There’s this classic thought experiment that people use to argue against utilitarianism. You’re a doctor with five patients about to die for want of different organs, when you get one patient who’s in no danger of dying but is a match for all five of them. You can harvest his organs (which will kill him) and no one will ever know. Killing him seems correct under utilitarianism, but is it really the right thing to do?
I’ve heard two utilitarian responses to the thought experiment. One is that killing the guy is the right thing to do, and our moral intuitions, not designed for weird edge cases such as this, are leading us astray. The other is that killing the guy is wrong, because you’re contributing to a precedent of killing random people whenever they come to the hospital and that outweighs the four lives you’re saving.
But with this and this floating around my head recently I’ve settled on a third solution. I think that killing him does increase utility. But if everyone made the utility-increasing choice, then the world would be a worse place. It’s the altruistic version of the prisoner’s dilemma.
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The issue as I see it is that if you establish a precedent of nearly healthy people going to hospitals and being killed against their will as donations then you would discourage people with tolerable illnesses from ever seeking medical attention for fear of losing their lives.
The obvious solution to this is to keep an organ compatibility list of everyone in the country, and when you require organs to save a few lives with high probability of success you can quickly contact them for volunteers to see if any suicidal people close enough to help wish to volunteer - If nobody replies then you pick one at random and send a hit squad to collect them.
Best of both worlds :p
Or we could, y’know - Cease some of the crazy restrictions on biomedical research and advance plans for synthesizing human organs.
Haha yes, there are in fact many less drastic ways to get more organs. Like opt-out organ donation. Or organ markets. Or taking them from dead people. If none of those solve the problem fully I like your random hit squad idea, though ^_^