The medical ethicist’s ethics

A friend who runs an Alzheimer’s support group told me about a seminar in medical ethics he attended. The speaker used this analogy:

“You are on the bridge above a railroad track and see a train coming, as well as five individuals on the track who cannot see the oncoming train. The five do not know they are moments from being hit by a speeding train. The man next to you is fat. If you throw the fat man into the path of the oncoming train, it will slow the train and the five people on the track will be saved. Do you sacrifice the one, in order to save the five?”

The speaker’s position is yes!, throw the fat man under the train to save the five. His argument being “the greater good”. But, we don’t know that throwing the one under the train to save the five is the greater good. What if, unknown to us, the five were Hitler and his henchmen and the fat man were Ghandi, before he got skinny?

A man who will throw another person under the train to save five others will throw an entire ethnic group under the train to save a nation. It’s the same thing, and we call it “crimes against humanity”.

Let’s rewrite the analogy.

You are on the bridge above a railroad track and see a train coming. There are five individuals on the track. The man next to you is our speaker on medical ethics. If you throw the man who came up with this scenario into the path of the oncoming train, the five people on the track will be saved. How will the medical ethicist react to his humanity being stripped from him and being sacrificed in order to save the five?

Let’s make it personal. Will the speaker on ethics want done to him what he suggests is done to the fat man? He has no choice as to whether he lives or dies. You have deprived him of choice; his life, liberty and pursuit of happiness are in your hands, not his. His humanity taken from him, he is reduced to a sack of meat.

Let’s change the analogy again.

You are on the bridge above the railroad track, and see a train coming, as well as five individuals on the track. The five do not know they are moments from being hit by a speeding train. The man next to you is a powerfully built man, whereas you are rather portly. If you are thrown into the path of the oncoming train, the five on the track will be saved. The man next to you reduces you to a mere object, sacrificing you, the one, in order to save the five.

Do you want someone to take away your choice and decide you must die in order to save other folk who could very well be the most evil men alive?

When you hear folk say things like: “You can’t make an omelet without breaking some eggs…” Run! You can bet when he looks in a mirror he sees the cook. When he looks at you, he sees the egg. Hitler and Mengele are not dead, they are teaching ethics at medical seminars.

On the other hand, Jesus teaches voluntarily surrendering ourselves for others. Jesus said, “If any man would come after me, let him deny himself, and take up his cross daily, and follow me” (Luke 9:23). The ethical difference? Christ’s call to self-sacrifice is voluntary and noble; the ethicist’s call to sacrifice others is coercion.

Scott Wiley