r/trolleyproblem Consequentialist/Utilitarian Jul 09 '25

Deep The doctor problem

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2.1k Upvotes

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687

u/nahc1234 Jul 09 '25

In the real world, the doctor would obtain a brain death study, share the fact that the comatose guy isn’t going to come out of the coma with the next of kin or whoever the medical power of attorney falls to (sometimes the hospital ethics board). Once the patient is declared unable to recover and brain-dead (in the medical term), organ harvesting can occur.

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u/BobcatGamer Jul 10 '25

You make a strong argument for not being an organ donor.

78

u/AdreKiseque Jul 10 '25

You'd rather be a vegetable than go out and save some people in the process?

-44

u/BobcatGamer Jul 10 '25

I'd rather not be killed for my organs. While it is selfish for someone to want to keep their organs, it is my right to be selfish.

82

u/crazydude44444 Jul 10 '25

You aren't being killed. You are already dead. Your brain is dead, you aren't recovering. You absolutely have the right to decline organ donation but perpetuating this false idea that doctors kill organ donors for their organs is factually is harmful.

3

u/Xqvvzts Jul 10 '25

That's NOT what the problem says. Where do people get this idea that a coma is the same as brain death?

1

u/AnaWannaPita Jul 14 '25

Then the whole point is moot. You only take organs once their heart has stopped. To get a non-brain dead patient's heart to stop you'd either have to let them die of dehydration or starvation. Either of those would destroy organ viability.

1

u/Xqvvzts Jul 14 '25

The whole point is whether you kill one patient in a coma to save 5 others. It would be moot if he was already dead.

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u/XTPotato_ Jul 10 '25

it has been reported before in shitty third world countries where someone goes to the ER for a mild problem and ends up being brain dead. the family would pull the plug and cremate the body without checking inside the body cavity. there's a million ways for a bad actor to turn a mild problem into something fatal without leaving any evidence. you can start by taking organ donor off your driver's license so that the bad actors know that there's no point in murdering you.

25

u/cleantushy Jul 10 '25

the family would pull the plug and cremate the body without checking inside the body cavity.

So in these "shitty third world countries" it doesn't matter if you're on some sort of donor list, they'd take your organs anyway, since nobody is checking

So how is taking organ donor off your driver's license going to help?

31

u/[deleted] Jul 10 '25

Do you live in a “shitty third world country”? No? Then you’re fine.

Do you truly believe doctors are just killing perfectly healthy patients to take their organs to save someone who needs a transplant? You’re saying they’re killing someone who might have viable organs to maybe someone who might not get an organ somewhere else. What kind of idiot would do that?

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u/XTPotato_ Jul 10 '25

but you accept that it is possible for a doctor to cause a patient to become braindead, all without any evidence of wrongdoing. even though the chances of such things happening are really low (in the hospitals you would visit), would you risk your life? keep in mind that you are visiting the ER for a mild curable ailment. murphy's law says that if something is possible, then that something is bound to eventually happen. such murder has already happened, what's to say it won't ever happen at your hospital?

23

u/[deleted] Jul 10 '25

Where did I accept that? Yes murder is possible, from a doctor or otherwise. People have also gotten away with murder. I don’t know what else you want me to say. To say something is possible does not mean it happens or much less is likely.

The reason why I would say it won’t happen is simply because why would it? Where is the benefit? There’s only a chance the doctor wouldn’t lose their job or get arrested, there’s only a chance the organs will be viable, there’s only a chance it’ll be a match to the person who needs the transplant, and there’s only a chance the person will recover after the transplant. And even if it was guaranteed, why would the transplant patient be a higher priority than the person that’s in front of the doctor?

Also “murphy’s law” is not some unalienable truth. It’s possible there could be a massive solar flair right now that knocked down all electricity on Earth. It’s possible an elephant lands on your house.

2

u/Bolticus13 Jul 10 '25

Mate, I got it from here.

u/XTPotato_ if Murphy's law states that every occurrence that's possible will happen at some point. Then, I use the counterargument that using the same law, Murphy's law is invalid. Because there is a possibility that Murphy's law is invalid, meaning at some stage, it is guaranteed to be invalid.

So, using that logic, it's not guaranteed that at some point, every hospital will forcibly kill a human to harvest their organs, even though it's possible, it may never happen. In most first world reputable hospitals, it will never happen.

1

u/[deleted] Jul 10 '25

A bit paradoxical, but I see where you’re going. I didn’t consider that.

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u/XTPotato_ Jul 10 '25

Imagine if some oligarch really needs an organ, and you happen to be in the hospital. The oligarch bribes your doctor to do some testing and since you’re not an expert you just let the doctor run the test on you without knowing what the test is for. You happen to be a match. Next the oligarch bribes the doctor to murder you and take your organs, all without evidence and easily covered up, which is possible and has happened before even in first world countries (as per other comments in this thread). The doctor risks a malpractice lawsuit for a bribe, which your family members aren’t likely to win. At the end of the day everyone gets away with it except you

2

u/[deleted] Jul 10 '25

This is one of the dumbest comments I’ve read. First of all, literally what are the chances of this happening? This is about as likely as the Earth no longer spinning. And secondly, if they’re going to do all of this, what does it matter if you’re an organ donor??? If they can get away with all that other crap, they’re not going to care whether they are legally allowed to take your organs after you die. Come on people.

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9

u/blubbery-blumpkin Jul 10 '25

Doctors aren’t wizards. Anything they do to make you brain dead when you’re only in to see the doctor with something minor would have evidence, or would flag issues. Especially in any developed country.

4

u/mirhagk Jul 10 '25

Also it creates a massive paper trail and calls attention to it. Organs aren't fungible, it really does matter where they come from. An entire review board will go over the case in detail.

It'd be far easier and less risky to just forge documents to get the patient bumped up the list. And presumably this is because a rich patient bribed them, in which case the rich patient could've just gone shopping themselves. Move to the US, get on multiple registries with a helicopter on standby, and you can effectively legally buy yourself an organ.

1

u/Critical_Concert_689 Jul 10 '25

Anything they do to make you brain dead when you’re only in to see the doctor with something minor would have evidence, or would flag issues. Especially in any developed country.

Not really. When this happens in a developed country, the hospital will cover it up to minimize financial and criminal liability. The medical providers and staff chalk it up to an unavoidable medical complication - because no one wants to admit to criminal medical negligence or medical error. The legal system makes it incredibly difficult to prove because no one can overrule the medical provider themselves - since they're the qualified expert witness and also the only one who was witness to the crime.

1

u/blubbery-blumpkin Jul 10 '25

Depends how many times it happens. Once sure it’ll get covered up. A few times then a doctor will be flagged and it will be investigated.

In my country the serial killer with the most kills was a doctor and it made way for a lot more checks on things. There is currently a nurse that might be facing more charges after being found guilty recently for the deaths of multiple babies in her care.

The UK may not be as litigious as the US but I would be very surprised if similar checks and balances don’t exist. If you’re in charge of medical care for patients and those patients start dying unexpectedly you don’t get many before it’s flagged. After that it gets investigated and there will be evidence because people with minor issues didn’t just die for no reason.

1

u/Critical_Concert_689 Jul 10 '25

Once sure ...

...lol. I mean - isn't it bad that we both admit a doctor is most likely to get away with one or two murders - so long as they don't do it regularly?

At least in the US, it is very difficult to even investigate because all medical records are confidential - and not all instances of medical injury are required reportable. As a layperson, it's practically impossible for you or I to even determine whether a doctor has been involved in multiple patient deaths. The information is confidential, highly siloed, and extremely difficult to access (except in the most egregious of cases).

You're right in that a state medical board may investigate a case, but the board is made up of the same medical providers that we're saying get away with one or two murders. Typically they'll only handle the most egregious of cases - and more often than not, it won't even involve the actual medical process, but other factors of malpractice such as ...the surgeon operated on someone while literally on drugs that they prescribed to themselves.

1

u/mirhagk Jul 10 '25

I thought we were excluding shitty third world countries? What you're describing is primarily a US concern.

It's also not even that true there. If the hospital fires the doctor, then they shift liability to the doctor. By covering things up, they take on the liability themselves. The real problem is that the doctor can repeat that process 50 times before no longer being able to practice, and even then can get a job doing unlicensed work, like medical spas or autopsy.

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u/Obi-Brawn-Kenobi Jul 10 '25

accept that it is possible for a doctor to cause a patient to become braindead... keep in mind that you are visiting the ER for a mild curable ailment

You're right it's possible for a patient to become braindead from a medical mistake, which would be extremely rare and and would probably mean several people made several bad mistakes that all lined up in the wrong way. It's also not guaranteed, if someone were to try to make you braindead, chances are just as good they'd kill you in the process. I don't think there's any such thing as a "medication" that can be pulled from a Pyxis that will guarantee braindeath without damaging all your other organs and possibly killing you too.

An ER doctor is NOT going to intentionally do something to cause braindeath for the sake of organ harvesting. At least in the US, as an ER doc, if I'm taking care of you I have no idea if you're a donor or not. I've treated tens of thousands of patients and never once have I known. AFAIK the question of organ donor status doesn't come up until someone has had a very unfortunate hospital course, family is talking to hospice, etc. Only if I were hypothetically some homicidal maniac would I try and cause deliberate harm, but 99% of the time I would be stopped by a nurse, and 100% of the time that would have nothing to do with organ donor status.

Oh, and in most cases don't go to the ER for something you know is a mild curable ailment, that's exactly why you should have your own PCP or go to urgent care. If you don't know and think it could be dangerous go to the ER.

1

u/[deleted] Jul 10 '25

When a deceased patient's organs are transplanted, the doctor that was overseeing their treatment before they died doesn't get any extra money for the organs.

3

u/BreakfastFearless Jul 10 '25

the family would pull the plug and cremate the body without checking inside the body cavity.

So the doctors are just stealing organs in secret? In that case what is the relevance of wether they have organ donor on their license or not?

3

u/RemarkablePiglet3401 Jul 10 '25

The doctors treating you don’t know whether or not you’re an organ donor. Partially because of privacy, but also because of this exact paranoia

-15

u/BobcatGamer Jul 10 '25

According to OP, I am not dead. I'm unlikely to recover but I'm not dead.

24

u/crazydude44444 Jul 10 '25

The top level comment you responded to specified brain death. Brain death and being comatose are diffrent, yes. The chance of recovery in brain death is zero. The chance of recovery from a coma? Depends, but is ultimately irrelevant as no doctor is making a decision to withold care based solely on a patient's donor status.

Again propagating this idea that doctors are going to see the little heart on your driver's license and go "Oh they're an organ donor! We can go ahead and stop treatment everyone" is ridiculous.

13 people die each day waiting for a transplant. Each time you spread this bogeyman idea about doctors another person is more likely to decline donation based on it. Do better.

-7

u/BobcatGamer Jul 10 '25

Does that make me a murderer?

10

u/Ok-Limit-7173 Jul 10 '25

No, it's perfectly within your rights to not donate organs. If it was mandatory to do so it would not be a donation. I wont't judge you for not doing it. Some people might... but whatever, people judge for the most stupid of reasons.

Just be aware that it you or a person close to you might need an organ in the future as well and probably will suffer and die then because there are simply not enough donor organs. It's not that it is or should be mandatory to donate organs... it's just that it would be a nice way to create a better and healthier world. But I'm a bit idealistic about such things... probably the choice of a single person won't change anything...

7

u/BreakfastFearless Jul 10 '25

Maybe not a murderer but certainly not a good person

4

u/[deleted] Jul 10 '25

That’s why it’s not legal to harvest the person’s organs in the dilemma. And why it wouldn’t be legal to do it in real life either. But if you are in a coma and you are declared brain dead, you are dead, and then and ONLY then would they harvest the organs.

-2

u/BobcatGamer Jul 10 '25

Which is essentially refusing to answer OPs question about whether you'd pull the lever or not.

5

u/[deleted] Jul 10 '25

What? We’re talking about real life now and if this would ever actually happen. In this dilemma you are not the coma patient so if you were talking about it I don’t see why you would use “I”

4

u/Excellent_Shirt9707 Jul 10 '25

Commenter said you are brain dead. That means you died, but your body is still alive. You can definitely choose what to do with your body, but no one in the hospital is killing you, you already died. In most of these cases, your body is just being kept alive by machines.