According to a reflection published on LessWrong, effective altruism imposes a profound psychological cost. When philanthropist Dawn Drescher began allocating charitable funds in 2010, she faced a moral arithmetic: every cause she supported meant implicitly abandoning another. For years, watching numbers transform into human suffering—children who wouldn't receive malaria nets, lives saved versus lives lost—created intense emotional anguish. She eventually developed a mental dissociation to function without collapsing under the weight. Her insight: those with the power to help also have the power to harm. The only sustainable path forward is accepting this moral responsibility, not as a burden to escape, but as the sword we must carry if we want to matter.

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