Epidemic: An epidemic ravages the population, causing unconsciousness from which only 1 in 6 people will recover. A day after falling ill, unconscious patients can be tested to discover whether they produce the necessary antibodies for survival. One such patient can, if their blood is extracted, produce enough antibodies to save five patients who would otherwise die -- but the one will not survive the process of extraction. Which policy would you (antecedently) prefer:
- Inaction -- 1 in 6 will recover, all others are left to die.
- Extraction -- 1 in 6 are killed, all others are treated and recover.
Extraction strikes me as clearly the preferable policy (does anyone disagree?), despite the fact that it involves killing as a means -- often thought to be the most difficult kind of utilitarian sacrifice to justify.
A couple features of the case stand out:
* The antecedent distribution of harms and benefits is more readily acceptable as "random" and morally arbitrary, compared to transplant cases where it is easy for us to think of ourselves as healthy, and those dying of organ failure as "others" who may (for all we know) be partly responsible for their ill health. Our reluctance to give up a position of privilege (especially if we can blame the victims) may obstruct our moral reasoning in those cases.
* It is unique and population-wide, better enabling us to consider the case on its own terms rather than being distracted by implicit concerns about downstream effects (e.g. rogue organ harvesting making people scared of doctors).
For these reasons, it strikes me as a better -- more pure -- case than most that ethicists discuss in this context. Do you agree?