What makes an action right · Quiz question 17/35

The Transplant Surgeon

The Transplant Case

One healthy person's organs could save five. It's the same math as the trolley problem — so why does almost everyone say no? The transplant case explained.

As it appears in the quiz

A surgeon has 5 patients who urgently need organ transplants. By secretly using the organs of one healthy person in for a checkup, all 5 could be saved — and nobody would ever find out.

No matter the outcome, that must never be done.

Who came up with it

In the same 1967 paper where she introduced the trolley, Philippa Foot compared it with killing one person so their body could save several patients. Judith Jarvis Thomson later framed this as the "Transplant" case (1976, 1985) and asked why something allowed in the trolley case is forbidden here. In "The Survival Lottery" (1975), John Harris pushed it to the level of policy, imagining a society that picks organ donors by lottery.

Original papers & key readings

What it's really asking

By the numbers it's the trolley again: 1 dies, 5 live. But here even people friendly to consequentialism mostly say no. That gap is one of the strongest counterexamples to consequentialism.

Deontologists see a textbook rights violation: using someone's body as a means without consent. Consequentialists have an answer too. Rule consequentialists say that if "doctors may secretly kill patients" were a known rule, nobody would go to hospitals — so a rule forbidding it produces better results overall. But once the case stipulates that "nobody will ever find out," that answer gets weaker.

Where philosophers stand

Deontology / rights (never)

A person's body and life can't be violated for others' benefit.

Key names: Kant, Robert Nozick, Thomson

Rule consequentialism (no)

Judge rules, not single acts — a rule forbidding this leads to better outcomes.

Key names: Brad Hooker

Act consequentialism (in principle, maybe)

If truly nobody knows and there are no side effects, you'd have to accept saving the 5 — though real life almost never meets those conditions.

Key names: A strict application of Jeremy Bentham's principle; Harris (as a provocation)

Philosophers to check out

Sources