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A Solution to the Trolley Problem

Rick Coste says the solution depends upon what we’ll realistically allow.

In a famous essay in the Oxford Review in 1967, Philippa Foot presented us with ‘the Trolley Problem’. It is no small statement to say it has vexed anyone with an interest in moral philosophy ever since. For those of you who may not be familiar with it, one version goes something like this.

Imagine you’re out for an afternoon stroll and walk across a bridge that overlooks a train track. The track splits in two. Upon one track, five workmen are playing a game of cards as they eat lunch. On the other track is a solitary workman, who appears to be sleeping. As you look down upon this peaceful scene something horrific catches your eye: a runaway trolley (or tram) rounds a far corner and barrels down the track towards the five men playing cards – a fact of which they are unfortunately oblivious. They are too far away for you to call out to them. In your panic, you look around for some way to alert the men, when you see the track switch a few feet away. If you throw the switch, you will divert the trolley onto the track upon which lies the sleeping man. Although he will die, he won’t know what hit him, and you will have saved the lives of five men. Do you throw the switch?

A good utilitarian – such as John Stuart Mill – would opt to switch the track. For utilitarians, the good of the many comes first, and the only option here is to save as many lives as possible. When first presented with the problem, many of us would opt for the same action, whether we’ve ever heard the term ‘utilitarian’ or not.

Hold on. We’re not done yet. Let’s rewind the scene and start over. You’re on the bridge and the same runaway trolley is bearing down on the same five men. This time there is no split in the track, and no switch to throw. However, a rather portly gentleman stands on the bridge next to you, equally frantic. You notice that he is large enough that if he were to suffer an ‘accident’ and fall onto the track below, he might stop the trolley’s progress. Helping this ‘accident’ along would appear to be the only way to save the five men. So you must decide – and rather quickly – whether or not to push the man off the bridge to his death. (This variant was suggested by Judith Jarvis Thomson in 1985). It’s not so easy a choice this time. Here you do not have a switch sitting between you and the act of ending a man’s life. In this instance, you will be physically, viscerally responsible for a man’s death. Then again, by doing so, you would save the lives of five men. The cold calculus of utilitarianism would still seem to point you toward gathering your moral courage and pushing the man off the bridge.

What I propose, especially for the morally tortured utilitarian, is a solution to this dilemma. Before doing so, let me make a few adjustments to the scenario. Forget the trolley, the bridge, and the fat man for now. This time you are not out for an afternoon stroll, but you are instead the Director of a large hospital. You have been made aware of a situation involving five patients, all of whom are suffering unique forms of fatal organ failure. There are no donors available; but you also know a healthy patient was admitted that morning for a sprained ankle. The ankle has been bandaged, and they will soon release him. It occurs to you that if you were to harvest this patient’s organs, you could save the lives of the five. Would it be right to do so?

I could make this decision a little easier. I could alter this scenario so the unsuspecting potential donor patient is elderly and on life support. All you’d have to do is pull the plug – similar to throwing the train switch. But I’ll instead go straight to the difficult dilemma. If you wish to save the lives of the five terminal patients, you must sacrifice a healthy patient.

You can stop worrying about it. I will make this decision for you. You should do what you can, everything medically possible, to save the five and the one (even though he only has a sprained ankle, so good for him). The same goes for the unfortunate fat man on the bridge. You may enlist him to try to help you warn the five doomed men; but you should not push him to his death.

John Stuart Mill being chased by a trolley, with Philippa Foot and Judith Jarvis Thomson looking on. Painting by Stephen Lahey, 2023

Why? Let me answer this with another question. Could you live in a society in which your life could be arbitrarily sacrificed at any moment to save the lives of a thousand, or a hundred, or even two people? Of course not. As a social structure consisting of organisms that have survived for millions of generations, our morality has evolved with us. Some may argue that true altruism does not exist since (as their argument goes) all our actions have selfish motivations driving them. But either way, a society that would allow, or even condone, the sacrifice of one life for the many as an integral component of its value system would not survive for long. The immediate benefits to the five are clear, but the long-term negative effects of a policy that advocates the involuntary sacrificing of people are many. For one, our group sense of personal liberty would rally against a society that cast those liberties aside. It is one thing to remove or quarantine a cancerous cell, as we do an incarcerated criminal. It is another thing to eradicate or quarantine a healthy cell because the surrounding cells might enjoy more resources. In fact, the analogies are endless, but I think you get the point.

Utilitarianism aside, unless you’re a sociopath you will feel the horror that accompanies the thought of pushing a man to his death. It is not a virtuous act, and doesn’t play well with the morality and values that have evolved with us. While intended to serve the greater good, in the longer run it would do the opposite. Indeed, it would create a malignancy that would sit dormant before metastasizing with a vengeance , eventually destroying its host and the society that cultivated such a policy.

Rick Coste is a podcast producer in the USA. His book Evolution Talk was recently published by Prometheus Books.