Matters of life and death
7th October 2010 — Issue 175Interest in “trolleyology”—a way of studying moral quandaries—has taken off in recent years. Some philosophers say it sheds useful light on human behaviour, others see it as a pointless pursuit of the unknowableThe “trolley problem” thought experiment is designed to test our moral intuitions
A shocking memo leaked to Prospect, drafted by civil servants from the treasury and the department of health, exposes the stark reality of future cutbacks. Harsh decisions are inevitable, says the memo; in one NHS trust people on life-support systems are to be “finished off” on 1st November—either by smothering, or by having the plugs pulled out. Their organs are then to be used to save the lives of others on transplant-waiting lists, who have themselves become a considerable burden to the taxpayer. The total saving to the trust is estimated at £2.3m a year.
Hogwash, of course. But the government will make some tough choices in its spending review on 20th October, and these will cost lives. Whether “efficiencies” are made in the department of transport, the military or the NHS, there will be victims, even if they are unidentifiable. Governments always have to prioritise—choosing, for example, between a cheap medicine which benefits few people a little, and an expensive one which benefits many people a lot. But in hard financial times, such predicaments become more acute.
Moral philosophers have long debated under what circumstances it is acceptable to kill and why, for example, we object to killing a patient for their organs, but not to a distribution of resources that funds some drugs rather than others. To understand the debate you need to understand the trolley problem. It was conceived decades ago by two grande dames of philosophy: Philippa Foot of Oxford University (click here to read more about Foot) and Judith Jarvis Thomson of MIT. The core problem involves two thought experiments—call the first “Spur” and the second “Fat Man.”
In Spur, (see diagram one, below), an out-of-control trolley—or train—is hurtling towards five people on the track, who face certain death. You are nearby and, by turning a switch, could send the trolley onto a spur and save their lives. But one man is chained to the spur and would be killed if the trolley is diverted. Should you flick the switch?
In Fat Man (see diagram two), the same trolley is about to kill five people. This time, you are on a footbridge overlooking the track, next to a fat man. (The Fat Man is now sometimes described as a large gentleman. But fat or large, the fact of his corpulence is essential.) If you were to push him off the bridge onto the track his bulk would stop the trolley and save the lives of those five people—but kill him. Do you push him?
Study after study has shown that people will sacrifice the spur man but not the fat man. Yet in both cases, one person is killed to save five others. What, then, is the relevant ethical distinction between them? This question has spawned a thriving academic mini-industry, called trolleyology.
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