Trolley Problem- Playing God

Good morning, here I discuss the most common defense that students give when confronted with the Trolley Problem: “I cannot play god.”

When I present someone with the Trolley Problem and promote the idea that sacrificing a person to produce a net benefit is a permissible action, students and cohorts often say something to the effect of “I cannot play god”- though this often comes out in secular fashion as “I cannot change fate.”  When I ask for clarification they say that this means they cannot take this responsibility into their own hands to alter the “natural course”.

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First this is logically inconsistent.  If we define the will of god or fate as a natural order that should be maintained at all cost then one should do nothing.  Ever.  But we make life altering interventions all the time.  Would not administering medicine or pulling someone out of the path of a speeding car be interfering with natural order just as much as sacrificing a person to save five?  Participants to the Trolley Problem do not see these life saving interventions as a contradiction, which is OK because people are seldom logically consistent when identifying their moral codes.  And indeed, administering medicine and pulling someone from the path of danger are not ambiguous.  The power of the Trolley Problem is that there are no purely good options.

Secondly, I dislike the way in which people who say they cannot play god because it seems to shrug responsibility.  Surely inaction is just as much of a decision as is the decision to push the person.  If a person is put in such a position by whatever circumstances then I would argue they should confront those options and not dismiss his or her role a priori.

One would limit their ability to do a great deal of good by deciding not to interfere with natural orders.  Fate and natural order show striking injustice and cruelty.  The intervention of sentient beings can transfer some of the injustice or distribute it to mutual benefit.  In a Radiolab podcast about triage, assigning degrees of urgency to patients, nurses gave their stories about treating patients with dire limitations.  During hurricane Katrina the power went out, the hospital was surrounded by water, and the nurses struggled to find a means of transferring their limited resources to the patients with the best odds of surviving.  Some, it appeared, were given morphine to mask their pain until they died.

The episode demonstrates some of the concerns that people question when faced with the Trolley Problem: will I be held legally responsible?  Certainly there were family members of the deceased in the hospital who were ready to assign blame and call murder when their family members were not the ones chosen to live.

Because people are self interested the individual who hangs in the balance cannot be a reliable decision maker to determine whether or not they receive treatment or protection over another (think of the trope of saying “I have a family” as if those others did not).  And neither are the family members likely to be understanding that their loved one was seen as less worth saving than a stranger.  And at times of crisis and distress the acts which will save one life over another should be made logically and consistently to prevent personal judgments from clouding decision making.

Fortunately a protocol exists in certain professions.  The US Army medics receive training on triage with the following categories of urgency:
Immediate: i.e. uncontrolled hemorraging, extremity amputations, airway obstruction
Delayed: i.e. fractures, survivable burns
Minimal: no explanation necessary
Expectant (oddly placed below minimal): injuries which overwhelm capabilities or patients who appear to be beyond saving i.e. arriving with no vital signs or high spinal cord injuries, which are set aside and checked but do not receive the attention that Immediate and Delayed patients receive.

The purpose of the assignation is “the return of the greatest number of warfighters to combat and the preservation of life, limb and eyesight.”  It ensures that medics are making good decisions about how resources are used under tactical constraints.  Army medicine is a good example because combat and crisis situations provide the closest real world examples of the Trolley Problem.  If a person enters a position to save lives whether it be combat, crisis or unfortunate geography and made the defense “I can do nothing because I cannot play god” then I think it would be correct to condemn them for professional incompetence, malfeasance in addition to being intellectually lazy.

-TK

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