You Really Decide Who Lives and Dies

Yesterday I discussed the Trolley Problem, and today's post will not make much sense if you are not familiar with the set up explained therein. Today I would like to address the 10% of the population that would not switch the track to save five lives at the expense of one.

It really is your choice, even if you do nothing and let five people die, that is a choice you made if you could have made it otherwise. I emphasize this because the only reason that I can think of for someone to choose to let five people die rather than letting one person die, excluding possible personal reasons for preferring specific individuals live or die, is the belief that by throwing the switch they are responsible for the resulting death in a way that they are not responsible for the five deaths should they refuse to throw the switch. It would be interested to test this assumption by reversing the situation, and requiring the participant to throw the switch if they want to divert the train away from the one person into the five, to test that it isn't the case that 10% of the population just wants to maximize carnage. I would also be interested in seeing the results of a situation where everyone will die unless the person on the lever chooses one group to die. I would not be surprised if some people let everyone die in order to avoid the responsibility of choosing a subset to save, dismayed perhaps, but not surprised.

I think that it is important for people to accept that, if it is within their power to alter the outcome of an event and they fail to attempt to do so, then they must bear some responsibility for the outcome. A popular quote whose provenance is not clear captures this idea, "all that is necessary for the triumph of evil is that good men do nothing." This emphasizes that one of the causes of the evil is the inaction of the good people who might have otherwise prevented it from coming to pass. So, even if one abstains from touching the track switch, the blood of the five dead workers is on one's hands as much as the single dead worker's would be if the switch were thrown.

However, this view of morality does chronically cause me problems when I consider the question of forcibly "donating" the organs from prisoners convicted of violent crimes to less sordid citizens whose lives would be ended without them. This is yet another example of ethical theories being critiqued based on moral intuition. I feel that it would be immoral for us to kill prisoners and harvest their organs for use by other people, yet I cannot find convincing differences between this scenario and the Trolley Problem. Because one can harvest multiple organs from one donor, it seems likely that many lives would be saved at the expense of one. Even more disturbingly, the Trolley Problem makes no reference to the civic contributions of the workers involved, leading me to wonder if a more apt metaphor would be choosing one citizen to provide organs for a group of other needy citizens.

One might object that there are quality of life issues and uncertainty about the outcome. We do not know that all the organ transplants will be successful, so we may end up saving fewer lives than we expect, and even after a successful transplant the recipient must live with a regimen of immuno-suppressors in order to avoid rejecting the transplant. However, if we put stock in these technical objections we must also agree that if transplanting techniques became so advanced that transplants were nearly always successful and the side effects of a successful transplant were minimal, then we would accept that mandatory transplantation would be the ethical thing to do.

On the other hand, perhaps they are. Is it more ethical to allow death to break families apart when we have the techniques to prevent it, merely lacking the supply of organs? Especially considering that we put prisoners to death anyway, with no noticeable benefit to society? Since we posses the technology, are we not choosing the life of a murderer over that of a loving mother when we fail to reallocate the murderer's organs to the mother?

The most obvious place to take the discussion from here is to the liberal notion of ethics, that is responsibilities based on human rights, as a notion that humans have sovereignty over their own bodies is the most obvious rebuttal to forced organ donation. One might also discuss the ethical implications of technology, as without the means to perform organ transplants we would not be presented with this quandary. Since either of these would probably fill up a blog post on its own, I shan't discuss either here, but I may address them at some later date, or not. Until then, enjoy your organs while society believes you are the best person to be using them!