If doctors killed random patients then patients wouldn’t go to hospitals and medicine would collapse.
You’re fixating on the unimportant parts.
Let me change the scenario slightly to fix your collapse-of-medicine problem: Once in a while the government consults its random number generator and selects one or more, as needed, people to be cut up for organs. The government is careful to keep the benefits (in lives or QALYs or whatever) higher than the costs. Any problems here?
That people are stupefyingly irrational about risks, especially in regards to medicine.
As an example; my paternal grandmother died of a treatable cancer less than a year before I was born, out of a fear of doctors which she had picked up from post-war propaganda about the T4 euthenasia program. Now this is a woman who was otherwise as healthy as they come, living in America decades after the fact, refusing to go in for treatment because she was worried some oncologist was going to declare a full-blooded German immigrant as genetically impure and kill her to improve the Aryan race.
Now granted that’s a rather extreme case, and she wasn’t exactly stable on a good day from what I hear, but the point is that whatever bits of crazy we have get amplified completely out of proportion when medicine comes into it. People already get scared out of seeking treatment over rumors of mythical death panels or autism-causing vaccine programs, so you can only imagine how nutty they would get over even a small risk of actual government-sanctioned murder in hospitals.
(Not to mention that there are quite a lot of people with a perfectly legitimate reason to believe those RNGs might “just happen” to come up in their cases if they went in for treatment; it’s not like American bureaucrats have never abused their power to target political enemies before.)
The traditional objection to this sort of thing is that it creates perverse incentives: the government, or whichever body is managing our bystander/trolley tracks interface, benefits in the short term (smoother operations, can claim more people saved) if it interprets its numbers to maximize the number of warm bodies it has to work with, and the people in the parts pool benefit from the opposite. At minimum we’d expect that to introduce a certain amount of friction. In the worst case we could imagine it leading to a self-reinforcing establishment that firmly believes it’s being duly careful even when independent data says otherwise: consider how the American War on Drugs has played out.
And of course, I wouldn’t trust a government made of mere humans with such a determination, because power corrupts humans. A friendly artificial intelligence on the other hand...
Edited away an explanation so as not to take the last word
Any problems here?
Short answer, no.
I’d like to keep this thread focused to making a life vs. saving a life, not arguments about utilitarianism in general. I realize there is much more to be said on this subject, but I propose we end discussion here.
You’re fixating on the unimportant parts.
Let me change the scenario slightly to fix your collapse-of-medicine problem: Once in a while the government consults its random number generator and selects one or more, as needed, people to be cut up for organs. The government is careful to keep the benefits (in lives or QALYs or whatever) higher than the costs. Any problems here?
That people are stupefyingly irrational about risks, especially in regards to medicine.
As an example; my paternal grandmother died of a treatable cancer less than a year before I was born, out of a fear of doctors which she had picked up from post-war propaganda about the T4 euthenasia program. Now this is a woman who was otherwise as healthy as they come, living in America decades after the fact, refusing to go in for treatment because she was worried some oncologist was going to declare a full-blooded German immigrant as genetically impure and kill her to improve the Aryan race.
Now granted that’s a rather extreme case, and she wasn’t exactly stable on a good day from what I hear, but the point is that whatever bits of crazy we have get amplified completely out of proportion when medicine comes into it. People already get scared out of seeking treatment over rumors of mythical death panels or autism-causing vaccine programs, so you can only imagine how nutty they would get over even a small risk of actual government-sanctioned murder in hospitals.
(Not to mention that there are quite a lot of people with a perfectly legitimate reason to believe those RNGs might “just happen” to come up in their cases if they went in for treatment; it’s not like American bureaucrats have never abused their power to target political enemies before.)
The traditional objection to this sort of thing is that it creates perverse incentives: the government, or whichever body is managing our bystander/trolley tracks interface, benefits in the short term (smoother operations, can claim more people saved) if it interprets its numbers to maximize the number of warm bodies it has to work with, and the people in the parts pool benefit from the opposite. At minimum we’d expect that to introduce a certain amount of friction. In the worst case we could imagine it leading to a self-reinforcing establishment that firmly believes it’s being duly careful even when independent data says otherwise: consider how the American War on Drugs has played out.
That’s a very weak objection given that the real world is full or perverse incentives and still manages to function, more or less, sorta-kinda...
Only if the Q in QALY takes into account the fact that people will be constantly worried they might be picked by the RNG.
And of course, I wouldn’t trust a government made of mere humans with such a determination, because power corrupts humans. A friendly artificial intelligence on the other hand...
Edited away an explanation so as not to take the last word
Short answer, no.
I’d like to keep this thread focused to making a life vs. saving a life, not arguments about utilitarianism in general. I realize there is much more to be said on this subject, but I propose we end discussion here.