Abstract
This paper deals with the core version of the Trolley Problem. In one case (Trolley) many people favor an act (throwing a switch) which will bring about the death of one person but save five other persons (rather than letting five die and one go on living). In another case (Transplant) most people would refuse to “sacrifice” one person in order to save five other lives (rather than letting five die and one go on living). Since the two cases seem similar in all relevant respects, we have to explain and justify the diverging verdicts. Since I don’t find current proposals of a solution convincing, I propose an alternative one according to which (Transplant)—but not (Trolley)—violates two forms of equality. I also test the underlying egalitarian principle against other cases. I argue that it offers a good explanation and also a normative justification of our intuitive verdicts about the cases.
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Notes
Both case descriptions are simplified; each of them invites certain ceteris-paribus assumptions not spelled out explicitly. But this should not be problematic. However, if one still has doubts about the realistic character of the above two scenarios then one can consider decisions in war like Churchill’s alleged decision concerning the “Coventry Blitz” (disputed historically but certainly still a realistic case), contemporary cases of illegal organ trade, certain mining accidents or shipwrecks, or the case of the fourth plane in the 9/11 attacks (there are even court decisions concerning similar cases). Wood (2011), Fried (2012) and Hare (1981, 139), however, argue (not convincingly in my view) that the consideration of Trolley-type cases is useless and at best very misleading. See also Bauman et al. (2014).
What seems to be clearly out of the question is to turn a trolley away from one to five others (ceteris paribus) or to harvest five persons for their organs in order to benefit one person (ceteris paribus). This kind of “turn” seems clearly worse than the one presented in the above two cases.
I am using the term “bringing about” as neutral between acts and omissions and between killing and letting die.
The current discussion has been initiated by Foot (1978). Fischer and Ravizza (1992b, 1–15), Bruers and Braeckman (2014), and Edmonds (2014) offer overviews over the problem’s discussion; also see Cathcart (2013). See also Ishiguro (2005) for a novel dealing with closely related topics.—There has been a lot of empirical (psychological, neuro-scientific, etc.) research about our reactions to trolley cases. See, e.g., Cushman et al. (2006), Di Nucci (2013), Greene et al. (2001), Hauser et al. (2007), Lanteri et al. (2008), Liao et al. (2012), Mikhail (2011), Navarrete et al. (2012), Petrinovich and O’Neill (1996), Rai and Holyoak (2010), Terbeck et al. (2013), Waldmann and Dieterich (2007), and Wiech et al. (2013). I won’t go into this here.
Foot 1978 invokes the difference between the more weighty negative duty not to kill and the less weighty positive duty to help. Thomson (1976, 1985) argues that in Transplant but not in Trolley bringing about the death of the one involves rights violations and the creation of a new threat (for a later position based on a view of what’s to a person’s advantage see Thomson 1990, ch.7; finally, see Thomson (2008, 2016) for the view that there isn’t a problem in the first place because we’re not allowed to turn the switch in Trolley). Kamm (1989, 2000), Kamm (2001, chs. 6 and 7, 2016a, b) locates the morally relevant difference between the cases in the different causal profiles of the different acts. Costa (1986, 1987) applies the doctrine of double effect in order to locate a relevant difference between the two acts harming the one; for another defense of the doctrine see Kaufman 2016. For the presumed difference between killing and letting die (related to the difference between acts and omissions) see, amongst others, Locke (1982) or Norcross (2008, 68–72). For further proposed relevant differences see: Clark (1995), Gert (1993), Griffin (1996, 98–102), Hallborg (1997), Hanna (1992), Haslett (2011), Laycock (1985/86), Locke (1982, 474–475), Montmarquet (1982), Naylor (1988), Richardson (2008), Russell (1977), Schmidtz (2006), Shaw (2006), Sheng (1995), and Stark (2017).—One could make the following objection against my claim that there is no widespread agreement on the proper solution of the Trolley-problem: One could claim that there is, for instance, widespread agreement amongst consequentialists (e.g., “Use considerations of maximizing expected utilities and disregard recalcitrant intuitions”) or amongst deontologists (e.g., “Don’t use people as mere means, like in Transplant (though not in Trolley)”). However, none of these and other views constitute majority views; apart from that, there are very different consequentialist (permissible killing in both cases vs. impermissibility in Transplant because of the overwhelmingly bad consequence of missing trust in hospitals and doctors) as well as very different deontologist solutions of the Trolley-problem (Kant’s means-end formula vs. the doctrine of double effect). (Also see the examples mentioned above). Thanks to a referee who pressed me on this issue!
Going more into any of them would change the focus of this paper, make it much longer and still not change much at all about the overall argument to come.
Thanks to a referee whose suggestions convinced me to rethink and rewrite a former version of this passage.
We shall focus here on the more “direct” threats (e.g., to the five at the outset of Trolley) and put the more “indirect” threats (e.g., to the one at the outset of Trolley) aside as comparatively minor. By the way, at least Trolley could be easily changed in such a way that both sides are equally under threat, both directly and indirectly.—More importantly, we can leave the comparatively small gains or losses resulting just from the posing or removing of threats (getting anxious, feeling relieved) out of the picture here for the sake of simplicity. This doesn’t change the overall situation: Being alive or not matters much more than whether one is under some threat.
But doesn’t throwing the switch improve the situation of the five (considerably) because otherwise they would have died? And doesn’t not throwing the switch keep their situation the same? This way of judging gains and benefits seems to presuppose that there is a “normal course of events” with which the outcome of the act of the person at the switch is being compared so that one can determine “relative” gains and losses. I have doubts about the applicability of the idea of a normal course of events in general but also in this case in particular: What determines normality when the choice situation leaves it (wide) open what will happen? One might propose to use a distinction between acts and omissions here and let the result of omissions determine the normal course of events. This proposal would be very much in need of argument, also given how controversial and problematic this distinction is; I doubt very much that a convincing case like that can be made. However, I won’t go into this here, also because I don’t need to. My comparison point for the determination of gains and losses is different: It is what results from the agent’s decision (to throw or not to throw); this is being compared with the status quo ante the decision (see above). This is a different way of determining gains and losses but the one relevant and used here. Thanks to Bruce Russell who raised this issue.
I am using “to harm” as neutral between acts and omissions here, like “to bring about” (see fn.3 above).
There is certainly a counterfactual element in the evaluation of the possible states of the subjects here. But this does, of course, not entail that counterfactual considerations play a role when comparing states to judge the equality in expected gains and losses (see fn.9 above).
72 of the 81 possible combinations of gaining, losing or remaining the same for two parties are cases of unequal gains-losses-profiles. It is not necessary to discuss each of these cases.
I am using “role-equality” and “risk-equality” for lack of better terms.
One might want to add “obligatory” to “permissible”. I will leave this aspect aside here.
These are cases of indeterminacy: it is neither (true that it is) permissible nor (true that it is) impermissible to harm the smaller number.—Sometimes, risk-inequality is being attributed greater weight than role-equality, or vc.vs. I have to leave the question open here why and under what conditions one aspect of (in-)equality might be weighed more than the other. I also have to leave the question open whether this is just a psychological bias or rather something that can be justified with good reasons (see also Sect. 5 on borderline cases and the possibility that our verdicts are quite unambiguous).
(PEH) doesn’t entail that “numbers count” in a decisive way (see, e.g., Taurek 1977); it rather only tells us that given certain conditions it is permissible to do harm to the smaller number of people and prevent harm to the greater number of people without claiming (nor ruling out) that this is because of the numerical difference as such.—I won’t go into possible principles for distributing benefits (rather than harms) or into the question under what conditions it might be permissible to do lesser harm to one person and save another person from more harm.
Thanks to a referee!
Thanks to a referee who pressed on on this pair!
What if the five are also overweight? Well, then the trolley would only hit and kill the first of them. In this case we would have a very different choice situation: an “indifference dilemma” like in drowning twin cases. A referee objected to this (thanks for this challenge!), presenting the following case: “Suppose for example that behind the bridge there is a downhill slope, such that if the trolley is not blocked under the bridge, it will go downhill and gain enough speed to kill five overweight people. Or suppose it requires five heavy items to block the trolley, and on the bridge there are four heavy stones and one overweight person that one could easily push off the bridge.” The critical suggestion is that there is role-equality in this case, in addition to risk-equality but still no reason at all to think it is permissible to push the person from the bridge. I agree that there is role-equality here. Shouldn’t I then conclude that it is permissible to push the one? Yes, but is this the wrong answer? There does not seem to be a morally relevant difference between pushing the one person here and (a) using a trap door which opens to the tracks, or (b) using a “Lazy Susan-type device” (Kamm 1989, 228–229), or (c) throwing the switch in Trolley. Hence, there is good reason to claim permissibility of harming the one here, given that it is permissible to throw the switch in Trolley (see also below in the main paragraph). Apart from that, one could say in my defense that this is not a very serious counterexample because it already contains some additional complexities and a degree of far-fetchedness such that intuitions are starting to become less and less trustworthy (see, for instance, also the baroque cases in Unger (1996) which should reduce confidence in taking one’s “intuitive” judgments very seriously). However, I don’t want to use this kind of reply here. A more serious reply in case one doesn’t agree with my permissibility verdict would be to invoke the methodology of reflective equilibrium (see above) and argue that the weight should rather be on the side of the principle here than on the side of the particular intuitions. I don’t want to pursue this particular methodological point any further here and rather put the main weight on the claim of permissibility.
See also Bruers (2016) on this pair of cases and the general idea of “moral illusions” about relevant moral differences in such cases. For the method of “intermediate cases” used here see Fischer (1992a, b), Fischer and Ravizza (1992a, 1994), Unger (1996, ch. 4), Harris (2000) as well as Boorse and Sorensen (1988) and Boorse (1994) in exchange with Fischer and Ravizza (1994).
The following case would also count as borderline, according to (PEH):
Shipwreck
Six persons have survived the sinking of their ship. They are all on a lifeboat but close to starving to death. In desperation they consider drawing straws to determine one who will be killed in order to feed the others.
Here the individual persons are exchangeable but the profile of gains and losses between the would-be victim and the would-be survivors shows the relevant inequality. For one well-known real life case like that see, e.g., R v Dudley and Stephens. If, in addition, the one harmed had special characteristics that uniquely qualified him for being “chosen”—like the fact that their last name is prior in alphabetical order to the other last names -, then there would also be role-inequality and killing the one would be impermissible, according to (PEH).
It also matters whether the baby will survive if discovered or not. If not, then the intuition of permissibility is much stronger because the question rather boils down to whether all in a group or not all in a group should die.—If the situation of the rest of group will improve if not detected (and the baby will survive and get better if detected), then there is (much more) risk equality and the case looks much more like a borderline case.
Finally, one might want to entertain oneself by considering the following kind of (admittedly) far-fetched case:
Switching Organs
A bystander notices a runaway trolley (whose driver has fainted after brake failure) on the track ahead of which are five people who will not be able to get off the track in time. As the trolley approaches and before it reaches the switch, each of the five suffers a serious shock upon noticing the trolley and consequent organ failure (everyone a different one); if the trolley passes the switch and goes towards the five they all die just before the train hits them. The track has a spur leading off to the right. The bystander can throw a switch thus turning the trolley off the main track and onto the one on the right. Unfortunately there is one person on the right-hand track who will also not be able to get off the track in time. If the trolley hits and kills the one (who also happens to be an organ-donor), then his organs will be taken out and implanted in the five on the other track to save their lives. The bystander can either turn the trolley, bringing about the death of the one; or he can refrain from turning the trolley, bringing about the death of the five.
Switching Organs appears to have all the relevant features of both Trolley and Transplant (assuming that it doesn’t matter how the trolley kills or how lives are being saved). I can’t settle the question here how to judge such cases. For similar cases see also Gert (1993, 175), Russell (1993, 170), Kamm (2001, 182), Richardson (2008, 85).
Thanks to a referee for this suggestion!
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Acknowledgements
For discussions and comments I am very grateful to Reinhard Baule, Gisela Cramer, Paul Rablen, Robert C. Robinson, Bruce Russell, an audience at the 2018 APA Eastern Division Meeting in New York City, an audience at Sungkyunkwan University in Seoul in October 2018, and some referees.
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Baumann, P. Trolleys, Transplants and Inequality: An Egalitarian Proposal. Erkenn 87, 1737–1751 (2022). https://doi.org/10.1007/s10670-020-00271-y
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DOI: https://doi.org/10.1007/s10670-020-00271-y