Principle of Utility, the Trolly Problem, and the Surgeon
Introduction
In her 1985 Yale Law Journal article, “The Trolly Problem,” Judith Jarvis Thomson wrote:
“Some years ago, Philippa Foot drew attention to an extraordinarily interesting problem. Suppose you are the driver of a trolley. The trolley rounds a bend, and there come into view ahead five track workmen, who have been repairing the track. The track goes through a bit of a valley at that point, and the sides are steep, so you must stop the trolley if you are to avoid running the five men down. You step on the brakes, but alas they don’t work. Now you suddenly see a spur of track leading off to the right. You can turn the trolley onto it, and thus save the five men on the straight track ahead. Unfortunately, Mrs. Foot has arranged that there is one track workman on that spur of track. He can no more get off the track in time than the five can, so you will kill him if you turn the trolley onto him. Is it morally permissible for you to turn the trolley?
“Everybody to whom I have put this hypothetical case says, Yes, it is.”
Thomson continues:
“Now consider a second hypothetical case. This time you are to imagine yourself to be a surgeon, a truly great surgeon. Among other things you do, you transplant organs, and you are such a great surgeon that the organs you transplant always take. At the moment you have five patients who need organs. Two need one lung each, two need a kidney each, and the fifth needs a heart. If they do not get those organs today, they will all die; if you find organs for them today, you can transplant the organs and they will all live. But where to find the lungs, the kidneys, and the heart? The time is almost up when a report is brought to you that a young man who has just come into your clinic for his yearly check-up has exactly the right blood-type, and is in excellent health. Lo, you have a possible donor. All you need do is cut him up and distribute his parts among the five who need them. You ask, but he says, “Sorry. I deeply sympathize, but no.” Would it be morally permissible for you to operate anyway? Everybody to whom I have put this second hypothetical case says, No, it would not be morally permissible for you to proceed.
“Here then is Mrs. Foot’s problem: Why is it that the trolley driver may turn his trolley, though the surgeon may not remove the young man’s lungs, kidneys, and heart? In both cases, one will die if the agent acts, but five will live who would otherwise die—a net saving of four lives. What difference in the other facts of these cases explains the moral difference between them?”
Prompt
Well, is there a moral difference between these two cases that is explained by the other case-specific facts concerning the trolley and the surgeon? Or do these two cases show that there is something just not quite right about the moral reasoning of the principle of utility? Do you agree or disagree with the general reactions to these two cases? If so, why; if not, why not? How do you think Mill would respond to the two cases? Could the distinction between act utilitarianism and rule utilitarianism be relevant here as a way of showing how a utilitarian could respond to the two cases while maintaining consistency both to the principle of utility and most people’s moral intuitions about these cases?
The Trolley Problem, as proposed by Judith Jarvis Thomson, presents two intriguing moral dilemmas that involve the choice between saving multiple lives at the expense of one life. In the first scenario, a trolley driver faces the decision of diverting the trolley to a track with one person to save five lives. In the second scenario, a surgeon contemplates harvesting organs from a healthy individual to save five patients in critical need. The key question is whether there is a moral difference between these cases that can be explained by the specific facts surrounding the trolley and the surgeon. This essay will delve into the moral reasoning of the principle of utility and explore how John Stuart Mill’s utilitarian philosophy might respond to these two cases, considering both act utilitarianism and rule utilitarianism.
The principle of utility, a foundational concept in utilitarianism, posits that actions are morally right if they promote the greatest overall happiness or pleasure and minimize suffering or pain. In the context of the Trolley Problem, a utilitarian analysis would likely suggest that the trolley driver should divert the trolley to the track with one person, as it results in the greater net saving of lives (four lives saved). This decision aligns with the principle of utility, maximizing overall happiness by minimizing the total number of deaths.
The moral difference between the two cases lies in the presence of direct intention and agency. In the trolley scenario, the trolley driver’s actions result in the death of one person, but it is an unintended consequence of an effort to save five others. The driver has no direct intention to harm anyone; the death of the one person is a side effect of attempting to avoid a larger tragedy.
In contrast, the surgeon faces a situation where the act of harvesting organs from a healthy individual is the direct means to save five patients. The surgeon must actively and intentionally harm the young man to achieve the desired outcome, which most people find morally objectionable.
John Stuart Mill, a prominent utilitarian philosopher, would likely weigh the consequences of each action and consider the overall happiness generated. Mill’s response to the two cases might align with the general reactions mentioned by Thomson.
In the trolley case, Mill would likely endorse the decision to divert the trolley, as it maximizes happiness by saving more lives. However, in the surgeon case, Mill might argue against proceeding with the operation, as the direct harm caused to the healthy individual might outweigh the happiness gained from saving the five patients. Mill’s utilitarian perspective might prioritize the importance of respecting individual rights and autonomy, which could conflict with the surgeon’s action.
Act utilitarianism focuses on maximizing happiness in each individual situation, regardless of established rules or principles. In contrast, rule utilitarianism adheres to moral rules that, when followed consistently, lead to the greatest overall happiness.
Regarding the two cases, act utilitarianism may lead to conflicting judgments, as it solely considers the specific circumstances of each scenario. On the other hand, rule utilitarianism could provide a more consistent approach. For instance, a rule against harming innocent individuals may be more reliably applied in the surgeon case, resulting in the rejection of the operation.
In conclusion, the Trolley Problem and the Surgeon cases present moral dilemmas that challenge the principles of utility. The moral difference between the two scenarios lies in the presence of direct intention and agency, where the trolley driver’s action results in an unintended consequence, while the surgeon’s action involves direct harm to a healthy individual. John Stuart Mill’s utilitarian philosophy might align with the general reactions, advocating for the trolley diversion but opposing the surgeon’s organ harvest. Additionally, the distinction between act utilitarianism and rule utilitarianism could offer insights into maintaining consistency between the principle of utility and common moral intuitions. Ultimately, these thought-provoking dilemmas continue to spark discussions about the complexities of ethical decision-making and the application of utilitarian principles in real-life situations.
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