scholarly journals Medical ethics and the trolley problem

2019 ◽  
Author(s):  
Gabriel Andrade
Keyword(s):  
Medical Ethics ◽  
Double Effect ◽  
Trolley Problem ◽  
Ethical Challenges ◽  
Doctrine Of Double Effect ◽  
Life And Death ◽  
Ethical Decisions ◽  
Moral Decisions ◽  
Philippa Foot ◽  
Alternative Scenarios

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.    

scholarly journals Thomson's Trolley Problem

2017 ◽  
Vol 12 (2) ◽  
pp. 168-190 ◽  
Author(s):  
Peter Graham
Keyword(s):  
Moral Theory ◽  
Double Effect ◽  
Simple Solution ◽  
Trolley Problem ◽  
Doctrine Of Double Effect ◽  
The Past ◽  
Philippa Foot ◽  
Judith Jarvis Thomson ◽  
Vexing Problem

No one has done more over the past four decades to draw attention to the importance of, and attempt to solve, a particularly vexing problem in ethics—the Trolley Problem—than Judith Jarvis Thomson. Though the problem is originally due to Philippa Foot (“The Problem of Abortion and the Doctrine of Double Effect”), Thomson showed how Foot’s simple solution would not do and offered some solutions of her own. No solution is uncontroversial and the problem remains a thorn in the side of non-consequentialist moral theory. Recently, however, Thomson has changed her mind about the problem. She no longer thinks she was right to reject Foot’s solution to it. I argue that, though illuminating, Thomson’s current take on the Trolley Problem is mistaken. I end with a solution to the problem that I find promising.

Double Effect, Triple Effect and the Trolley Problem: Squaring the Circle in Looping Cases

Utilitas ◽  
2008 ◽  
Vol 20 (1) ◽  
pp. 92-110 ◽  
Author(s):  
MICHAEL OTSUKA
Keyword(s):  
Double Effect ◽  
Trolley Problem ◽  
Squaring The Circle ◽  
Main Track ◽  
Philippa Foot ◽  
Judith Jarvis Thomson ◽  
Side Track

In the Trolley Case (Figure 1), as devised by Philippa Foot and modified by Judith Jarvis Thomson, a runaway trolley (i.e. tram) is headed down a main track and will hit and kill five unless you divert it onto a side track, where it will hit and kill one.

Reasoning beyond Consequences

2018 ◽  
Author(s):  
Joshua May
Keyword(s):  
Moral Judgment ◽  
Experimental Research ◽  
Process Model ◽  
Moral Dilemmas ◽  
Double Effect ◽  
Dual Process ◽  
Moral Cognition ◽  
Trolley Problem ◽  
Doctrine Of Double Effect ◽  
Post Hoc

Experimental research demonstrates that moral judgment involves both conscious and unconscious reasoning or inference that is not mere post-hoc rationalization. The evidence suggests in particular that we treat as morally significant more than the consequences of a person’s actions, including characteristically deontological distinctions between: intentional vs. accidental outcomes, actions vs. omissions, and harming as a means vs. a byproduct (familiar from the Doctrine of Double Effect). And the relevant empirical evidence relies on more than responses to unrealistic moral dilemmas characteristic of the trolley problem. The result is an extremely minimal dual process model of moral judgment on which we at least compute both an action’s outcomes and the actor’s role in bringing them about. This view resembles the famous linguistic analogy (or moral grammar hypothesis) in only its least controversial aspects, particularly the emphasis on unconscious reasoning in moral cognition.

Semi-qualitative study of staff attitudes to care following decision to withdraw active treatment in a neonatal intensive care unit

2007 ◽  
Vol 2 (3) ◽  
pp. 133-138
Author(s):  
M Davie ◽  
A Kaiser
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pain Relief ◽  
Active Treatment ◽  
Neonatal Intensive Care ◽  
Double Effect ◽  
Structured Interview ◽  
Staff Attitudes ◽  
Doctrine Of Double Effect ◽  
Normal Dose

The management of an infant after a decision to withdraw active treatment creates dilemmas. Both lingering death and active killing are undesirable, but palliative interventions can hasten death. We investigated what staff on our neonatal unit thought were the limits of acceptable practice and why. We administered a structured interview to elucidate their views, and asked them to justify their answers. The interviews were analysed quantitatively and qualitatively. A total of 25 participants (15 nurses and 10 doctors) were recruited. 80% emphasized the importance of pain relief following withdrawal, 60% mentioned meeting parental needs at that time. 76% agreed that death can be a desired consequence of withdrawal, yet 52% felt that death should never be hastened. 96% felt that morphine is acceptable after withdrawal, and 72% would give a higher than normal dose if necessary. 56% would stop paralysis at extubation but not reverse it, while 24% would continue paralysis. 16% would consider a drug that ended life instantly in some cases. A wide variety of views emerged, but there were two main positions, a cautious majority, and a more proactive minority. Apparent contradictions within the majority position could be explained using the doctrine of double effect and the acts and omissions distinction.

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