"Counterfactual number of lives saved" is not the normal sense of the phrase "save a life". By that logic, each person's life can only be saved once, which is not how people normally use the phrase.

Your definition may be useful for cold hard utilitarian calculus, of the sort that hospital directors need to do if they've run out of fundraising opportunities. However, "effective altruism" – which I suspect you're alluding to here – isn't actually an efficient way to save lives, the way it's usually practised (ignoring second-order effects, and everything that doesn't fit on a spreadsheet).

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ag8 3 hours ago | parent [-]

You're right; I should've been more precise. However, we have tools for dealing with this—that's what quality-adjusted life-years are for! I don't contest that surgeries often significantly increase QALYs, and may do so pretty cost-effectively.

	▲	kalvin 2 hours ago \| parent [-]
		Yes they are surprisingly cost-effective in the countries Watsi operates in, which isn't intuitive for those of us who live in places where surgeries are very expensive. "A review across 23 LMICs found that low-complexity surgeries (e.g., appendectomy, hernia repair) cost only about ~$17 per DALY, whereas even complex procedures were often cost-effective" (Most surgeries on Watsi are low-complexity) "Reports from the WHO and Lancet Commission consistently emphasize that investing in surgical capacity has high value, in many cases, more than essential drugs or vaccines on a per-DALY basis" Both quotes from: https://link.springer.com/article/10.1186/s12893-025-03204-0