Ethicists make many uses of the story of the transplant surgeon—the surgeon who uses one healthy patient as an organ bank and saves five lives. Surely this must be a villain, not a hero, but why? Most of us think it would be right, not wrong, to flip a switch so a train didn’t head toward five people lashed to a track but instead toward one. The scenario helps raise questions about killing and letting die, doing and allowing, and also poses a problem for act utilitarianism, which assesses actions in terms of outcomes.
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