Wednesday, 20 October 2010

The Moral Trolley Problem - The Actual Answer

The obits column of the FT this Saturday tells me that the British philosopher Phillippa Foot died recently. She invented the "trolley problem", which goes something like this: you are standing by a set of points on a railway line and a runaway trolley is coming towards you. If it continues, it will kill five people who are trapped on the line. You can however pull the lever to work the points and divert it to the other line, where it will kill one person trapped on the line and then stop. What do you do?

Most people say they would pull the lever. You can have an argument about it and the point is, there is no right answer, what matter is the discussion in which you make explicit your moral principles. Well, maybe not. Here's a version: we're at war, you're in the army, the Five are enemy soldiers and the One is a member of your platoon. That's not even a decision. Your duty is clear. Here's another version: the One is your thirteen year-old sister and the Five are paedophiles who have been stalking her recently. I don't think that's a decision at all either. Here's another version: the Five are a bunch of bullies who have been making your son's life at school hell and the One is his best friend. Odd how that level has suddenly rusted in place isn't it? Here's another one: the One is a surgeon who is the only person who can do a life-saving operation on your wife, the Five are the medical staff who told her that there was nothing wrong with her and she should stop wasting NHS time. Okay, that lever's still rusty, but you're going to have a conscience about it. Finally, try this: the Five are blameless Philosophy professors and the One is... another blameless philosophy professor. Okay, we're back where we started.

Justice is properly blind. Morality isn't, but a lot of moral philosophers treat it as if it should be. In the trolley problem, it's not supposed to matter who the people are, but from those examples, it's clear it does matter. When Western Liberals are doing their best formal moral philosophy, they stipulate that all lives are equal and pretend that there are no evil people. When Western Liberals are making real decisions, it matters who the parties are.

Of course it does. The whole point of having relationships, agreements and understandings with people is so that you have a priority with each other. Family come first. Military colleagues after family, when on active service. Then friends and after that business associates and neighbours you trust and like. Drug dealers, child molesters, wife-beaters, serial killers and other such low-lives aren't even on the scale. They don't get any breaks. Until you're sitting in a jury, when the rules say they get treated as innocent until you're convinced otherwise. Because that's a legal process and the Law is blind.

But that's not what's wrong with trolley-ology. To explain what is, I'll give you the correct answer to the original problem. Which is this: "I would immediately pull some of the debris at the side of the railway line across the track and de-rail the trolley, thus saving everyone's lives."

I know. I cheated. Where did I get the debris from? Ummmm, ever seen a real railway line near a set of points? There's always debris. But even that's not the point: I'm not supposed to put the problem in a real-world context. I'm supposed to take one or the other option - when neither is really acceptable. Whereas in the real world, there's almost always a third way, there's always some debris - and it's thinking of the other, pragmatic, options that characterises the leader (JFK and the Blockade option especially at 1:15) and the practical person.

So the discussion that the trolley example generates is not just theoretical - which can be a good thing - it's unrealistic, which is always a bad thing. Here's a real life example from a recent trolley article. "When NICE said yes to [the drug] Herceptin, for early breast cancer, one NHS trust closed its diabetic clinic to pay for it,” said Michael Rawlins, head of NICE. “These are rotten decisions to have to make.”

Well, except the Trust should have asked me. I would have told them to keep the Diabetes clinic open. When the first Herceptin request came along, the Trust should have said "we're sorry, but we don't have the money" and that the Trust is an administrator, not a judge of who is more deserving of medical treatment. She was welcome to try other Trusts who might have the cash. I suspect a number of Trusts did that and I bet it worked.

However, cancer drugs have an odd way of usurping others. This is because the drug companies - Genentech make Herceptin - sponsor charitable foundations who in turn help Mrs X (a photogenic teacher with a family to make you sigh "Aaahhh" when you see the photographs) to "gain her rights" to treatment. Once Mrs X turns up with a strangely effective publicity campaign and a lawyer, we're no longer talking about morality, but whether a corporation with a slick PR campaign gets to decide how our taxes get spent on healthcare.

That's what I mean when I say the Trolley problems are unrealistic. Real moral problems, if they can't be solved by reference to the relationships you have with the people, have to be solved by finding the "blockade option". Trolley problems assume we have to choose between two evils and then discover that we have a limited repetoire for doing so.

No comments:

Post a Comment