World Philosophy Day
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  1. #1

    World Philosophy Day

    Yesterday was World Philosphy Day and an article at bbc.co.uk had four philosophical questions. Follow the link for all four; I'll just post the one question that made me re-evaluate my initial response the most.

    1. SHOULD WE KILL HEALTHY PEOPLE FOR THEIR ORGANS?

    Suppose Bill is a healthy man without family or loved ones. Would it be ok painlessly to kill him if his organs would save five people, one of whom needs a heart, another a kidney, and so on? If not, why not?

    Consider another case: you and six others are kidnapped, and the kidnapper somehow persuades you that if you shoot dead one of the other hostages, he will set the remaining five free, whereas if you do not, he will shoot all six. (Either way, he'll release you.)

    If in this case you should kill one to save five, why not in the previous, organs case? If in this case too you have qualms, consider yet another: you're in the cab of a runaway tram and see five people tied to the track ahead. You have the option of sending the tram on to the track forking off to the left, on which only one person is tied. Surely you should send the tram left, killing one to save five.

    But then why not kill Bill?
    My actual initial response was to wonder if Bill was volunteering or not, though it doesn't really matter in the context of the entire question, and my thought, was "no" if Bill didn't volunteer.

    Then I got to the kidnapping and tram questions and my gut response was 5 > 1. And then I started going .

    Trying to figure out what distinguishes each situation in my mind, what the basis was for my decision and why was it different for the first has been keeping me occupied.
    Why is everyone who drives slower than me an idiot, and everyone who drives faster a maniac?

  2. #2
    Registered User Exalted Member Fireand'chutes77's Avatar
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    The kidnapping one is easy - kill the whiny, snivling Vichy that you and the other five are fed up with. :P

    If that whiny, sniveling one happens to be you.... Guess who just got a gun!

    EDIT: Wait, couldn't you just turn around and kill the kidnapper?
    Carpe Navi: Because you never know when you'll get to go boating at government expense again.

  3. #3
    Well, my answer to the first one about Bill is no. Because that's a bit inhuman. It's wrong to kill someone who didn't do anything, even if it is to save others. And if he did volunteer, well, that's a whole different story. Then, I suppose he'd have to kill himself, because no one should really be doing that sort of thing for him.

    The second: I think the person who has to decide, in this case me, should be killed. Otherwise they'll have to live with that decision forever. And if that isn't an option, then kill the one to save the five.

    The third: Kill the one to save the five.

    I think the difference between the first and the second two are that the last two are sort of dangerous circumstances, in which a person would be scared and decisions would most likely need to be made very quickly. If they didn't act, everyone would probably be dead, or most of them. The first situation has none of that danger. Sure, if Bill isn't killed then five people die. But if no decision is made he still gets out alive more likely than not. Most likely, actually.

    I like this sort of thinking.
    "There's an old Earth saying, Captain. A phrase of great power and wisdom. A consolation to the soul, in times of need: ALLONS-Y!"~Doctor Who

  4. #4
    I think the difference between the first and the second two are that the last two are sort of dangerous circumstances, in which a person would be scared and decisions would most likely need to be made very quickly. If they didn't act, everyone would probably be dead, or most of them. The first situation has none of that danger. Sure, if Bill isn't killed then five people die. But if no decision is made he still gets out alive more likely than not. Most likely, actually.
    To play devil's advocate, I'd say that all 3 situations are "dangerous" because lives are at stake in all cases. The possibility that in the kidnapping and tram cases there maybe a rush to a decision doesn't make it more dangerous than Bill's -- the potential for harm in all 3 cases are identical: one death or five.

    The idea that in the kidnapping/tram we can sacrifice 1 for 5 because it's potentially more urgent, because quick decisions have to be made -- isn't that just an excuse for making a bad decision? Does that mean if the kidnapper lets us take longer to decide (say half a year, and also say it's the same amount of time we have to make a decision on Bill, else it would be too late for the waiting organ recipients) then would we change our mind and sacrifice 5 for 1, or all 6?

    I'd also say that not making a decision in Bill's case is still a "decision"-- a choice not to do anything is still a choice.
    Why is everyone who drives slower than me an idiot, and everyone who drives faster a maniac?

  5. #5
    Administrator Honored Elder jeriddian's Avatar
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    On the face of the questions, they really are all the same question. You are making a decision whether or not to intentionally kill one person to save five others. That is key question, intentionally choosing to kill someone, regarding of the circumstances.

    The first situation is obviously unacceptable, and one I certainly can answer considering my profession. It doesn't matter even if the person was willling to sacrifice himself to give his or her organs, doing so is unethical, immoral, and illegal, even at the risk of the people who needing those organs dying as a result. I have faced this question in real life several times. Besides, we have more practical alternatives.

    In the second case, this is a false argument. Realistically, you are assuming this fictional kidnapper is going to keep his word, which is not very likely. Secondly, the fault of any homicide cannot be forced onto a fellow hostage. If such an act occurs, that person makes a conscious choice and is still commiting a crime, no matter the circumstances. That is simply not an ethical or viable argument. The crime being committed here is by the kidnapper/ murderer. Any crimes will lie on his or her head and no hostage should permit himself or herself to be suckered into participating in those crimes.

    The third case is the same thing as a Kobyashi Maru situation. This is the situation where there is no choice and someone will die no matter what you do. In that case, you have to do what we in the medical field call triage, and you choose the situation that will save the most lives. A good comparison to this is the situation in a nuclear blast of triaging the casualties. The sad situation in that scenario is that the most severely injured people would likely not be treated except for pain, because the chance of their survival from the resultant radiation is virtually zero. The incoming casualties form a nuclear blast would be overwhelming and we would have to direct our limited medical services to those patients who are only lightly or moderately injured as their chances of survival are much better. This is triage, the process to save the most lives possible in a severe catastrophe.
    "Say the Word"

  6. #6
    The first situation is obviously unacceptable, and one I certainly can answer considering my profession. It doesn't matter even if the person was willling to sacrifice himself to give his or her organs, doing so is unethical, immoral, and illegal, even at the risk of the people who needing those organs dying as a result. I have faced this question in real life several times. Besides, we have more practical alternatives.
    jeriddian, is there a line somewhere? Say Bill volunteered and wouldn't die; organ donation would only result in a lower quality of life (hard to live without a heart, I know ) -- or is that still doing someone harm in regards to the Hippocratic Oath and hence still a big NO.

    As an aside, my impression is that MDs recite the Hippocratic Oath when they become doctors (if not then ignore this question)-- has the oath changed at all in modern times, eg. is the swearing by Greek gods still included?
    Why is everyone who drives slower than me an idiot, and everyone who drives faster a maniac?

  7. #7
    Administrator Honored Elder jeriddian's Avatar
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    Quote Originally Posted by canuck31003 View Post
    The first situation is obviously unacceptable, and one I certainly can answer considering my profession. It doesn't matter even if the person was willling to sacrifice himself to give his or her organs, doing so is unethical, immoral, and illegal, even at the risk of the people who needing those organs dying as a result. I have faced this question in real life several times. Besides, we have more practical alternatives.
    jeriddian, is there a line somewhere? Say Bill volunteered and wouldn't die; organ donation would only result in a lower quality of life (hard to live without a heart, I know ) -- or is that still doing someone harm in regards to the Hippocratic Oath and hence still a big NO.

    As an aside, my impression is that MDs recite the Hippocratic Oath when they become doctors (if not then ignore this question)-- has the oath changed at all in modern times, eg. is the swearing by Greek gods still included?
    As far as physicians go on where to draw the line? No, ethically for us there is no such line. We will not sacrifice life if there is ever a choice. That may mean people would die from their disease processes but it emphasizes the first and foremost rule for a physician which is Primum Non Nocere. "First, Do No Harm". That does not mean we do not make some very severe decisions. There are times for example where a pregnant woman has a severe disease process that is caused by her pregnancy, and in which the mother's life will almost certainly be lost, along with that of the fetus, if the pregnancy continues. In such a case, we would do the abortion, even a late one, because that way we can save the mother's life, whereas the alternative is that you would almost always lose both of them. So, even if Bill volunteered to donate all his organs like that, an ethical physician would refuse. Now if it were a kidney or lobe of the liver, that might be possible, but there are some legal hurdles to get past.

    In terms of organ donation, it is standard practice for living organ donation where the health of the donor is not duly affected. We often have living related and living unrelated donors for kidneys as people can live with just one kidney all their lives just fine. In fact about one percent of the general population only have one functioning kidney and the vast majority don't even know it (usually thorugh maldevelopment in utero). We also have been able to have people donate a lobe of the liver for liver transplantation as the liver has a unique ability to regenerate those missing lobes afterwards (although this is a relatively new technique). Obviously we do not have living donors for hearts, lungs, or pancreas as that would be far too detrimental to the donor.

    The Hippocratic Oath is really just a formality to finishing medical school, and is the same Oath used in ancient times. However, the actual wording is not as important (like the swearing to the gods phrase) as the ideals emphasized by the Oath. It's just tradition therefore to recite it. The actual act of taking the Oath is not indicative of anything. A physician makes the commitment to the ethics of medicine that the Oath represents the second he or she steps into the first class of medical school, period.
    "Say the Word"

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