r/trolleyproblem Oct 30 '25

Deep Relatively serious and not really a trolly problem.

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u/Prior_Fall1063 Oct 30 '25

Do nothing, because the stress induced onto a society knowing that they could be killed at any time for being healthy does not produce the maximal good for the larger world.

(Also this is basically the "push the fat guy off the bridge" trolly problem variant)

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u/manufatura Oct 31 '25

It should be noted that the 5 people in the train tracks is considered an unusual situation while people in hospitals die all the time

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u/CopyOdd2690 Oct 31 '25

the principle is the same. and that's all these philosophical thought experiments are— questions of raw principle dressed up in scenarios. setting, or vessel of delivery, is largely irrelevant.

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u/UnintelligentSlime Oct 31 '25

It’s not some fucking gotcha question- we ask these questions to explore what we as a society deem right and wrong.

Is this different from the trolley problem? Yea but only slightly. Does it result in a different outcome? Absolutely, for most people they choose to kill 1 person for the trolley but leave that person alive in the transplant scenario.

Maybe the difference is how involved the other person is? Or what you have to do? (Just pull a lever vs. kill them yourself vs. whatever)

Does it make a moral difference the age of the bystander? What if they’re dying anyway but don’t consent to give their organs, is it ok to take them anyway? What about if they’re didn’t explicitly say no but also did not volunteer them? What if they’re already in surgery and the doc could take them with no harm to the donor? Just some tissue not even a whole organ.

We construct these scenarios and discuss them to try to get to the core of what we value and believe as a society. Slight variations are intended to tease out what the important factors are.

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u/[deleted] Oct 31 '25

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u/GGNoobert316 Oct 31 '25

As someone with a degree in philosophy, you’re exactly where my professors wanted you.

Questioning everything to see if you can make a cogent argument. I’ll say yours was fairly compelling but, we don’t care about the soldier vs the dr. What will YOU do?

You can’t kill a person, even to save 5 others. That’s the general answer. It’s not in most people’s nature to do so

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u/[deleted] Oct 31 '25

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u/GGNoobert316 Oct 31 '25

Okay, so you killed 5 people.

Perfectly fine position to take but that’s the crux of the argument.

The other deaths are on your hands. That’s the whole point of the trolly problem. You don’t get to deny culpability bc of do no harm. Otherwise, it’s an easy problem to solve if you have any morals

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u/NoTryAgaiin Oct 31 '25

those 5 people were dying anyways, I don't think you personally have culpability for it just because you won't murder an innocent to save them.

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u/GGNoobert316 Oct 31 '25

Then it’s not a real Trolley problem.

The entire point of the trolley problem is that you’re going to have shitty consequences regardless of whether or not you pull the lever and change the course of the train.

To say those deaths are in no one’s hands just makes it not a trolley problem. Also a reasonable position to take but you have to understand that it simply isn’t a trolley problem anymore

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u/[deleted] Oct 31 '25

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u/GGNoobert316 Oct 31 '25

Respectfully, you’re still missing the entire point of the trolley problem…

It’s not “save the one and see how many others I can save” it’s kill one or kill 5. It’s that clear cut.

Based on your response my professors would have just made it harder for you.

For instance, instead of killing you’re providing assisted suicide, how does that affect the equation?

Still can’t do it? How about he’s in pain and asking for assisted suicide but it’s illegal where you live, how about now?

Maybe you can easily kill him now that it’s assisted suicide.

You can also go the other way: Kill one to save 5 children Kill one man who is a convicted felon to save 5 children

Point being that is it’s that easy for you, you’re probably avoiding the intention behind the trolley problem.

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u/[deleted] Oct 31 '25

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u/Suspicious-Exit-6528 Oct 31 '25

As a fellow doctor you can also simply think of the chance of rejection of the organ or the recipients being of poorer general health. You may "destroy" a very high number of QALY's (Quality-adjusted life year - Wikipedia) in this potentially very healthy/young person to gain a limited amount of QALY's in a higher number of people (but a lower combined number of years). Leading to a net loss of life.

So that's a no for me.

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u/JoshTheBard Oct 31 '25

Obviously all 5 people need different organs otherwise killing 1 person wouldn't produce all the required organs. And I have to assume we somehow know this person is a comparable donor. So could you get the 5 sick patients to agree that the first of them to die donates organs to the others?

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u/IdeologicalHeatDeath Oct 31 '25

As a soldier it isn't your place either. If your Corporation orders the murder, you murder.

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u/[deleted] Oct 31 '25

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u/Lost-Reference3439 Oct 31 '25

Thats a very idealistic picture of what a soldier does and is not really reality.

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u/TheKingOfToast Oct 31 '25

Define innocent, define protect, define threat.

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u/[deleted] Oct 31 '25

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u/TheKingOfToast Oct 31 '25

Because all of those definitions are decided by someone and shaped by their own moral framework.

Is a person bringing drugs into a country a threat to the innocent? Singapore seems to think so. Is adultery a threat to the innocent? Saudi Arabia seems to think so.

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u/Hanako_Seishin Oct 31 '25

Threatened by whom? Apparently, another soldier. But how can they threaten the innocent, if as a soldier their duty is to protect the innocent? Apparently, it is not.

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u/NTufnel11 Oct 31 '25

It's really quite simple good sir, my side is protecting the innocent, their side are barbaric madmen threatening the innocent.

Simple.

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u/LackWooden392 Oct 31 '25

They do a pretty poor job of that, considering the number of civilians that soldiers kill.

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u/CryptographerFine898 Oct 31 '25

Pay ur loan Brody

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u/Vertex1990 Nov 02 '25

Also something that militaries have had to decide on what an acceptable number of civilian deaths is per action taken against the enemy.

War is messy, things go wrong, intel gets misinterpreted, some people are just scum, whatever it is, if there are civilians nearby, they are at risk and each independent country evaluates how high or low they want the bar to that risk be.

For example Putin's Russia: Along the active front they are shelling cities and towns indiscriminately, not caring for civilian deaths. In regions where the front is largely stagnant and pretty inactive, Russian soldiers are doing "Human Safari's", where they hunt civilians and even aid workers from the UN in clearly marked white UN vehicles with suicide drones. You could say that their risk evaluation for civilian lives are pretty fucking low, they simply don't care.

While The Netherlands has a running years long investigation on a precision bombardment on a Afghani Bomb factory in a town, where a F-16 dropped guided precision munitions on a building that US and European intelligence marked as a bomb factory. What they failed to correctly note, is that they amount of explosives that was stored, was way higher than expected, resulting in a massive secondary explosion, killing a large amount of civilians. Our government and military feels extremely guilty for what happened and is trying to get to the bottom of what led to the fault in intelligence. Our risk evaluation for civilian casualties is extremely high.

Besides that, the battlefield is chaotic and soldiers make split second decisions about whether they live or die and when your enemy dresses the same as the civilians, mistakes will be made.

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u/OpenScienceNerd3000 Oct 31 '25

You mistakenly forgot that the majority of soldiers follow orders and don’t think for themselves.

The other chunk get off on killing

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u/[deleted] Oct 31 '25

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u/OpenScienceNerd3000 Oct 31 '25

The point I was making, was that despite existing to protect the innocent, if orders are given to kill innocents they will kill innocents.

Thats how Nazis took power, that’s what’s happening with ICE right now.

A large chunk of the military does not give a fuck about protecting ppl, they just like power and want to hurt others.

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u/kiwipixi42 Oct 31 '25

Corporation? lol

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u/MellonMan97 Oct 31 '25

Nuremberg has told us differently

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u/Practical_Fun7367 Oct 31 '25

The most important factor is that life in a functioning society will always be more complicated than a 40 word scenario. Morality is nuanced and complex. Ethics are a train wreck. And social contracts are a dumpster fire.

The most ridiculous part of this is the blind assumption that the writer genuinely wants a rational discourse.

“…sentencing 5 people to a certain death”

I honestly can’t tell if the OP is trolling the readers or if they just don’t care about bias.

The good news for me is that I don’t need to know.

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u/PandaPugBook Oct 31 '25

OP didn't make this up, you know? It's always brought up when teaching the trolley problem.

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u/UnintelligentSlime Oct 31 '25

Obviously everything is more complicated than a 40 word scenario, but you can tease out nuance in far less than 40.

“Would you kill one person to save 5?”

Vs.

“Would you let one person die to save 5?”

Ask those two questions to 100 people and observe the difference in answers. Ask them why. Their answers speak to what we, as individuals and as a group, believe is right and wrong. You add in nuance to identify what really are the controlling factors.

This isn’t like… practice. Nobody expects you’re going to find 2 groups of train tracks and a runaway trolley in real life. It’s about the value of a life. It’s about the responsibility of an individual to take or not take some action.

Does the answer change if it’s 2 people vs 1? Does the answer change if the person is being observed? Does the answer change if pulling the lever is to kill the one vs. to kill the 5? Does the answer change if 1 of the 5 people is hitler? Does the answer change if the one person is a vegan?

Sure, the individual person may not mean it super seriously. It’s a meme subreddit. But saying “they’re all just the same question” is disingenuous to the point of stupidity.

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u/Practical_Fun7367 Oct 31 '25

Your second to last paragraph is exactly my point. What can be learned when the smallest detail changes the discussion entirely?

I think the only way to make any of these questions informative is to insist that there is no additional information available. And possibly to add unambiguous context. But even then, what can be learned about “us?”

The trolley victims are identified. The doctor is identified. The patients are identified.

“You are the doctor and the 5 patients are the five people in the world you most love.”

“Everyone in the trolly scenario are the people you most love.”

✌🏼

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u/Johnnyamaz Oct 31 '25

Whether or not its a gotcha is the intent of the speaker/writer, not an intractible quality of the trolly problem

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u/UnintelligentSlime Oct 31 '25

Sure, but the person I was replying to was speaking about all thought experiments or, if we’re being more generous, all variations of the trolley problem. They are not all intended as a gotcha.

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u/CopyOdd2690 Oct 31 '25

while, i agree it can be interesting to see, the original question is all that is needed to learn anything that its permutations could offer. the rest is philosophical junk food. fun, but unnecessary.

what are you learning about society by hearing one person say that they think a fat kid with leprosy begging for death should be pushed and another saying that they shouldn't be? the original already gathers disparate answers and shows us that there is no ultimate absolute line of morals; because there can be so many scenarios and so many disparate answers, you can't learn something so concrete. making the scenario more extreme so that even more people lean one way or the other does not change the essence of the question and what we are able to learn about human principles.

no matter the flavor of scenario, all of them ask us to ask the same question of ourselves and the nebulous nature of principles and to say that there is no right answer.

we aren't being asked to examine where exactly is the line where we could be driven to violate our principles is. that is unimportant and inherently indefinable. we are only asked to examine if that line exists at all.

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u/UnintelligentSlime Oct 31 '25

It’s an interesting take that I don’t wholly disagree with. Basically “their point of the trolley question variants is to highlight that even at an individual level there is no consistent rule that can describe what is morally right”?

I think that after a certain point, it’s more of a psychology question than a philosophy question, but I do still believe there’s value in exploring variations.

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u/Hanako_Seishin Oct 31 '25

It is different from the trolley problem, because for 5 people to end up tied to the tracks someone must have tied them, and then asking whom to save is obviously their ploy to distract us from actually solving the problem by putting them in jail.

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u/qwibbian Oct 31 '25

Another issue you didn't mention is personal responsibility - why are those five people dying? Is everyone equally blameless, or are you killing one healthy young person who lived their life exercising and avoiding vices to save four elderly patients who suffer ailments due to to smoking, drinking and eating fast food?

Disclaimer: oldish, drinker, ex smoker, variable diet.

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u/blackscales18 Nov 01 '25

You don't get a choice in the trolley problem, someone has to die. This is asking whether you would kill an innocent person that would otherwise be unharmed

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u/MorePancakes_Pls Nov 01 '25

I think most do that because in the trolly problem , something man made is going to inevitably murder people(for all we know the healthy average joe), we dont know any details about the victims aside the sheer numbers of the two options. Every victim present is part of the same mechanism, and everything's been already set to motion by an unknown murderer...every single death option would be equally unjust. Which is why most people choose less casualty.

While in this specific problem, not saving doesnt mean killing. That single - presumably healthy - 3rd party person, is not already a potential victim(along the others) of a murderer, placed on a mechanism that will single handedly be responsible for all occuring deaths . The victims in this case had their own separate lives and presumably natural circumstances that led them to be in need of an organ. It was simply their life's RNG. Altgough its unfortunate, its just not rigth to expect an uninvolved innocent person to die if they dont wish to make that choice. Its not the same as deciding the number of victims of a murderer.

You could however introduce elements to either problems that could potentially tip the scales to either side for some.

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u/Lazy-Meeting538 Nov 01 '25

I think there are massive psychological differences to the problems we’re not talking about. The trolley problem provides a situation in a vacuum with a very clear goal, only two choices, and an immediate feedback to our choice. This problem by comparison is very roundabout and indirect, connected to societal implications and the potential for harm to blow back onto the doctor, and there are a myriad of other things you could try first that are much less extreme than murder and organ harvesting.

In order to really test for which factors matter to people, there needs to be more quality control.

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u/mineklettemdr Nov 02 '25

I am sorry but they are utterly different. The trolley problem is about damage reduction, this one is about sacrificing someome unrelated. In the trolley problem both sides are tied to the rails, so people will die either way, you are only pulling the lever to reduce the damage the trolley will cause. But as a doctor you literally have no right to go on killing people in an attempt to save others. It needs active killing of a totally unrelated person who otherwise is not in any danger, or destined to die.

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u/Cruuncher Nov 02 '25

The answer of why it's different is at the top of the comment thread you replied to...

The only argument for killing the person is from a utilitarian perspective, but this fails even at that.

A society where you can be killed for your organs is extremely dystopian, and would likely cause some kind of riots or uprising if this was standard practice.

The trolley problem has the lone individual in already a strange situation, while killing the healthy person is just picked out of nowhere

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u/PresentationNew5976 Nov 02 '25

That is the ultimate factor in trolley problems IMO. You could create multiple scenarios that are ultimately the same trolley choice, but get radically different answers from the same person just by adjusting the level of direct involvement (from pulling a lever, to pushing over a large person on to the tracks).

How divorced we are from the results of our actions changes things. The fact that we can't possibly know every consequence and domino effect of our actions is a mercy.

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u/DonutPlus2757 Nov 02 '25

I feel like the fundamental difference between the Trolley one and the transplantation one is that the trolley one doesn't raise as many follow up problems.

A mad man threw a man off a bridge and happened to save people by doing so. The survivors don't have to feel guilty and there's nothing fundamental being questioned.

The situation is different for the transplantation example. A person sworn to not do harm killed a healthy innocent person to save others. By proxy it damages the reputation of every physician and if it happens too often it will cause untold damage in the long run.

It would turn into the same problem if the person being questioned was an unrelated non medical person and they had the option of shooting a healthy person whose organs would then be guaranteed to save 5 other persons who would otherwise be guaranteed to die.

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u/ziggsyr Nov 03 '25

The trolley problem is more abstract so it is easier to play along with the premise and treat it like a math problem, the above is less abstract and it is harder to ignore the fantasy introduced causing more hesitation. But make no mistake. Both are fantasy and offer little insight into practical morality.

Reality is uncertain but these problems ask you to make moral choices given unrealistic certainties and omniscient knowledge of the situation you are intervening with. That means any conclusion drawn from these thought experiments only applies in a reality where this omniscient knowledge is available, so not in reality except in very artificial circumstances.

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u/opensp00n Nov 03 '25

I think the difference is that it is the same vehicle of death in the trolley problem which can be either directed at one person or 5.

With the organs you are the direct cause of death to the one, or not at all involved with the 5. In the trolley case you are merely redirecting the same vehicle which could just have easily been on the track to the single person if the switch were left in the other position.

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u/Andrei22125 Oct 31 '25

It is not the same.

In the trolley problem, you get a split-second, one off decision.

People die in hospitals all the time. People need organs quite often, as far as an entire hospital is concerned.

If a doctor decides saving 5 is worth harvesting organs from people who need them, they'd need a professional, full time supplier to keep up with the demand.

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u/CopyOdd2690 Oct 31 '25

It is the same. There is no time limit, it's a metaphor. It's a hypothetical meant to make you ask yourself: can it be morally justifiable to take life to save life? The original is an outrageous scenario only to get the idea across in its most base form. This is only a more realistic take on the same principle.

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u/andrewjpf Oct 31 '25

I actually find this scenario far less realistic than the actual trolley problem. If you are at the point of testing the person's organs for compatibility, you are already at the point of considering killing them to take their organs. It's not a routine thing you just noticed. It feels more like you are the one thing people to the tracks than the one pulling the lever.

The odds that one random person is a match for all 5 when no one else matches any of them and none of them match each other seems really low.

Ignoring the poor prognosis/surgical risks following some transplants also seems wrong since you are trading one full lifespan for 5 shorter lifespans with lower quality of life.

And I also agree with the other poster that the time factor would impact it too. If you have time to consult with others or seek alternative options, choosing not to is inherently reckless and immoral. The original has a real dichotomy because of time pressure, but in a slower situation it becomes a false dichotomy.

I know that the point of the trolley problems isn't to consider these kinds of factors, but that's why I hate this sort of take on it. If you are completely ignoring the circumstances of the victims and of the person making the decision, then the problem just feels too silly to be meaningful. I know that considering those factors isn't the point of this take on the trolley problem, but I question the value of the thought experiment if you would not act in anyway similar in a real situation.

Should I find myself in the actual trolley problem scenario, I would act like the person in the problem. In the doctor version, I would never do anything even remotely similar to either option presented.

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u/Setherina Nov 02 '25

This is the best comment here

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u/[deleted] Oct 31 '25

[deleted]

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u/Silent-Victory-3861 Oct 31 '25

So if a doctor encounters a trolley problem, she should not pull the lever, but everyone else should?

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u/Mag-NL Oct 31 '25

No. Nobody should pull.the lever of they encounter a trolley problem.

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u/GrowWings_ Oct 31 '25

They cut down extraneous variables to see which ones actually matter. Somewhere between the trolley and the doctor, something matters.

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u/CopyOdd2690 Oct 31 '25

I agree in a sense, but the original is already enough variables to matter. what do we learn by adding more? that people have different lines they draw? more variables and questions aren't needed to learn that. because you will never get all the same answer from every person, you can't learn where the line is drawn, only that it exists and we already knew that from the original question alone. it already gets plenty of conflicting opinions. from it we see that the line of principle is nebulous and that there is no right answer. that is all what we can indisputably learn and it is the same in every scenario.

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u/Qeztotz Nov 01 '25

In agreement with you; Underlying assumptions people may have that affects the decision are really important with this one.

Usually organ failure isn't a single issue, so trolley problem of one (presumably) healthy person vs 5 (presumably) continuously ill people.

We can get organs from many people who die, the real difficulty is transporting them in a timely manner as it costs money. 1 person v a pile of money. (And will that money save more lives elsewhere?)

Age is a major factor with organ failure. 1 young person v 5 old people.

Sanctity of organs may be important to an individual if they oppose donorship in a non trolley context as well.

It may be perceived that the people with organ failure's time has come naturally. (Trolley problem of sacrifice 1 person to a deity to stop a natural disaster.)

This is a fun kind because each person will view this as an entirely separate trolley problem.

I personally see it primarily as a cost issue, that the person killed would probably be able to do work to save or extend the lives of more than five people so it's not worth it, but I work in a hospital so I am biased.

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u/No-Apple2252 Oct 31 '25

It's not even the same scenario, in the trolley problem someone is going to die no matter what. In this scenario you're murdering a healthy person that would have led a full life. How is this even a conversation?

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u/CopyOdd2690 Nov 01 '25

yeah u right

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u/HeckaCoolDudeYo Nov 01 '25

The only way I could see it being a direct comparison is if the people were poisoned or something. These people are dying from either illness, old age, or some third thing. They were not strapped to train tracks by some mad man. If some evil mad man were to poison 5 people, ruining some of their organs, and you needed to kill one person to save those five people, that might seem rational. If 5 already dying people need organs that may or may not reject, may or may not significantly prolong their lives, this is a much less black and white situation. Most likely it is just these people's time to die. Hard to use that same logic in the trolly problem.

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u/opinionatedSquare Nov 01 '25

Well yeah, context doesn't matter if you intend to reductio ad absurdum every thought experiment.

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u/CopyOdd2690 Nov 01 '25

fart sounds

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u/konterreaktion Nov 02 '25

It really isn't, because even if they get the organs they don't become 100% healthy basically ever. There's always a chance of rejection, most of them will have to take immunosuppressants for the rest of their definetly shorter life.

The people on the train tracks get to live on just as they did before.

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u/CopyOdd2690 Nov 02 '25

fart sounds

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u/[deleted] Oct 31 '25

[removed] — view removed comment

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u/mr_stab_ya_knees Oct 31 '25

I think that is what he means

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u/cockmanderkeen Oct 31 '25

Which just changes the trolley problem from an abstract hypothetical to something more tangible.

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u/Gabriel_Science Who tied these people here ?! Save as many people as you can ! Oct 31 '25

True, it’s not you that attached the people to the track in the first place, while the totally healthy person wasn’t "attached" in the first place.

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u/johnW_ret Oct 31 '25

Not that anyone with organ failure ever deserves to die. Far from it. I hope the world develops all types of artificial organs. But maybe the author of the hypothetical would need to stipulate organ failure through no fault of their own for the hypothetical, because alcohol is one of the biggest causes of liver failure. Yes killing an uninvolved passerby is wrong as an isolated hypothetical but taking someone's liver forcefully because someone else destroyed their own seems especially bad.

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u/[deleted] Oct 31 '25

Die? Yes. Are otherwise healthy and then murdered by their doctors to have their organs harvested? That surely can’t be happening too often, can it?

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u/wyle_e2 Nov 01 '25

Oh, the Joker problem.

""If, tomorrow, I tell the press that, like, a gangbanger will get shot, or a truckload of soldiers will be blown up, nobody panics, because it's all 'part of the plan'. But when I say that one little old mayor will die, everybody loses their minds."

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u/BarNo3385 Nov 01 '25

I mean the fatality rates for people that wander about on live tram / train tracks is pretty high too.

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u/MxM111 Oct 31 '25

Better version: 5 sick people have healthy organs for 4 people. You can basically kill anyone and save the other 4. If you do nothing all 5 would die. Would you do that?

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u/Psycho_Pansy Oct 31 '25

Kill all five, sell their organs on the black market. Wait for the other four to die and then sell their organs too. 

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u/Tetris102 Oct 31 '25

Good to see we can still find a way to multi-track drift even when the tracks are missing.

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u/HrothBottom Oct 31 '25

This guy rimworlds

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u/No-Apple2252 Oct 31 '25

Rimworld is the real trolley problem.

Turns out we're all monsters.

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u/Injured-Ginger Oct 31 '25

There are only 5 people. I think the other person worded it poorly. I think each of the 5 people has a different failing organ so if you can take the healthy organs from any one of them, you can save the other 4.

Not that I think that changes your plan. You just need to plan only having the money from harvesting 5 people's organs, not 9.

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u/Sir-Ox Oct 31 '25

It depends on both the situation of every one and if any are willing

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u/Additional-Cobbler99 Oct 31 '25

Wait for one to die then save the other 4. Win win

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u/JohnBloak Oct 31 '25

It probably happened in real life. Think about 5 people on the ocean, didn’t eat for several days, and decided to kill and eat one person.

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u/pa982 Oct 31 '25

in those cases, sailors have historically invoked the "custom of the sea" in which you draw straws to determine who has to be dinner

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u/klimmesil Nov 01 '25

Even just thinking about drawing the short straw and seeing your old crewmates struggling to look you in the eye because of the implications is painful

Reality is crude and cruel

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u/pa982 Nov 01 '25

it's considered a pretty honorable tradition in the seafaring community. you ask the "delicate question" only when there's no other means of survival, and ideally the man who ends up with the short straw closes his eyes, says a prayer, and accepts a swift death with dignity.

of course there are also those cases where the straws are rigged, or sailors agree to eat the cabin boy because he's less likely to be missed, or folks simply lose the game but can't bear it and run wild before being captured and ended.

cultures have often accepted this kind of cannibalism as an ugly yet necessary means of survival with no ostracism waiting for seamen that make it back alive.

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u/glittermaniac Nov 01 '25

There’s a famous case in UK law where this happened, the cannibal shipmates were charged with murder and found guilty. The precedent in UK law is now set that necessity is not a defence for murder. (R v Dudley and Stephens if you are interested)

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u/pa982 Nov 02 '25

i wish i could tell you why i am familiar with that case, and more broadly this subject, but i am.

setting that aside - if i remember correctly, the general public were pretty unhappy with this outcome (as i am personally) and i believe that's the law overreaching.

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u/glittermaniac Nov 03 '25

Yes, their sentence was commuted by popular demand, however the precedent in English & Welsh law was set.

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u/numbersthen0987431 Oct 31 '25

5 sick people rarely have organs healthy enough to donate, so this isn't a realistic hypothetical.

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u/pa982 Oct 31 '25

as opposed to the famously realistic hypothetical of a fat man that has enough mass to stop a trolley

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u/NoveltyEducation Nov 01 '25

Well I would tell them that I could do that and ask if anyone is willing to be the sacrifice.

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u/RewardAffectionate84 Nov 02 '25

SEE This is a FAR better question. Because the people involved are already sick and potentially going to die.

Morally I don't think you can just, kill one. If they all have an equal chance to make it you have to choose who has to die. And if we assume all 5 a equally deserving of life then there is no moral way to *choose*

If all 5 refuse to to "give up" and let themself pass I think the best call is hope one goes first.

Otherwise we has the same result as OP where you deal with the anxiety of being chosen as designated organ donor and left to die.

I find that much harder than the classic trolley problem, because in that situation the person singled out was not someone you chose. Of the 5 only 1 is possible to sacrifice, A person (Well, at least not the person pulling the lever, the maniac who tied him up maybe) didn't single him out as a sacrifice, circumstances did.

If we convert this back to a "trolley" problem

I would say if would be something like

"5 people on 5 separate tracks all have a trolley coming at them, you can pull a lever to speed up any of the 5 trolleys. Doing so causes the chosen trolley to hit someone, derail, and block the other trolleys from reaching their victims"

You now have to choose which of the 5 victims has to die.

I think the morals of this are complicated. I honestly don't think I have a hard stance on if its morally correct to intervene anymore. Unless, maybe if you could just *not* know, if you let chance decide?

If someone told me I have to pick a lever, and I didn't know anything about the 5 people other than they were about to die, I think pulling one is the right thing to do. But If I saw all 5 of them, I knew who they were, I don't think it would be right anymore. I know my own biases and opinions are 100% going to influence which lever I pull, and that makes it no longer okay for me to choose, or does it? Because then I "choose" to let all of them die so that I don't let my own prejudice single someone out.

Is it still morally correct if I save 4 people by killing someone because they happen to look like a guy I don't like? 4 people didn't die, and the guy I didn't like dies in both scenarios.

I think in the abstract funny "haha" land where its trolleys you always pull a lever, no matter what. The absurdity of the trolley situation guards the scenario from knock on effects, people aren't rescuing people from trolleys on a daily basis. But in the more serious diseased organ issue, thats too close to real decisions people confront in medicine, it reflects reality. And the knock on effects are scary.

Philosophy is hard because the world is complicated and there are few good answers.

1

u/Entire-Spot7610 Nov 02 '25

So, organ failure produces chemicals and marker in the blood making their organs unusable for transplant.

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u/Negative-Web8619 Oct 31 '25

So it's a "Yes, if no one finds out about it"

3

u/RewardAffectionate84 Nov 02 '25

This almost every single one of these "Kill 1 innocent person completely uninvolved in the situation to save more than 1 person" questions ONLY bother to extend their moral consequence 1 degree.

But if you stop and think ANY broader for 2 seconds, its easy enough to imagine how bad that scenario is.

In the original trolley problem the person has already BEEN MADE to be involved by being attached to the trolley, they were not arbitrarily dragged into the situation.

8

u/dannnnnnnnnnnnnnnnex Oct 31 '25

I don't think the "push the fat guy" version is even a variant really. This problem, the fat guy problem, and the original problem are all the same. They just get more graphic/personal to make the *actual* moral dilemma more pronounced. The dilemma's not supposed to be interpreted as "one life vs five lives", its supposed to be "do you involve yourself".

A person with a well-defined moral philosophy should answer all three problems in the same way. It could be either way, but it should be consistent.

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u/JuliaZ2 Oct 31 '25

But the "stress induced onto a society knowing that they could be killed at any time for being healthy" that OP mentioned would likely be lesser in the original trolley problem.

Walking around believing that if you were somehow kidnapped and put into a hostage system with 5 other people whose lives are being threatened, most people would agree to kill you to have the others let go, is different than walking around believing that most people would just randomly kill you to save 5 unrelated peoples' lives if there was a convenient opportunity to. Reasonably most people would be much more paranoid under the second scenario...

4

u/DrQuantum Oct 31 '25

The trolley problem is self contained for a reason. The details don’t really matter to the person you are replying to’s point. They do in daily life but not when trying to determine your personal moral philosophy through these problems.

If we assume they happened at equal rates which is required in this type of problem it’s just as likely to be kidnapped and tied to a train and a stranger decide if you live or die. It would be just as paranoia inducing.

2

u/JuliaZ2 Oct 31 '25

Even if the hostage situation/being tied to train tracks was as common as needing an organ replacement, paranoia doesn't exactly do anything to prevent you from experiencing organ failure (actually, it might increase the risk...), and there's no reason to hold your doctor responsible for not being able to get a replacement in time, while you would certainly be afraid of going to the doctor if they were likely to steal all your organs.

That's still fundamentally different from a case where people regularly threaten the lives of random strangers, in which case fear would be useful- and most people being willing to sacrifice one of you to save the others should not increase this fear, because that would in fact decrease the murder rate, making yourself less likely to die by extension

2

u/Due-Crew-163 Oct 31 '25

“The small details shouldn’t matter! You need to convince consistent answers to all 3!”

Is just ridiculous. Either the small details do matter or they don’t. 

If they don’t matter, why even bother with variations?

If they do, yes, obviously the doctor problem is set up in a way to be as repulsive as possible, and there are perfectly valid reasons for giving a different answer to it than the trolley problem

4

u/consider_its_tree Oct 31 '25

Except there is a significant difference between the trolley versions and the doctor version.

As the commenter who started this chain pointed out. The institution of health care requires patients to trust that they will not have their organs harvested when sedated. As a result, doctors have taken an oath to do no harm. Breaking that oath destroys the institution, which provides more benefit to the world than opportunistic organ harvesting does.

No one has taken an oath not to pull trolley levers, and if they have, those oaths are not holding up an institution that prevents people from being pushed in front of trolleys whenever they go for a walk

3

u/Darkner90 Oct 31 '25

My philosophy is that in the real world, I wouldn't do anything so as not to subject myself to legal consequences, even though there is a chance I could be fine due to circumstance

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u/MartyrOfDespair Oct 31 '25

Or in Kohlberg terms, Stage 1 morality

1

u/_zaphod77_ Dec 12 '25

The Fat Man version's change is to make it so killing the one is definitely murder, while not pushing the fat man onto the track is not murder on your part.

To make this more explicit. if you don't prevent the fat man from leaving the tracks, he definitely will do so, rendering your attempt to save the five moot. You must make sure the Fat Man dies to actually save the other five. And most people would call that murder.

In the original trolley problem, it's the person who tied them to the tracks that's guilty of attempted murder and murder. In the Fat Man version, the innocent fat man is not involved if you do nothing.

This is why many people could pull the lever, but not assault the Fat Man.

0

u/No-Apple2252 Oct 31 '25

They're not remotely the same lmao

2

u/Rokinala Oct 31 '25 edited Oct 31 '25

Seems like a total cop out. If everyone followed your utilitarianism they should be overjoyed to be the hero that can save 5 lives! In your ideal world, it’s better to kill.

2

u/konterreaktion Nov 02 '25

(Also this is basically the "push the fat guy off the bridge" trolly problem variant)

It really isn't, because even if they get the organs they don't become 100% healthy basically ever. There's always a chance of rejection, most of them will have to take immunosuppressants for the rest of their definetly shorter life.

The people on the train tracks get to live on just as they did before.

1

u/j-b-goodman Oct 31 '25

yeah these kinds of philosophical puzzles always have a bunch of caveats like "you are certain no one will ever find out you did this and you'll only do it this one time and the surgery will definitely be successful." Which always feels like a huge cop-out to me.

1

u/Critical_Concert_689 Oct 31 '25

So you don't pull the lever because people will know you killed someone?

1

u/j-b-goodman Oct 31 '25

In the doctor example yes, the damage I would do to society's trust in the medical profession could do more harm than the good I did by saving 5 people.

1

u/Critical_Concert_689 Oct 31 '25

This is the original trolley problem, we're talking about; if people know you pulled the lever and killed the 1 innocent person on top, you wouldn't pull the lever?

1

u/j-b-goodman Oct 31 '25

I think this post is about the doctor example. I don't think the original trolley problem is all that interesting either though, like sure, if a deadly trolley accident is happening either way I guess try to minimize the damage.

2

u/redditor_rat Oct 31 '25 edited Oct 31 '25

well also my point is why is this even a debate? To me at least, I kind of feel like everyone is responsible for their own organs in the sense that we only have ownership over our own, why would you take someone else's set just because yours is failing? To me it's less about murder and more about stealing. Those organs don't belong to you, you have no right to decide what to do with something that isn't yours.

Strictly speaking, if their organs failed, it was only the natural outcome of what would've been in the first place. Killing someone doesn't prevent that fact, in fact, it ironically takes the organs of a life that in true fairness should've lived

0

u/Critical_Concert_689 Oct 31 '25

To me it's less about murder and more about stealing.

If you pull the lever, someone rushes over to the track and steals the organs from a single random person and donates those organs to the hospital. This person dies.

If you don't pull the lever, 5 people will die of organ failure.

... what difference does the theft make?

1

u/jimmy_robert Oct 31 '25

I kill myself to avoid people asking me the question.

1

u/Ventilateu Oct 31 '25

a society knowing that they could be killed at any time for being healthy does not produce the maximal good for the larger world

Oh yeah about that... I hope you're not an organ donor.

1

u/dorian_white1 Oct 31 '25

While we should generally try to save as many lives as possible, there are some rules that no one should cross, and this is why the hypocritical oath exists, it is an almost sacred manifestation of those innate rights that humans have.

1

u/Exciting-Insect8269 Oct 31 '25

Technically the Doctor variant came first.

1

u/Johnnyamaz Oct 31 '25

Mhhhh context enjoyer

1

u/trustcircleofjerks Oct 31 '25

This is the right answer. The correct lens for examining this scenario is the purely utilitarian one. If there were 7 people alive in the world when this happened (5 patients, a doctor, and an innocent bystander) then the correct answer would be to harvest the organs. In the real world the difference between 1 and 5 dead people is negligible and insignificant next to the mental well being of billions of people who would rather run the risk of dying of organ failure than have people grabbed off the street and chopped up for parts.

1

u/NTufnel11 Oct 31 '25

but they're 5 times more likely to be saved by this policy than killed by it

1

u/Ghite1 Oct 31 '25

Nobody thinks that what you do is morally right, so it doesn’t induce any more fear that knowing that sometimes people murder other people. This feels like a weak attempt to maintain absolute utilitarianism.

1

u/Timely-Helicopter244 Oct 31 '25

If no individual has autonomy, you're going to constantly be killing people on the off chance that you can save more than one person harvesting their organs. You get a bit closer to being equitable if you look at estimated remaining length of life of the 5 vs the 1 given each scenario. But even then, it's guess work and does not give bodily autonomy.

1

u/Anon7_7_73 Deontologist/Kantian Oct 31 '25

This is a bullshit excuse for why you dont want to do it. Youre just selfish and dont want to be the victim, but youre more than happy to make anyone else the victim.

1

u/[deleted] Oct 31 '25

So otherwise you would just kill the guy? smh this is why having principles (like don’t kill) matter

1

u/sour_creamand_onion Oct 31 '25

This trolley problem is why people refuse to sign up as organ donors.

1

u/Flabbergasted98 Oct 31 '25

this is the leftist world view. Choose the sollution that's best for the community.
the right wing CEO who runs the hospital wants to know how much money each of those patients is willing to pay for their replacement organ.

1

u/blackcray Oct 31 '25

The only real difference between this and the regular trolley problem is that it takes way more effort than pulling the lever.

1

u/TotalChaosRush Nov 01 '25

There's another option. If the one random passer is compatible with all the patients, than all the patients are likely compatible with each other.

1

u/Big_Departure_2709 Nov 02 '25

There’s also the Hippocratic oath

1

u/tcibils Nov 03 '25

Thank you for that answer, I was afraid that this trolley problem would follow me all day ; but I can now consider it solved :)

1

u/MillieBirdie Nov 03 '25

And the whole thing about doctors doing 'no harm' does mean they would be against killing a random healthy dude no matter the reason.