Placed in a scenario where you are in control of a train that is set in course to run over and kill 5 people, with the only way of avoiding such a catastrophe being to change the course to the only other available track onto which 1 person will be killed, would you change the course and kill 1, or do nothing and kill 5?
To most this seems obvious, change the course, and kill one, basically saving net lives. However ponder the similarities of the following scenario.
Placed in a scenario where you are in control of 6 people, in a future in which organ transplants are nearly 100% efficient, 5 people are in need of 5 different organs or they will die shortly, and 1 living person has all of their healthy organs, would you harvest the organs of the 1 healthy person to save the lives of the 5 in need of organs?
I think this is a little bit more complex, because I'm trying to ascertain as to why one choice seems so obvious and the other so hazy, when at the core they are so similar. It isn't as simple as "what can one do out of desperation?" This question is more "what is the ethical choice given the scenario?"
Well put, I think you've analyzed the mechanism that is the cause of difficulty when deciding, very well. However this leads me to another, possibly more important question. What is the ethical choice? Selfishly what makes the transplant scenario seem wrong, is that I'm an immediate victim, and in no way do I feel deserving. However to think selflessly, if possible, executing the transplants would seem logical, and in effect ethical it would seem. So the dilemma I would say is torn between viewing oneself as a victim, and logic. When reviewing the question, I feel compelled to somehow sway logic into finding a way to describe it as unethical, however such attempts fail. So in conclusion I would say that executing the procedure would be the right choice to make, as difficult as it would be.
I'm not sure there is a "right" ethical decision to be made. In both scenarios, regardless of the decision, your action (or inaction) results in saving a life or lives.
Why are five lives better than one? Are ethics a matter of quantity? If the five people were convicts, then it certainly doesn't seem right to sacrifice an innocent person to save them - so why does sacrificing an innocent person, who might otherwise live a happy life if not for these 5 people, seem right if the five people are "good" citizens?
I'm not saying I wouldn't save 5 lives instead of 1, but the moment a doctor saves several patients at the expense of my life, or a loved one, I have to question the ethic behind his decision.
Common Dawkins analogy. For the inevitable death/train scenario, I prefer the utilitarian method.
In the other scenario, in choosing not to kill the one does not mean you are choosing to kill the other five, but simply refusing to kill, period. Rhetorically, you can say that you're technically choosing to kill in both situations, but in the practical sense, you have more control over the latter than the former and the assertion doesn't really have legs to stand on.
So really the only difference is that in the second scenario you don't feel qualified to make a decision regarding another life, where as in the first, it is your decision to make. Practically that is what makes the difference.
Well today you certainly wouldn't, because there's a fairly good chance all 5 of them will still be pretty darned unhealthy, but assuming there was an excellent chance they'd recover upon receiving their transplants, it still seems wrong, but when you think about it in the same terms as the first scenario, it seems right.
Regarding the second scenario, Sacrificing ones own organs is not part of the scenario. For two reasons, firstly it's an ethical question, not necessarily having anything to do with the reader, but rather is only asking what is the ethical decision to make in such a case. Secondly, if one person wished to save five specific people, the chances are that not all of their blood types will be compatible. So it would have to be implemented by creating a system of attaining large enough groups of people who can use an adequate amount of organs from one body in order to make the process worth it. Imagine if one life could save even ten or twenty people, then would it be worth it? Think about it, of all the organs one can die from a lack of function, one person could save many. A heart, two lunges, two kidneys, a liver. That's six off the top of my head, and I know relatively nothing about medicine, I imagine there are many more. Given ever increasing advancements in medical technology I imagine such a system could (in sheer numbers of lives at least) work for the better in the not so distant future. That's where ethics come into question, is saving lives worth the loss of security you have in taking your organs for granted?