Moral dilemma of choosing who dies

There is a classic thought experiment in ethics - in this experiment, by taking action you save some people but condemn others, what do you do?

Here is a version, known as the trolley problem. Imagine you find out about the plan of a dastardly villain - he has tied five people to the train line and set a runaway train heading towards them. You have realised that there is a junction between the train and the people and you can put a lever and divert the train onto a sideline. Unfortunately, the dastardly villain has also spotted the sideline but in his haste to get away he only had time to tie a single person to the tracks in this direction.

What do you do? Do you do nothing and let the actions of the villain be his responsibility solely or do you decide to take action, divert the train and choose to sacrifice the lone person in order to save the larger group?

In studies, most people say that they will take action and save the larger group, but some do say they will do nothing, so whichever category you fall in, you don't need to worry that you are a bad person. One YouTube channel, actually created a scenario where people were "accidentally" left in charge of a points switch and ended up having to decide whether to divert a train. If they did nothing the train would head onto a track where five people were working, but if they flicked a switch they could divert it to a track where only one person was working. In this practical, under pressure test, most people did not switch the train - but it wasn't exactly a scientific experiment.

Their are a number of variations on this scenario. Psychologists have developed the to explore people's expectations that go along with the basic trolley problem. For example, the lone person has been put their by the dastardly villain, so people perhaps don't feel at fault for selecting them to die - it is still the fault of the villain. But what about this scenario: again a dastardly villain has tied five people to the track and a runaway train is hurtling towards them. This time you are driving a lorry at a level crossing with one car between you and the train track. The runaway train will pass you before hitting the people. If you ram the car, it will be pushed onto the tracks derailing the train and saving the five, but the driver of the car will be killed. Does this more active role make you less likely to act, do you feel less comfortable being involved in the death of a bystander compared to a kidnappee, or do you feel it is the same choice as before? What about if you had to push a single person in front of the train to derail it and save the five, but it involved literally putting your hand on their back and pushing them - would you do that? Would it make a difference if the five or the one were pregnant women or children?

As a final, really pushing the limit, metaphor - how about murdering a single person, who had no friends or relatives, in order to use their organs to save five other people? This may feel very different to people tied on a train track, but the core is the same, deciding upon the death of one person to save five others.

Other similar problems are called lifeboat problems and discuss a group of people being stranded and whether you would sacrifice someone to feed the rest. Or what you would do if there is not enough space for everyone on a lifeboat.

How does this apply to pandemics

We are in the midst of the covid-19 pandemic right now and many countries are actively deciding to lockdown to avoid transmission at the cost of other things. These other things include quality of life issues, from freedom to enjoy the outdoors or visiting family and friends, through to loss of livelihoods or denial of medical treatments for debilitating or painful conditions. There is also a cost in lives. For example, this article discusses the impact of unemployment on suicide rates in England and Wales, and this study found that death rates for unemployed people were higher for a range of diseases and were linked to an increase in homicides. Domestic abuse has increased under lockdown and it seems sensible to think there will be an increase in domestic homicide too.

By taking action we are sacrificing two things. The obvious thing is that we are choosing to sacrifice quality of life in order to increase quantity of life - by sitting indoors we stop people dying over the next few weeks. The less obvious thing is that we are choosing to sacrifice some people's lives to save others - the impacts on peoples future prospects and mental health will cost some people their life. Just like the trolley problem, we must decide whether to sacrifice a few, to save many.

Unlike the trolley problem, we never see who these sacrificed people are. When in, six months time, somebody dies of a stroke, we will never be able to directly attribute that person's death to the stress of losing their job during the covid-19 outbreak. We will only see the impact in the long term statistics. Instead what we see now are the headlines about the number of people dying with covid-19. Attention is squarely focussed on them.

It's not necessarily a bad choice, but maybe it shouldn't be taken for granted that it's a good choice either. If you have an opinion post it in the comments below.