The Transplant Problem

In this week’s video, I field a question about a tricky dilemma in moral philosophy: if you had to kill one innocent person to save five people, should you do it?

25 Responses to The Transplant Problem

  1. Max says:

    If murdering the healthy person for organs is acceptable, then every healthy person will be afraid to enter a hospital or even leave the house. It might be worth it in a world where 90% of the population needs an organ transplant to survive, but that’s not the world we live in.

    • Max says:

      Of course the much more realistic scenario is the Robin Hood problem: robbing the rich to feed the poor, also known as progressive taxation. It’s popular enough that it’s implemented in most of the world.

      • Nascentdreaming says:

        That’s not an accurate scenario. In progressive taxation the philosophy is to tax people more because part if their success is due to the parity if the society they live in do they are paying INTO a system from which they gave already reaped the benefits. Further more most criticisms of the tax system revolve around the government s inability to carry out tasks competently rather than an unfair redistribution of wealth, or “robbing” as you unbiasly put it.

    • Cory Albrecht says:

      Max, have you ever ready any of Larry Niven’s Known Space stories and his description of organleggers and how the progress of medical science affected for what reasons the death penalty was prescribed?

    • Andrew T says:

      This was my reaction as well, Max – it seems like an essentially utilitarian argument, in that the most utility to a functioning, productive society is gained by maintaining a society in which innocents are not arbitrarily murdered for organs, despite the loss of 5 members of the society. And as you say, this leads to a better understanding of where that “threshold number” comes from – once the potential death toll threatens the whole community, then the murder becomes justified as an exceptional measure. But of course this too is subject to a fluid definition of a person’s “community” and “society.”

      This reasoning is also dependent on the argument that personally sticking to social rules in a specific situation with no external consequences either way somehow reinforces those rules in a broad sense. Perhaps that’s pretty much invalid, in the same way that the “I might murder people later” answer can be argued around. In that case, this argument has no weight and the disinclination to kill starts to seem like an effect of social conditioning rather than an ethical argument in support of society.

      And now I feel bad for being distracted by the original question and not focusing on Julia’s meta-conclusion about such thought experiments!

  2. Cory Albrecht says:

    But doesn’t a utilitarian viewpoint still have to have some rules? For you have to define what “good” is and what “bad” is in order to determine whether a certain action will increase or decrease the greater good.

    If killing a person decreases the over all good, why does it do so? Even if one uses the reasoning that it decreases the good by depriving, say, a child of a parent who would have been an economic provider and now the child ends up poor. In that case the rule would be “poor is bad”. One may take it a few steps further, like people who are poor are generally less healthy, less healthy means increased suffering, but you still end up with the rule “suffering is bad”.

    I contend that if you follow the reasoning through enough hops like that you will eventually end up at some rule that says “$X is bad” (or “$X is good”). The best we can do is push something one step further back in a “but who created God”.

    Utilitarianism seems to be (with my limited exposure to the concept) a wonderful “how” to act but it still needs a “why” to give it a starting point.

    • Max says:

      Utilitarianism is supposed to maximize utility, so you’re talking about the definition of utility. I don’t know how you’d prove that a particular measure is right, and even if you can perfectly measure an individual’s utility, there’s still the question of how to calculate a single metric for a population.
      Economists use all sorts of metrics, from per-capita GDP to Human Development Index to Satisfaction with Life Index.

      • Cory Albrecht says:

        That’s kind of my point – eventually even a utilitarianist has to have some deontologist in them if you dig deep enough. Even for those economic metrics, when you examine them you still end up with some rule or another that allows you to say “$Value is bad, $Value+10 is good and $Value+20 is even better”.

  3. Max says:

    American emergency rooms perform wallet transplants by charging patients $800 “facility use” fees just for sitting in the waiting room, because many, if not most patients can’t or don’t pay, and emergency rooms are not allowed to turn anyone down, so the insured patients are forced to pay for the uninsured. What’s more, emergency rooms are not allowed to post prices warning patients that they’ll be charged $800 for sitting in the waiting room.

  4. alex says:

    That was an interesting video.

    I do have a minor quibble with something you said, namely, that our ethical intuitions are inconsistent because they developed over millions of years in ancestral environments. While there is a great deal of truth to this, I think the situation is somewhat more complicated. In many cases, our ethical intuitions have changed or even inverted over a fairly short time period.

    For example, a couple of thousand years ago slavery and genocide were common throughout the world. I can’t think of a single ancient text which condemns these practices as such. Nowdays, we think of slavery and genocide as not merely wrong but repellent, to the extent that its sometimes difficult to comprehend how so many people considered them acceptable only not so long ago. More recently, the commonly held intuitions on the ethics of homosexuality seem to be in the middle of an inversion that is taking on the order of decades.

    So our ethical intuitions are not entirely due to millions of years of evolution and indeed, its hard for me to avoid the conclusion that humanity is actually making moral progress. I’m not sure I understand the underlying causes of this progress, and I do sometimes wonder whether we can extrapolate it into the future – how (im)plausible is it to write a science fiction novel about spacefaring humans which own slaves?

    • Cory Albrecht says:

      Alex: But have those intuitions really inverted, as you say, or have we just grown the ingroup and shrunk the outgroup? Because in those days gone by you enslaved “the other” and doing it to your own tribe/nation was an extreme reaction to a serious situation, like making murderers into slave labour.

      • alex says:

        Cory: I believe you are wrong to assert that in ancient times only members of the “outgroup’’ were normally enslaved. I am no expert on such matters, but I do know that the old testament
        contains regulations allowing parents to sell their own children into slavery. Some of these can be found in Exodus 21 for example; both the slaves and the slaveowners would be jews in this case.

      • Cory Albrecht says:

        No, Alex I would have to disagree with you. The Exodus 21 situation is a good example of a reaction to serious events – so serious that they needed to have laws guiding and limiting the application of these extreme actions and which stated how those slaves were to obtain freedom.

        It is obvious that we treat ingroup and outgroup differently. There’s even a term for this in psychology – “othering”. Whether the other is everybody not yourself or those outside your clan or nation, ethics and morality seems have a lot to say about how we treat the other.

        Whether it’s taking that homeless man to a coffee shop and buying him a meal instead of walking past on the street, advocating for a global end to the death penalty or frequenting fair trade stores, almost all these actions we regard as good and moral are about treating the other as no longer the other.

        We are getting rid of the outgroup, or at least trying to.

  5. moneycrumbs says:

    I believe this “Transplant Problem” is along the same lines of another very common quote “Kill one man, and you’re a murderer. Kill millions of men, and you are a conqueror. Kill them all, and you are a god” –Jean Rostand

    What is most interesting is that one of the most famous books known in classical literature “Crime and Punishment” by Fyodor Dostoyevsky deals precisely about this dilemma – a short summary from wikipedia:

    “Crime and Punishment focuses on the mental anguish and moral dilemmas of Rodion Romanovich Raskolnikov, an impoverished ex-student in St. Petersburg who formulates and executes a plan to kill an unscrupulous pawnbroker for her money. Raskolnikov argues that with the pawnbroker’s money he can perform good deeds to counterbalance the crime, while ridding the world of a worthless parasite. He also commits this murder to test his own hypothesis that some people are naturally capable of, and even have the right to, do such things. Several times throughout the novel, Raskolnikov justifies his actions by connecting himself mentally with Napoleon Bonaparte, believing that murder is permissible in pursuit of a higher purpose, only to find out he “… is not a Napoleon.”

    In particular, the answer is that no, killing is not justified because the protagonist was not …. Napoleon.

    This can further be extrapolated to the Transplant Problem because you have not created the young healthy man and thus are not entitled to end his life – regardless if it is to save the other five humans. In fact, the “confusion” can stem from the concept of grouping both “killing” and “saving” into the same basket – i.e. establishing a relational dependence between the two. In my opinion however, if an argument is made to create a separation boundary between the two concept, than one, does not justify the other.



  6. Roda says:

    The question I’d ask you is – if that one person were you – what would be your answer then ???
    Do write and let me know. I’m curious to see how you would think hypothetically.

  7. dovearrow says:

    I always find it disappointing when people lose interest in questions like these. After all, it’s seemingly futile and unanswerable questions like these that lead to some of the greatest discoveries in science and mathematics. What is gravity? What is light? Where did we come from? What is our place in the universe? These are only a few of the questions that have defined the careers of people like Newton, Einstein, Darwin, and Galileo, and their efforts were often stymied by answers that many saw as intuitively simpler and more satisfactory. Case in point, you mention that you lost interest in these questions because you recognize that our morals and ethics have developed haphazardly, unlike mathematics, which relies on consistency with previous existing theorems. Other people, however, have looked at these questions and asked themselves what can these inconsistencies tell us about how the brain works, and how it has evolved over time? In fact, Radiolab recently did a story about a scientist, named Joshua Greene, who discovered something very interesting about how our brain reacts to moral dilemmas like these, and why our answers are not always as consistent as we would like them to be.

  8. Joanne says:

    No. The healthy person most likely earned their good health whereas the people needing transplants most likely smoked or did another unhealthy thing which caused them to need a new organ.

    • Nascentdreaming says:

      What’s if the healthy person was a sex trafficker and the unhealthy person was an outstanding citizen who suffered from some hereditary disease that destroyed their organs?

  9. Michael says:

    The only way that one could approach this hypothetical and leave it with his ethics intact is to attempt to kill the one that is forcing you to murder an innocent person, despite the risk (near-certainty?) of losing one’s own life. This avoids the pitfall entirely.

  10. Grognor says:

    As Russel and Norvig said, “Refusing to choose is like refusing to allow time to pass.”

    The last idea in this video, that intuitions are conflicting and give you poor answers to questions like these, is the entire argument behind utilitarianism. In other words, forget your useless, backwards, preference-reversing intuitions, and go with the greatest good for the greatest number. Done. End of story.

    That’s why of course I’d kill one to save five, or one to save two. Refusal to do so is ethically equivalent to killing five to save one, or killing two to save one, even if crazy old intuitions might disagree.

    • Nascentdreaming says:

      This is really poor reasoning. Hopefully people who follow this reasoning are the first to be sacrificed.

      • Nascentdreaming says:

        objectivity is only secured with the idea of parity. the reason people have evolved a preference for objectivity is because of the idea which is inherent to objectivity that guarantees an equal standard when judging an individuals subjective view. That’s called an INCENTIVE , without the INCENTIVE no one will be objective for long not would objectjectivity creep back up once gone. No objectivity no utilitarianism. Period.

        I will assume I don’t need to explain how killing me to save five other humans clearly favors some objective points of view over my own in an arbitrary manner.

      • Grognor says:

        “Hopefully people who follow this reasoning are the first to be sacrificed.”

        I should have stopped reading here. That’s an awful thing to say, you know.

        But I didn’t stop reading there, and I read the rest of what you said, and it’s really confusing. In fact, I read it several times, and it still makes no sense to me. Maybe you could clarify what you meant, but I’m really not interested in learning what valuable insights you may have after saying that I should be the first sacrificed because I believe sacrifices are sometimes necessary.

      • Nascentdreaming says:

        Grognor, you want me to sacrifice my life based on your subjective philosophy masquerading as objectivity then when I point out the fraudulent reasoning prohibiting this philosophy from ever being truely objective and suggest that those who advocate this philosophy be sacrificed first in order to maintain some sort of justice (which by the way is much more just and objective than subjecting your fellow humans to your arbitrary way of thinking) you imply I am being caustic and unreasonable. Also I do not doubt that you cannot understand what I wrote because if you could I would not have to explain it in the first place. A simpler (possibly too simple now) version: Objectivity incorporates many subjective views and measures them by some equal,fair, objective standard. This is how humans sidestep the chains of subjectivity. We agree to use the same rules when we measure one subjective view as another. Your view dismisses my view (and most likely a great many others that don’t wish to die due to your idiocy) that views my life as being intrinsically more important ( to me) than some others, especially strangers. Your view preaches that you dismiss my view in the interest of objectivity but fails to provide some rule of measurement or acknowledge its own subjectivity. I explained the inherent issues with your view above. Before you cry that it is unreasonable or illogical to place a higher value on my life than others remember that most of the things you enjoy in this world you enjoy due to someone following incentives and thus valuing their life more than another’s, further more there is no subjective opinion or objective opinion for me once mine ceases to exist. The idea that I should die for two others to live also assumes I think the unchecked procreation of this species is paramount and I do not believe that. So I say when this philosophy is applied you and all your moron lemming advocates get sacrificed first. If you think that’s insulting remember you wanted to arbitrarily sacrifice my life for two jerk offs I don’t know.

        PS I apologise for the insult to lemmings, since even
        lemmings don’t commit suicide with out the push of a helping human hand.

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