Open AccessMedical ethics and the trolley problem
Author(s) -
Gabriel Andrade
Publication year - 2019
Publication title -
journal of medical ethics and history of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.376
H-Index - 14
ISSN - 2008-0387
DOI - 10.18502/jmehm.v12i3.766
Subject(s) - principle of double effect , utilitarianism , medical ethics , bystander effect , bridge (graph theory) , test (biology) , lever , law , engineering ethics , psychology , medicine , sociology , political science , social psychology , surgery , engineering , paleontology , mechanical engineering , biology
The so-called Trolley Problem was first discussed by Philippa Foot in 1967 as a way to test moral intuitions regarding the doctrine of double effect, Kantian principles and utilitarianism. Ever since, a great number of philosophers and psychologists have come up with alternative scenarios to further test intuitions and the relevance of conventional moral doctrines. Given that physicians routinely face moral decisions regarding life and death, the Trolley Problem should be considered of great importance in medical ethics. In this article, five “classic” trolley scenarios are discussed: the driver diverting the trolley, a bystander pulling a lever to divert the trolley, a fat man being thrown from a bridge to stop the trolley, a bystander pulling a lever to divert a trolley so that a fat man may be run over, and a bystander pulling a lever so that a fat man falls off from a bridge to stop the trolley. As these scenarios are discussed, relevant moral differences amongst them are addressed, and some of the applications in medical ethics are discussed. The article concludes that Trolley scenarios are not the ultimate criterion to make ethical decisions in difficult ethical challenges in medicine cases but they do serve as an initial intuitive guide.