most reason to do, may be different from what we, together, have most reason to do. As I have argued, tragically, it might be that if each, individually, does what she ought to do, morally, on behalf of the needy, that we, collectively, will not be doing what we ought to do, morally, on behalf of the needy. Fourth, there are important moral reasons to personally help the needy, even though this may not do the most good. Similarly, there are moral reasons to not to perform certain jobs, or actions, even though doing so would most benefit the needy. Fifth, there are moral reasons to focus on people, rather than countries that are badly off, and it is likely that one will maximize the expected value of one's aid efforts by focusing those efforts in countries with good governance, rather than in countries with poor governance. Since the overwhelming majority of the world's neediest people live in the world's two most populous nations, China and India, it may well be that we should focus more of our efforts to aid the needy in such countries, or even in Journal of Practical Ethics LARRY S. TEMKIN20 richer countries, who have desperately poor inhabitants within their borders, rather than in other desperately poor regions of the world where the problems of poor governance are especially egregious. It is striking, for example, that in 2013, 3.2 million people lived on less than $1.90 a day in the U.S., and another 3.3 million people lived on less than that amount in other high income countries, and also that more people in the U.S are absolutely poor by global standards (5.3 million), than in Sierra Leone (3.2 million) or Nepal (2.5 million), and about the same as in Senegal (5.3 million) (Deaton 2018). Sixth, notwithstanding the previous point, many moral considerations will support aiding people urgently in need now, even if they live in countries with poor governance, and other available efforts might have greater total expected value. Indeed, in some cases, I believe that we should aid those in dire straits, even if doing so may ultimately do more harm than good. Seventh, we need social scientists, aid activists, Effective Altruists, and others, to explore even more deeply the probability of any negative effects of aid efforts. In doing this, they must attend to indirect, interaction, long-term, and collective effects, as well as direct, short-term, individual effects. Nothing short of brutal, clear-eyed honesty is acceptable if we hope to answer the critics of international aid and, more importantly, if we really hope to do as much as we can on behalf of the needy. Eighth, ultimately our aim is to break the cycles of poverty, war, repression, hunger, ignorance, prejudice, and illness that cause people to be needy. Thus, we must guard against aid efforts that indirectly contribute to such cycles by buttressing gangsters, warlords, evil leaders, or repressive or unresponsive governments. We must also identify effective, long-lasting approaches to undermining the root causes of hunger, poverty, and disease. This will need to include not only efforts to improve infrastructure, education, health care, energy production, and such, but efforts to promote equality, justice, human rights, the rule of law, and fundamental changes in the rules that govern national and international social, political, and economic interactions. Many will dismiss such claims as banal, impractical, and unrealistic. We know how to provide people with mosquito nets, and we can get a general consensus for malaria eradication. But, many will claim, substantial changes in the global political and economic order are another matter, with too many powerful interests lined up against it for it to be feasible. Perhaps. Yet, as the old proverb states, the journey of a thousand miles begins with one step, and if we hope to one day attack the roots of Volume 7, Issue 1 Being Good In A World Of Need 21 the problem of global need, and not merely its symptoms, then we must map out our journey, and begin taking its crucial first steps, however slow and hopeless they may seem. The point about attacking the roots of global need, and not merely its symptoms is, of course, a familiar one. Citing another well-known proverb-feed a man a fish, and he eats for a day; teach a man to fish and he eats for a lifetime-aid groups have long trumpeted the importance of development efforts, and not merely relief efforts (though this long-held staple of many international aid groups in not uncontroversial, and in recent years there has been significant pushback against it (see Ferguson 2015 and Van Parijs 1995)). Still, with a few notable exceptions-such as GiveDirectly, which focuses on direct cash transfers to the poor rather than development as the best way of aiding the needy and which has been endorsed by GiveWell as one of the most effective international aid organizations-aid groups have tended to focus on goals like improving water supplies, farming techniques, education, infrastructure, eradicating diseases, and empowering women, goals that seem fairly achievable via outside interventions. In doing this, perhaps aid groups have hoped that necessary social, political, and economic changes would accompany the improvements they achieve. Such hope is not entirely unreasonable, especially with advances in education and female empowerment. Still, I believe we need to try to identify more direct ways of effectively addressing the many systemic factors giving rise to the needy, including the many institutions, rules, and laws that regulate international political and economic relations. In choosing which aid agencies to support, one will inevitably make trade-offs. One could devote one's resources to relief efforts; to development efforts; or to longterm social, political, and economic changes. A fourth approach would devote different portions of one's resources to each of the three aims. Individually, it may not matter which of these approaches one adopts. I'm not sure about that. However, collectively, I believe that we, together, should adopt the fourth approach. Moreover, on my pluralistic approach, I believe there will be many cases where we ought to aid the needy even though, in terms of pure cost-effectiveness, that money could be better spent elsewhere. I remain convinced, as I have been throughout my life, that the well-off are open to serious moral criticism if they ignore the plight of the world's needy. Unfortunately, Journal of Practical Ethics LARRY S. TEMKIN22 what one should do in light of that truth is much more complex, and murky, than most people have realized. Acknowledgements This article is based on the third of my three 2017 Uehiro Lectures, sponsored by the Oxford Uehiro Centre for Practical Ethics, and delivered at Oxford University in November, 2017. I would like to express my appreciation to the Uehiro Lectures Selection Committee and, especially, Julian Savulescu, for inviting me to give the Lectures; to Rachel Gaminiratne and Miriam Wood for organizing them; and to the Uehiro Foundation on Ethics and Education for its generous support of the Lectures. I would also like to express my deep debt and gratitude to Peter Singer and Angus Deaton, each of whom, in their own ways, compelled me to address these topics; to Derek Parfit, my lifelong teacher, mentor, colleague, and friend; and, most of all, to my parents Lee and Bud Temkin, who instilled in me from an early age a deep concern about the world's needy. 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