by Clark Kent on February 9, 2017 - 1:20pm
In a theoretical terrorist attack in a city, doctors are flooded with patients with varying severity in injuries, and are seriously understaffed, when two 30 year old male patients come in. They were in a car accident. The driver is accused of driving recklessly. The paramedics inform the attending physician that the passenger suffers from primary biliary cirrhosis giving him four years to live. The driver has a wife and three young children, while the passenger has no wife, no siblings and both parents are deceased. The attending physician is forced to chose between three terrible options. Each patient would take an hour to treat properly. If the doctor chooses to treat the driver properly, he has a 70% chance of survival but the passenger will die. If the doctor chooses to treat only the passenger, he has a 60% chance of survival and the driver will die. The last option is to rush the treatments on both patients and give them both a 25% chance of living.
There are lot factors that can influence a doctor’s decision. This gives way to two ethical frameworks being viable options for the attending physician. The first being virtue ethics. Let’s consider the impact of being strongly guided by virtues, such as justice, empathy and humility. Justice would force the physician to take into account the actions taken by the patients that caused the incident. The doctor would therefore be inclined to attempt to save the passenger despite the odds, because he is more deserving of the treatment than the driver. The second virtue, empathy, would cause the doctor to take into consideration the lives that the patients lead. The passenger has lived a sad life with no family and was diagnosed with a terminal disease just prior to the incident. This could cause the doctor to choose the passenger, because he was feeling empathetic towards the man who has had a harder life. The last virtue that the physician might consider would be humility. Humbleness could lead the physician to believe that it is not his place to take a life, but to give everyone a chance. This mentality could influence the doctor to treat the patients equally giving them an equal 25% chance of survival.
Next let’s consider the same factors from a utilitarian perspective. Consider this scenario happening 100 times. On average, attempting to save the driver will save 70 lives, attempting to save the passenger will save 60, and attempting to save both will only save 50. Moreover, utilitarianism demands that we consider more than just the lives saved but the life years saved. Since the passenger has a terminal disease with a life expectancy of four years, saving his life would on average save 400 life years. While saving the life of the driver, who is expected to live another 50 years, would on average save 5000 life years. Adding in the life quality of the driver’s family only further increases utilitarian gains from saving his life. Finally, the actions of the patients prior to the accident have no bearing in determining the utility of the lives.
The particular set of virtue ethical guidelines considered here are irrelevant. The point is that if any given set of guidelines leads to saving less life years than the utilitarian approach, then following those guidelines is equivalent to following the utilitarian approach and murdering a few people. If we all agree that murder is undesirable, then we can agree that utilitarianism is the dominant ethical strategy.
Childress, James F., PhD. "VM -- Disaster Triage, May 04 ... Virtual Mentor." VM -- Disaster Triage, May 04 ... Virtual Mentor. American Medical Association, May 2004. Web. 09 Feb. 2017.