If you were given the opportunity to save the lives of five innocent people, but in exchange you caused the death of another, would you take it?
Most people answer yes, it’s simple math! It seems obvious to an outsider, five more lives would be saved, and the lowest mortality rate is always the best. But… it’s not quite that simple the more realistic it becomes. Picture yourself standing next to a lever as a train hurtles down a set of tracks towards five workers, you look to your left to see a lever. If you pull that lever the train switches tracks to one with a single unknowing worker standing upon it, and in that instant you must decide whether you will be responsible for the fatality of one, or a bystander to the passing of five. It’s a little bit harder to consciously choose what appears to be the most logical choice.
To make matters a bit more difficult, change the scenario and imagine there’s no lever and the only way to save the lives of the five was to push a worker (larger than yourself) in front of the train; that action would then stop the train from running over the five other workers. Again, it becomes a bit more tricky to decipher which is the more ethical option.
There are hundreds of variations of this dilemma – the trolley dilemma – whether one is deciding the fate of unsuspecting workers at the train tracks or they’re a doctor having to harvest necessary organs of a healthy person to save the lives of others. It is commonly used as an ethical crux in determining the most honorable decision in difficult political situation. Taking one through differing variations also builds to see the breaking point of when an action becomes more immoral than not. It reveals a great amount about the values of society; whether the moral value is determined solely by outcome.
When one weighs the moral value of outcome and the trauma it causes in the process, it can be a difficult exercise. Although, this undertaking is not a new issue; the doctrine of double effect was created to help guide this very discussion. Thomas Aquinas first introduced this doctrine in the Summa Theologica (II-II, Qu. 64, Art.7); it explains the permissibility of an action that causes a serious harm (or death) as a side effect of promoting some positive outcome. The overall thesis of this is that it is acceptable to have a fatal side effect that is not directly caused by one (such as diverting the train), but it is not acceptable to utilize harm as a means to reach a positive outcome (pushing another in front of a train).
Despite the seeming simplicity of this creed, the gray area is frequently explored throughout many political debates. One of the many discussions involving this very doctrine is Euthenasia. Euthenasia is a practice of giving patients drugs which are expected to shorten their lives, but they allow for relief from unbearable symptoms. The doctrine of double effect itself has four conditions; in order to fully explain these conditions, let’s take the dilemma of euthenasia through the four conditions to see whether it applies or not.
Roughly, the conditions can be described as the following:
- The act in itself cannot be morally evil or wrong
The act of administering a drug which a patient who is in pain consents to is hardly an evil cause. This is more straightforward considering that it involves individuals working for the best outcome for another person in pain. Providing care and aid to another in need is clearly a moral endeavor.
2. The bad effect cannot cause the good effect
This would only apply if the drug being taken killed the patient as a means of ending their pain. If it merely had the possibility to shorten the lifespan, it is not necessarily causing the positive effects. Therefore euthenasia meets this condition.
3. The agent cannot intend the bad effect
Here, one must avoid sloppy morality, as ignorance is not bliss. Ignoring the latest data or pretending not to know of the negative effects will not do. But there is the argument that the bad effect is not necessarily intended, and the good effect is what euthenasia is attempting to reach. It is not a malicious act.
4. The bad effect and the good effect must be proportional
In this case, the pain of the patient must be so intolerable that euthenasia is a viable option. The correct dosage must be administered as well. Giving a patient more of a dosage than the minimum necessary makes the double effect fall through. Otherwise, euthenasia would pass this condition as well.
Since euthenasia passes this doctrine of the double effect, it can be mostly be considered a moral deed. Of course, there are arguments to this as well and even those who say it is irrelevant as death for a person in that condition is not a “bad effect”. But for our sake of interpreting this doctrine, euthenasia would pass said conditions. These conditions can be utilized in determining the morality of less intense problems, though; in everyday life this doctrine can be applicable (on a smaller but still proportionate scale).
As many say, morality is the crux of humanity, and so it is our duty to make sure we go about life in a way that causes the most good. In order to deeper explore the ethical values of outcomes versus side effects and intentions, I would recommend The Good Place show on Netflix, it demonstrates these principles (in a rather elaborate manner). But if grasping the trolley dilemma in specific is more thought provoking for you – or you don’t quite have the time to be starting another Netflix show – I would recommend the video below. Hopefully these hypotheticals have convinced you to make sure to watch your surroundings around trains though – if nothing else!
Works cited:
BBC - Ethics - Euthanasia: The doctrine of double effect "BBC - Ethics - Euthanasia: The Doctrine Of Double Effect." Bbc.co.uk. N. p., 2019. Web. 8 Nov. 2019. Kockler, N. Kockler, Nicholas. "The Principle Of Double Effect And Proportionate Reason." AMA Journal of Ethics 9.5 (2007): 369-374. Web. 8 Nov. 2019. The trolley dilemma: would you kill one person to save five? "The Trolley Dilemma: Would You Kill One Person To Save Five?." The Conversation. N. p., 2016. Web. 8 Nov. 2019. Doctrine of Double Effect (Stanford Encyclopedia of Philosophy) " Doctrine Of Double Effect (Stanford Encyclopedia Of Philosophy) ." Plato.stanford.edu. N. p., 2019. Web. 8 Nov. 2019.
Hi Sophie,
I liked how your essay examines moral dilemmas, such as the trolley problem, in which every action chosen feels wrong. Your post was very interesting to read as it analyzed how some of these situations applied to the conditions of Aquinas’ doctrine.
You provided some examples of moral dilemmas with very extreme consequences, but I believe that what you discussed is very applicable to other decisions in life as well. In every decision that a person makes, they need to assess the trade-offs for each choice; most of the time, the consequences are not nearly as severe as in the situations that you discussed.
When I was reading through your post, especially with the trolley problem, the first thing that popped into my mind was another biological rule to justify an altruistic action: Hamilton’s rule. In this approach, an organism would act altruistically if the amount of offspring they sacrifice times relatedness to the saved organisms is greater than the offspring gained by the organisms saved. In my opinion, situations involving morals are very difficult and often flexible, so I believe that these rules and models that people make do not really hold true in reality.
Hey Sophie!
This was a really interesting read and I’m glad that someone talked about this morality problem that everyone was asked in their childhood. I remember that most people at first decided to pull the lever because it’s simply logical to save more people. Five is greater than one after all. However, once the problem changed to yourself having to push someone on the train tracks, the number of people who choose to act decreased tremendously. In this case, their own morality was more important than saving the life of five others. For euthenasia, there is less of a morality issue in administering the drug like you said so it is more of a viable option. However, I was confused about your second condition, “The bad effect cannot cause the good effect.” Doesn’t euthenasia, the bad effect, directly cause the good effect, the lessening of pain, by shortening their lifespan? Other than that I found it instructive how you scientifically analyzed euthenasia with these conditions because usually, we make decisions emotionally instead of using logical analysis.