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Old 13th January 2021, 02:23 PM   #1
suren
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Moral dilemma

Imagine there are 5 dying unconscious patients with various organ failures (heart, lung, kidney, etc.). There is a possibility to kill one of them and use his organs to save the other 4. There is no possibility of preference for a victim based on rationality, i.e. we can choose the victim randomly at best.

Is it acceptable to kill someone for the sake of saving others?

Some people might argue that we should leave them to die since we are committing murder which is by itself is very immoral. But what if we were in a similar situation with 100 or even 1000 (both are unrealistic but let's ignore this for the sake of the thought experiment) dying patients instead of 5? Can this number reach to some point where killing 1 person becomes more rational/moral?
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Old 13th January 2021, 02:45 PM   #2
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Problem with your type of hypothetical dilemma is that it doesn't actually represent a dilemma in the real world, it's too simplistic, so what usually happens is that after the yes or no answer the trap is sprung and it is claimed that x=y. With x being the hypothetical dilemma and y being a real world dilemma. But x and y are different in many ways.

I don't even know what type of answer you want, is it meant to be within the legal framework of our society, is it meant to be a logical argument?
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Old 13th January 2021, 02:54 PM   #3
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1. there is no such thing as random
2. in USA, would require consent
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Old 13th January 2021, 02:56 PM   #4
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Originally Posted by Darat View Post
With x being the hypothetical dilemma and y being a real world dilemma. But x and y are different in many ways.

...

I don't even know what type of answer you want, is it meant to be within the legal framework of our society, is it meant to be a logical argument?

X might be hypothetical but it's hard to argue that it's completely impossible. No, it isn't meant to be within the legal framework of our society, nor I'm arguing something. Just want to know others' opinion.

Three is a clear dilemma between "many victims but equality" and "few victims and inequality". I want to know arguments for and against each sides of the dilemma. Also how much does the number influence on this.
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Old 13th January 2021, 03:06 PM   #5
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Originally Posted by suren View Post
Imagine there are 5 dying unconscious patients with various organ failures (heart, lung, kidney, etc.). There is a possibility to kill one of them and use his organs to save the other 4. There is no possibility of preference for a victim based on rationality, i.e. we can choose the victim randomly at best.
It is generally not ethical to kill someone to save the others in this scenario. However:

Quote:
Is it acceptable to kill someone for the sake of saving others?
Yes, it is absolutely acceptable to do this. Just not in every scenario.

Quote:
Some people might argue that we should leave them to die since we are committing murder which is by itself is very immoral. But what if we were in a similar situation with 100 or even 1000 (both are unrealistic but let's ignore this for the sake of the thought experiment) dying patients instead of 5? Can this number reach to some point where killing 1 person becomes more rational/moral?
Yes.
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Old 13th January 2021, 03:06 PM   #6
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Originally Posted by suren View Post
X might be hypothetical but it's hard to argue that it's completely impossible. No, it isn't meant to be within the legal framework of our society, nor I'm arguing something. Just want to know others' opinion.
What's your opinion?
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Old 13th January 2021, 03:08 PM   #7
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Originally Posted by suren View Post
Imagine there are 5 dying unconscious patients with various organ failures (heart, lung, kidney, etc.). There is a possibility to kill one of them and use his organs to save the other 4. There is no possibility of preference for a victim based on rationality, i.e. we can choose the victim randomly at best.

Is it acceptable to kill someone for the sake of saving others?

Some people might argue that we should leave them to die since we are committing murder which is by itself is very immoral. But what if we were in a similar situation with 100 or even 1000 (both are unrealistic but let's ignore this for the sake of the thought experiment) dying patients instead of 5? Can this number reach to some point where killing 1 person becomes more rational/moral?
I expect that the medical people involved would say something like:

First, since all five people involved are unconscious, they cannot provide the consent that is needed to kill them. Therefore, it is quite unlikely that any of the medical people would get involved in the murder of one of the five people.

Second, in the USA it is generally quite illegal to kill someone, unless there is a very good reason for doing so. Therefore, it is quite unlikely that any of the medical people would get involved in the murder of one of the five people.

Third, being an organ donor also requires consent. And without that consent, then it is quite unlikely that any of the medical people would get involved in the harvesting of the organs that are needed by the other four.

As a result, I would expect that all five of the people in your scenario would die of their various infirmities.
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Old 13th January 2021, 03:11 PM   #8
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Originally Posted by suren View Post
Imagine there are 5 dying unconscious patients with various organ failures (heart, lung, kidney, etc.). There is a possibility to kill one of them and use his organs to save the other 4. There is no possibility of preference for a victim based on rationality, i.e. we can choose the victim randomly at best.

Is it acceptable to kill someone for the sake of saving others?

Some people might argue that we should leave them to die since we are committing murder which is by itself is very immoral. But what if we were in a similar situation with 100 or even 1000 (both are unrealistic but let's ignore this for the sake of the thought experiment) dying patients instead of 5? Can this number reach to some point where killing 1 person becomes more rational/moral?

Sometimes it's acceptable to kill someone for the sake of (that is to say, as a result of) saving others. And sometimes it isn't.

What makes the distinction most clearly is the shared-predicament principle, that says utilitarian tradeoffs can be made when the victims and the saved are in a shared predicament. (This is also where self-sacrifice to save others is most often seen, so it might operate on a near instinctive level.) Yes, you can switch the trolley and kill one person to save five others, because all six of them are standing around oblivious on the trolley tracks which puts them in a shared predicament. No, you can't push the spectator off the bridge to his death to save the same five on the trolley tracks, because the one on the bridge is outside the shared predicament. Yes, you can order a regiment of soldiers into a hopeless sacrificial position to save a division; that's a strategic decision. No, you can't execute a hundred innocent civilians to save a division; that's a war crime. Shared predicament, not shared predicament.

In your example, it's not necessary to take the analysis to that level. Since all five patients supposedly will die even if all measures short of killing one of them are undertaken (or else there's no dilemma), one of them will die first. Use those organs to save the other four.
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Old 13th January 2021, 03:11 PM   #9
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Originally Posted by Crossbow View Post
I expect that the medical people involved would say something like:

First, since all five people involved are unconscious, they cannot provide the consent that is needed to kill them. Therefore, it is quite unlikely that any of the medical people would get involved in the murder of one of the five people.

Second, in the USA it is generally quite illegal to kill someone, unless there is a very good reason for doing so.
I think the point of the question is not whether it's allowed in this or that jurisdiction, or if these or those doctors would do it. I think the point of the question is how you, personally would answer it. Do you, Crossbow, think it would be ethical to kill one to save four? If you were a legislator, would you propose legislation to legalize such acts? If you were a voter, would you vote for such legislation? If you were a dictator, would you dictate that such acts are permissible under your rule? Would you dictate that they are required?

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Old 13th January 2021, 03:15 PM   #10
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Look up the Trolley Problem. This is an equivalent moral dilemma, and this sort of thing has been extensively discussed for a very long time. A popular solution is that it is morally unacceptable to use people as one would a resource without agency, even if the result is a net increase in the number of people who survive; but it's a huge subject that I haven't studied in detail. Wikipedia is, as always, a good place to start, as long as it isn't seen as a good place to finish.

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Old 13th January 2021, 03:16 PM   #11
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Originally Posted by theprestige View Post
What's your opinion?
Honestly, I'm not completely decided. But it's likely there is some limit... The problem here is that you can't give precise answers to that. Sometimes leaving people to die is not much different from murder.
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Old 13th January 2021, 03:21 PM   #12
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Originally Posted by Darat View Post
Problem with your type of hypothetical dilemma is that it doesn't actually represent a dilemma in the real world, it's too simplistic, so what usually happens is that after the yes or no answer the trap is sprung and it is claimed that x=y. With x being the hypothetical dilemma and y being a real world dilemma. But x and y are different in many ways.

I don't even know what type of answer you want, is it meant to be within the legal framework of our society, is it meant to be a logical argument?
It's a popular "intuition pump" in pop ethics generally meant to be a challenge to a particular kind of utilitarianism. It's a variation on the Trolley problem.

Simplified is generally a good thing for ethical thought experiments/intuition pumps. The idea is to exclude all the distractions and remove from reality to ask a focused question about ethics. But also to make it visceral and specific enough that it has to be contended with instead of abstracted away.

There's no objective way to test ethics in the physical world. Hume's is/ought problem stands. So most attempts to challenge or argue ethics involve an appeal to intuition. "This ethical system is right because it maps well with everything that feels right to me!" of "Oh no, I thought this was a correct ethical system, but if I apply my stated ethical principles in this thought experiment, I get a result that feels very wrong".
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Old 13th January 2021, 06:03 PM   #13
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Originally Posted by suren View Post
Honestly, I'm not completely decided. But it's likely there is some limit... The problem here is that you can't give precise answers to that. Sometimes leaving people to die is not much different from murder.
The answer is that it depends. Would you kill a paedophile to save a generous person? Would you kill a generous person to save a paedophile? Those are two very different scenarios. There are too many undeclared variables, and this is why the trolley problem is not a good measure of moral values.
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Old 13th January 2021, 06:31 PM   #14
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The only clear cut cases of killing one to save another (medically) I can think of are those of a parasitic twin. Even if the twin has full brain function, both will die without surgery, or one will live.

Otherwise, you wait for a brain dead body with consented healthy organs to use.

Now, if these are the last 5 fertile female or male humans on the planet, my answer may differ. There are too many scenarios with such a vague starting point.
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Old 13th January 2021, 10:37 PM   #15
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Originally Posted by arthwollipot View Post
The answer is that it depends. Would you kill a paedophile to save a generous person? Would you kill a generous person to save a paedophile? Those are two very different scenarios. There are too many undeclared variables, and this is why the trolley problem is not a good measure of moral values.
If a criminal is doing a dangerous act such as shooting at people and there is no other option for neutralizing him other than to kill him, then it's probably acceptable.
In this case we have no additional information about those people. Actually I mentioned that there is no possibility of rational preference.
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Old 13th January 2021, 10:49 PM   #16
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as with all Consequentialist conundrums, the relevant question is time:
was killing/not killing the ethical choice after a week, a year, a century?

did the survivors go on curing cancer or start a genocide?
did freeing up the hospital beds save many more lives or cause a superbug to be created?

in the absence of perfect information or an existential crisis, I would stick with the laws and norms of not killing.
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Old 14th January 2021, 11:38 AM   #17
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Originally Posted by theprestige View Post
I think the point of the question is not whether it's allowed in this or that jurisdiction, or if these or those doctors would do it. I think the point of the question is how you, personally would answer it. Do you, Crossbow, think it would be ethical to kill one to save four? If you were a legislator, would you propose legislation to legalize such acts? If you were a voter, would you vote for such legislation? If you were a dictator, would you dictate that such acts are permissible under your rule? Would you dictate that they are required?
I cannot provide you with a sensible answer to any of your questions without being provided with a great many more details.
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Old 14th January 2021, 12:47 PM   #18
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Originally Posted by Crossbow View Post
I cannot provide you with a sensible answer to any of your questions without being provided with a great many more details.
That is close to the right answer, but just a tad off the mark:

I cannot provide you with a sensible answer to any of your questions without being provided with a great many more details proper funding for a research chair at our university devoted to this topic.
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Old 15th January 2021, 11:25 AM   #19
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Some questions do not have "right" answer. I'm not aware of any Law of the Universe that says they should.
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Old 15th January 2021, 11:37 AM   #20
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I'm more interested in the actual real world versions of this conundrum, where we actually do have to come up with some kind of practical answer. Like, what's permissible when you're at war, and your enemy uses hospitals as ammunition depots or artillery parks? What's permissible when your enemy makes the HQ of a major command, and its staging area, coterminous with an urban center?

Or, what's permissible when a pregnant woman's life is seriously threatened by the baby growing inside her?

What's the best course of action when a self-driving car could crash into the baby stroller in the road, killing the baby but leaving the car's passengers relatively unharmed, or it could swerve into a concrete abutment, saving the baby but gravely injuring or killing its passengers? A human driver would likely swerve, and would likely defend that reflexive choice with their dying breath. But what should an ethical programmer of self-driving cars ethically program into the AI's risk assessment?

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Old 15th January 2021, 02:25 PM   #21
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Originally Posted by theprestige View Post
I'm more interested in the actual real world versions of this conundrum, where we actually do have to come up with some kind of practical answer. Like, what's permissible when you're at war, and your enemy uses hospitals as ammunition depots or artillery parks? What's permissible when your enemy makes the HQ of a major command, and its staging area, coterminous with an urban center?

Or, what's permissible when a pregnant woman's life is seriously threatened by the baby growing inside her?

What's the best course of action when a self-driving car could crash into the baby stroller in the road, killing the baby but leaving the car's passengers relatively unharmed, or it could swerve into a concrete abutment, saving the baby but gravely injuring or killing its passengers? A human driver would likely swerve, and would likely defend that reflexive choice with their dying breath. But what should an ethical programmer of self-driving cars ethically program into the AI's risk assessment?
People are forced to make choices all the time. There are not always "right" answers but choices have to be made.
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Old 15th January 2021, 03:09 PM   #22
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Originally Posted by Gord_in_Toronto View Post
People are forced to make choices all the time. There are not always "right" answers but choices have to be made.
Exactly. And we have bodies of practical applications in law and custom to deal with these real-world questions.

The ethical question of aborting the child to save the mother is well-discussed and has a generally-accepted answer in modern medical practice.

The ethical question of collateral damage in warfare is well-discussed and has a whole body of national and international law addressing it.

These aren't philosophic hypotheticals, where it doesn't matter what answer you give, or if you don't give an answer. These are real-world problems that doctors and soldiers have to face. These are real-world problems that real-world societies debate and make rules about, because they actually do matter to real people in a practical way.

I can understand not wanting to discuss the problem of five people dying and you can kill one at random to save the other four. I can't really understand not wanting to discuss how the armed forces of your democratically-elected government should conduct themselves when the question of collateral damage comes up in battle.

Unless you're a hardcore pacifist that wants use of force taken entirely off the table as an option even for self-defense, you should probably take the time to form an opinion about that one.
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Old 15th January 2021, 03:14 PM   #23
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Originally Posted by suren View Post
If a criminal is doing a dangerous act such as shooting at people and there is no other option for neutralizing him other than to kill him, then it's probably acceptable.
In this case we have no additional information about those people. Actually I mentioned that there is no possibility of rational preference.
A toy problem will have a toy solution. Here's my toy solution: The needs of the many outweigh the needs of the few. So roll the dice, save some lives, pat yourself on the back for being a net lifesaver.

But the truth is I think it's probably better for society overall if we absolutely do not treat people as commodities. So I discard my toy solution in favor of saying the ethical answer here is to let these lives run their natural course, and not try to pick winners and losers based on a coin toss and simple arithmetic.
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Old 15th January 2021, 03:59 PM   #24
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Originally Posted by suren View Post
Imagine there are 5 dying unconscious patients with various organ failures (heart, lung, kidney, etc.). There is a possibility to kill one of them and use his organs to save the other 4.
Nobody's insurance is going to pay for murder-transplant procedures, so this possibility would never be realized.
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Old 15th January 2021, 04:18 PM   #25
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Originally Posted by TragicMonkey View Post
Nobody's insurance is going to pay for murder-transplant procedures, so this possibility would never be realized.
Maybe, but the point of this is to imagine that you faced a hard dilemma and what would you do. "It's unlikely to happen" is not really a good answer. Many things happen, even statistically unlikely.
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Old 15th January 2021, 04:24 PM   #26
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Where are the preliminary trolley problems?
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Old 15th January 2021, 04:26 PM   #27
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Originally Posted by suren View Post
Maybe, but the point of this is to imagine that you faced a hard dilemma and what would you do. "It's unlikely to happen" is not really a good answer. Many things happen, even statistically unlikely.
Well, if it were me I'd do nothing. Because that would be the easiest course, and also the only one that would be guaranteed to be free of legal consequences. Especially since I'm not a surgeon so really even a successful operation on anybody is likely to get me in trouble. Hell, if you even cut someone's hair without a license or their permission it's a whole big fuss, cutting into them for organ removal/addition is even more so. People are weird!
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Old 15th January 2021, 04:27 PM   #28
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Originally Posted by Sideroxylon View Post
Where are the preliminary trolley problems?
Where the hell even has trolleys any more? Didn't that dilemma die out in the 1920s?
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Old 15th January 2021, 04:44 PM   #29
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Originally Posted by Gord_in_Toronto View Post
People are forced to make choices all the time. There are not always "right" answers but choices have to be made.
Yeah, these are my thoughts. You can't quantify human values, experiences and moral/amoral actions. The additional difficulty comes when all your best options seem to be equally bad.
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Old 15th January 2021, 05:01 PM   #30
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Originally Posted by suren View Post
Yeah, these are my thoughts. You can't quantify human values, experiences and moral/amoral actions. The additional difficulty comes when all your best options seem to be equally bad.
I think in real life we tend to find that there's always one option that's a little less bad than the others, if you look at it the right way and are highly motivated to find a least-bad option.

Philosophers always seem to want to try to force real-life responses through mounting contrivances. "What if Evil Superman promised he'd zap you with his eyebeams if you didn't give an answer right now?" "What if your Truth Goggles confirmed that Evil Superman is telling the truth?" Etc.
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Old 15th January 2021, 06:29 PM   #31
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Y'all are the people in math class who leave the questions about "When will the train arrive" blank because trains never travel at a fully consistent mph and who actually takes a train anymore.
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Old 15th January 2021, 07:07 PM   #32
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I prefer to think of myself as the people who blow off the Voight-Kampf test because why would I be walking in the desert or noticing a turtle in the first place.
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Old 15th January 2021, 07:30 PM   #33
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A real-world example of a variation of the Trolley Problem came up on 9/11:

Is it legal, or is it super-legally ethically mandated, or is it morally reprehensible to order the shoot-down of a hijacked airliner full of innocent victims when it seems possible/likely/certain that the hijackers intend to hit a target on the ground with many more victims?

This question has been pondered by at least one highest court in a country: The German federal parliament, at the proposition of the government, passed a law a few years after 9/11 with a provision that would allow for ordering such shoot-downs. The Federal President (a largely ceremonial position) signed this law only with hesitation, urging that it be tested before the Constitutional Court in Karlsruhe, which happened within a year, and the CC binned that provision as unconstitutional:
The basis of all human rights, of the relationship between the state and the individual, is the "dignity" of the individual. Our Constitution begins with the words "The Dignity of Man is untouchable. To heed and protect it is the duty of all state power."
The CC held that, by deciding to end the lives of the innocent for the benefit of targeted victims on the ground, they are being turned into mere objects of state decision making, and this violated the very dignity of each one of them. It does not matter that they would die a little later anyway as a result of having been turned into mere objects by the hijackers: The government absolutely cannot do the same.
Now, the CC deliberately and explicitly left open the question of criminal culpability of a fighter pilot who would act on such a shoot-down order.

Each course of action comes with some non-zero degree of uncertainty: It is not 100% that, say, the kidney patient will die of that condition, or when (or that the hijackers succeed in crashing the plane; or that the trolley ends up killing someone), nor is it certain that harvesting the organs of the one you kill will end up saving the lives of the others.
This uncertainty, which you replace with the certainty of killing, makes the decision to kill unethical, IMO.
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Old 15th January 2021, 07:36 PM   #34
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Originally Posted by Cavemonster View Post
Y'all are the people in math class who leave the questions about "When will the train arrive" blank because trains never travel at a fully consistent mph and who actually takes a train anymore.
I take the train still, and I can attest that trains are so unreliable[*] that the better question is not "when will it arrive", but "what is the latest time at which you can be reasonably sure it has not yet departed?"



[*] Just yesterday, I missed a train that was reported delayed 26 minutes by my smartphone app, and 25-29 minutes late by the display on the platform - and then it pulled in and out 22 minutes too late, and that's how I missed it: The delay notice was wrong!
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Old 15th January 2021, 07:39 PM   #35
theprestige
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Originally Posted by Oystein View Post
A real-world example of a variation of the Trolley Problem came up on 9/11:

Is it legal, or is it super-legally ethically mandated, or is it morally reprehensible to order the shoot-down of a hijacked airliner full of innocent victims when it seems possible/likely/certain that the hijackers intend to hit a target on the ground with many more victims?

This question has been pondered by at least one highest court in a country: The German federal parliament, at the proposition of the government, passed a law a few years after 9/11 with a provision that would allow for ordering such shoot-downs. The Federal President (a largely ceremonial position) signed this law only with hesitation, urging that it be tested before the Constitutional Court in Karlsruhe, which happened within a year, and the CC binned that provision as unconstitutional:
The basis of all human rights, of the relationship between the state and the individual, is the "dignity" of the individual. Our Constitution begins with the words "The Dignity of Man is untouchable. To heed and protect it is the duty of all state power."
The CC held that, by deciding to end the lives of the innocent for the benefit of targeted victims on the ground, they are being turned into mere objects of state decision making, and this violated the very dignity of each one of them. It does not matter that they would die a little later anyway as a result of having been turned into mere objects by the hijackers: The government absolutely cannot do the same.
Now, the CC deliberately and explicitly left open the question of criminal culpability of a fighter pilot who would act on such a shoot-down order.

Each course of action comes with some non-zero degree of uncertainty: It is not 100% that, say, the kidney patient will die of that condition, or when (or that the hijackers succeed in crashing the plane; or that the trolley ends up killing someone), nor is it certain that harvesting the organs of the one you kill will end up saving the lives of the others.
This uncertainty, which you replace with the certainty of killing, makes the decision to kill unethical, IMO.
Interesting! I wonder if this ruling has any bearing on the legality of the German approach to warfare.
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Old 15th January 2021, 10:49 PM   #36
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Originally Posted by Cavemonster View Post
Y'all are the people in math class who leave the questions about "When will the train arrive" blank because trains never travel at a fully consistent mph and who actually takes a train anymore.
Or who would write "I'd be delighted to do all the calculations you want, but first you need to explain to me what this 'time' thing is. Showing your work."
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Old 16th January 2021, 06:40 AM   #37
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Originally Posted by theprestige View Post
I prefer to think of myself as the people who blow off the Voight-Kampf test because why would I be walking in the desert or noticing a turtle in the first place.
Tell me about your mother.
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Old 16th January 2021, 06:57 AM   #38
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Originally Posted by suren View Post
Imagine there are 5 dying unconscious patients with various organ failures (heart, lung, kidney, etc.). There is a possibility to kill one of them and use his organs to save the other 4. There is no possibility of preference for a victim based on rationality, i.e. we can choose the victim randomly at best.

Is it acceptable to kill someone for the sake of saving others?

Some people might argue that we should leave them to die since we are committing murder which is by itself is very immoral. But what if we were in a similar situation with 100 or even 1000 (both are unrealistic but let's ignore this for the sake of the thought experiment) dying patients instead of 5? Can this number reach to some point where killing 1 person becomes more rational/moral?
Why not just wait for the first one to die, and then use the organs of the dead person for the others?
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Old 16th January 2021, 07:10 AM   #39
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The above is my practical answer to the thought experiment as outlined. It seems that they all have interchangable organs, which is nice. And it seems that everyone will recover if they get the organs of any of the others. That's great.

In terms of ethics, I think organ donation should be opt-out rather than opt-in, so I would hope that all people involved have consented in one way or another.

But the thought experiment needs more work to make it challenge my intuitions. Maybe you could add a ticking clock and say that the patients are far away from each other and need the organs urgently, so to prevent all of them dying at once, it would be safer to choose one at random and have their organs used.

Personally, it doesn't challenge my intuitions if we were sure that all of them will die without an organ transplant, so we decide to sacrifice one of them. If they have no hope of living, then saving four others seems perfectly reasonable to me.

What is the ethical issue?
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"Evolution and Ethics" T.H. Huxley (1893)
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Old 16th January 2021, 07:11 AM   #40
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Originally Posted by angrysoba View Post
Why not just wait for the first one to die, and then use the organs of the dead person for the others?
Yeah waiting for someone to die is also an option, although some might argue that after the first patient death it might be too late to rescue most if not all of the patients.

Actually the point of such "trolley problem" type dilemmas is to force us to imagine in situations where no alternative options are available.

The current one that I brought is about choosing between a huge number of victims or a few number of unfairly (randomly) chosen victims.
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