So far, in this series, I have considered cases in which you have to decide whether to save one individual person from death or a larger group of people from the same faith. Through critically thinking about John Taurek’s work, we have reached an appealing way of thinking about these situations. I should say that this way of moral thinking is also very much inspired by an ethical theory called contractualism which was recently made popular by T.M. Scanlon in his book What We Owe to Each Other.
If you are in a tricky situation like the case where you have to save either one person or five people, you first consider what kind of general policies could be adopted for that situation. We could adopt a principle that requires to save the greater number, or to flip a coin, or to always save the single person, or to always save whoever you fancy, or … We then think what consequences these principles would have for individuals. If a principle would cause serious and unnecessary burdens to some individuals, then the use of that principle can’t be justified to those people. If it doesn’t, then it’s fine to act on the principle in the situation you are in.
If we think of the principles for the life-saving case in this way, in the basic case the saving the greater number principle seems to be the only justifiable principle. All other principles would cause each one of us a higher risk of death in the live-saving incidents we might have to face during our lives. For that reason, you are not allowed to do anything else except to save the greater number, other things being equal.
This way of comparing the moral principles has attractive consequences also in other kind of cases that are problematic for utilitarian thinking. Consider a case in which you can either save one person from getting a broken bone or million people from a mild headache. When utilitarians think about this type of cases, they’ll have to sum up all the headaches and thus for them it seems like saving a lot people from mild headaches is the better outcome which you should bring about. This to me seems like the wrong to say.
But let’s consider this case with the previous method of moral reasoning. We could all either adopt a principle that requires us to save an individual from breaking a bone in this type of cases or a principle that requires saving the million people from mild headaches instead. When you compare these principles, you don’t know how you will end up being affected by them. You might be end up being the one person whose bone can get broken or you might end up being one of the million people who’ll get a mild headache. Thus, one of the principles will generally protect you from mild headaches in these cases whereas the other principle protects you from breaking a bone in similar situations. It seems to me that it is far more important to be protected from broken arms than mild headaches even if it is likelier that you will occasionally be in the group of million who’ll get a mild headache.
The previous case shows why adopting a principle that requires us to save a huge number of people from trivial harms instead of fewer people from significantly more serious harms can’t be justified to us as individuals. This case too has important implications for distributing healthcare resources. It offers us a way of thinking about the seriousness of harms when we make policy.
Of course this way of thinking about saving lives also has its problems. For example, it will be difficult to deal with cases in which the sizes of the groups and the seriousness of harms are very close. Given a choice between saving one person from death or three people from complete paralysis, what should you do? Adopting the save the one person policy would give us all slightly lower chance of death but a somewhat higher chance of paralysis. Adopting the save the group policy for this type of cases would give us a somewhat lower chance of paralysis but a slightly higher chance of death. Which one of these patterns of risk is a more serious burden to bear that couldn’t be justified to us? This question then seems here just as difficult as the question of what you should do in the original situation.