The Trolley vs Transplant Case

The Trolley vs Transplant Case

What would you do?
Anu Rao
Anu Rao
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Philosophy is a subject not intended for individuals who are unwilling to look past their personal opinions and challenge their beliefs. Philosophers look past their personal opinions by using thought experiments meant to challenge what they believe is right or wrong. A thought experiment is defined as, “a description of a possible state of affairs which elicits an intuitive reaction typically for or against a specific view”. Two thought provoking cases that bring forth questions of morality include the trolley case and the transplant case. These two cases individually can be answered without much hesitation, but together, they create a paradox, or contradiction to each other. This can be quite bothersome to individuals who believe that morality has a definitive right or wrong answer.

In the trolley case, imagine you are driving a trolley on its track. When you look ahead, you see that it splits into two ways: right or left. The right track has five construction workers working on it and have not noticed the oncoming trolley. You have no way of signalling them to move out of the way. On the other side, the left track has only one construction worker. The single worker also does not see the trolley and you have no way of warning the individual. You are left with two options. You can decide to let the trolley continue down the right track. This would lead to the death of the five construction workers. Or, you can press the button to move the train to the left track, which would only kill one construction worker. While this is a tough situation to be placed in, many people would say that the obvious answer is to press the button and save the five construction workers with the idea that five lives are more valuable than just one.

But let’s consider a similar situation to this, called the bystander problem. Imagine you are watching the trolley travel down the track that is about to turn right, and hit five construction workers. You notice that the conductor tried to stop the trolley, failed, and consequently passed out from horror and embarrassment for the lack of intelligence to honk the horn. To your right, there is a switch box that allows you to change the path of the trolley to the left, which would kill only one construction worker. You now are given the option of throwing the switch to move the trolley to the left, killing just the one worker, or simply not doing anything and letting the five construction workers die. The question becomes whether you are morally responsible to intervene, and whether your choice is morally permissible. Most people would say you are morally obligated to intervene, and save the lives of the five workers, or the greater number of individuals. It would, in fact, be morally impermissible for you not to act in that situation. I believe that there is a big difference between letting someone die and killing someone. If you had not been the bystander, those five individuals would have died from the trolley. This would not have been your fault. But, by intervening and changing the course of events that would have taken place, the death of that one person would be your fault. This is because letting someone die is wrong, but you didn’t choose to kill them. You chose to let the natural course of things play out. But despite the difference between letting someone die or killing someone in this situation, people still believe you are obligated to disrupt the natural process, until one brings the transplant case into perspective.

Let us consider an analogous case, the transplant case. Imagine you are a surgeon and you have five patients who need a transplant. Two of your patients need a lung each, two patients need a kidney each, and the last patient needs a heart. The patients have come to you because you are the best surgeon and every transplant you perform takes. Now imagine you have a patient come in for a routine checkup. This individual is perfectly healthy and is coincidentally a perfect match for all five of your patients that need a transplant. Keep in mind, your five patients need a transplant today, or they will die. All you need to do is cut the individual open, distribute his organs respectively, and you’d save those five patients. When you ask the individual, he declines. The question then becomes whether it is morally permissible for you, the surgeon, to save the five patients and instead, kill the one. Most people would say that it is morally impermissible for you to kill the individual, distribute his organs, and save the lives of the five patients. But why? Some conceptions of morality lead us to believe that saving the greatest number of people is the right thing to do. In this case, the doctor performing this surgery wouldn’t be broadcasted in the news as a hero; instead, he’d be seen as a murderer. He’d lose his license, his ability to practice medicine, and he’d most likely be put on trial and sentenced to jail.

The paradox that comes from the trolley and transplant case is the belief of what is morally permissible or impermissible. It begins with the notion that the morally right thing to do is to always save the lives of greatest amount of people. This concept is solidified through the trolley case, in which people believe that saving five construction workers is better than saving one. The person who saved the five would be paraded around as a hero for saving their lives. But in the transplant case, the ideology is reversed, and it becomes morally impermissible to operate on the one patient to save the lives of five. The public's reaction to this doctor would be dramatic. People would call him a monster instead of congratulating and celebrating his effort to save the five people. But why is this? Why does morality differ depending on the situation? When you're simply a bystander, you are morally required to intervene, but why, as a doctor, whose main job is to save people, does it becomes an issue?

Moral relativism is the position that moral or ethical principles are not objective moral truths, but instead make claims relative to social, cultural, historical or personal circumstances. This means that morality differs depending on the situation, context, and personal circumstances. An example of this would be the idea that murder is wrong. We are taught at an early age that this action is wrong. We have rules and laws that force this notion upon us and punish us if we break these rules. But this rule changes when the circumstances changes. Murder becomes acceptable under different conditions. If you are being attacked, and you retaliated by murdering the person, suddenly, it's morally permissible to murder.

However, to answer the question on how to resolve each of these instances. In the trolley case, I would have let the laws of natural selection make the choice and kill the construction workers who were not paying attention. There are five individuals on the track. This means there are ten eyes and ten ears that could have seen the trolley coming down the track. The one person in the left track is probably a hard worker because he was working alone, so I wouldn’t choose to kill him simply because he’s a loner. Thus, I would rather the five individuals be killed because they were too busy being dependent on each other. After those five die, I would use their organs to make the transplant to the individuals. That way, the perfectly healthy individual can live a normal life, and the five patients can live. If, for whatever reason, the organs could not be transplanted, or the organs of the five construction workers could not be salvaged, I would use the same concept of natural selection in the transplant case. The five patients were already sick and their own organs failed them. We do not know if these individuals smoked their way to bad lungs or drank their way to bad livers. Hence, there is no reason for the healthy individual to lose their life without being ill himself.

The trolley case brings attention to the idea that almost everyone agrees that saving the greatest number of people is morally permissible and you must always save the greatest number. The transplant case uses the same situation, saving the same amount of people for the life of just one, but morality in that case changes. It then becomes morally impermissible to save the lives of those five. To resolve this conflict, I have introduced the notion of natural selection to make the decision on who lives and who dies. Regardless, in both situations, letting the course of events take place without intervening leaves you with one less murder on your hands.

Cover Image Credit: Youtube

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