It's a trick isn't it? The woman with gastric issues actually has RABIES and you won't find out until the other 5 patients die of rabies and that's what you get for being a cock.

(January 24, 2018 at 1:46 pm)Khemikal Wrote: If we propose that this were the same person in two different situations in their life it;s easy to see that in saving five in the trolley example a person is being consistent with their consequentialist ethics.,..but having had their moral agency compromised by mortality has chosen a course of action in body farming quantitatively less optimal in killing 1 to save 5 rather than killing 1 to save 6.  

In the one, the subject could do no better.  In the other, he has failed by degree and made himself a murderer in the process.

The numbers game can get interesting... kill one to save 5?--nah. Kill one to save 50?--nope. Kill one to save 500?--um... 5,000? What about 5,000,000?

Comparing the thought experiments does cause me to rethink my intuitions, perhaps more than you. To me, it demonstrates that consequentialism is important in ethics, but not final. At some point it fails, and other considerations supercede the "maximally good outcome." You and I agree that the doctor's particular brand of responsibility causes a divergence, but you seem to stick to consequentialism a bit more than I do: "the medical system could not function if this were permissible" (or perhaps yours is a more Kantian take on the issue). I see the doctor's unique responsibility in terms of his being individually responsible for each patient, while a person next to the trolley switch is collectively responsible for the lives of those on the track. For me, moral responsibility exists in both situations (I part with Steve on this) but the nature of that responsibility prompts different courses of action.

Aside from the difference in causation, I think another issue here are the cirumstances like Mathilda, Khem and others mentioned. You have a moral obligation as a practitioner of medicine to never deliberately harm your patients. Being a bystander in an extraordinary situation, choosing between the inevitable death of one or five, neither directly caused by you doesn’t follow the same rules.

(January 24, 2018 at 2:08 pm)vulcanlogician Wrote: The numbers game can get interesting... kill one to save 5?--nah. Kill one to save 50?--nope. Kill one to save 500?--um... 5,000? What about 5,000,000?

Comparing the thought experiments does cause me to rethink my intuitions, perhaps more than you. To me, it demonstrates that consequentialism is important in ethics, but not final. At some point it fails, and other considerations supercede the "maximally good outcome." You and I agree that the doctor's particular brand of responsibility causes a divergence, but you seem to stick to consequentialism a bit more than I do: "the medical system could not function if this were permissible" (or perhaps yours is a more Kantian take on the issue). I see the doctor's unique responsibility in terms of his being individually responsible for each patient, while a person next to the trolley switch is collectively responsible for the lives of those on the track. For me, moral responsibility exists in both situations (I part with Steve on this) but the nature of that responsibility prompts different courses of action.

I don't personally think that consequentialist ethics are final, I only illustrated how..confined solely to consequentialist ethics, killing one to save six is a better trade than killing one to save five and in the process turning hospitals into a den of vultures, lol.

I also think that "the maximally good outcome" can be superceded, but even if it couldn't, the desert of either actor (or action) is not and would not become equivalent by fiat. I can see why, for example..killing himself would not be an acceptible solution to the doctor. I don't expect him to make that decision....no moreso than I would expect the rolley switch thrower to lay down his own life if..for example, he could gum up the works and save errybody with his bones.

I simply note that, from a purely consequentialist standpoint from numbers, that would be the way to go..and since the one is in a situation in which that option is present and the other is not..it;s more an example of predictably compromised agency than of moral inconsistency.

I, personally, would kill 50k to save one.....lol. To be honest, if I;d committed to saving one single person..and everyone on earth was trying to kill that person..the killings wouldn;t end until I was dead, because I;d keep killing in retribution if they managed to off that one person. I'm not big on consequentialism in killing. I'm duty bound, not outcome seeking. Besides, somebody has to water the grass, amiright?

(January 24, 2018 at 2:15 pm)Khemikal Wrote: I don't personally think that consequentialist ethics are final,

I'm with you here. But do you think consequentialism is important? If so, is it more central or peripheral?

Just curious. I kind of struggle with consequentialism because of the paradoxes that arise from it (that's what I was trying to express in the OP). But in a more basic way of looking at "is this action ethical?" what better measuring stick can there be than a good or bad outcome?

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You kinda answered me in your edit...

I can elaborate.  I think that consequentialist ethics have more value to the group than to the individual.  Particularly, I think that they are useful in compelling an individual to do "the bad thing" for the greater good or allow "the bad thing" to happen to them without reprisal in service of that same greater good, which might explain why c-ethics are normative and institutional..because a single individual is unlikely to be able to assess the full consequences of an action (or inaction) in a moment..or, if they could..have the interests of the group at heart over their own personal ones.

A person, for example..may not want to flip the switch at all, hoping someone else comes along and does something.  People are notoriously inactive.

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I see another poster mentioned that we have laws that might be set against a person who chooses either option.  That is nothing if not an institutional consequentialist ethic.  The notion that a world full of switch flippers that make trolleys run over one person or another person is..in point of fact..not actually likely to yield a world in which fewer people die.

So, we're compelled to allow the bad thing to happen even if we -didn't- want to, because otherwise jackasses would make stupid decisions.  Heroes with guns come to mind.

(January 24, 2018 at 1:13 pm)vulcanlogician Wrote: I guess there is a third solution...

I guess that takes care of survivour's guilt. Uh-oh.