The Case of Sam

Sam, a basically normal, rather nondescript but ‘nice’ human being, goes to the hospital

to visit his only living relative, his senile, sick aunt. His visit coincides with five medical

emergencies at the hospital. One person needs a liver transplant, another a spleen

transplant, another a lung transplant, another a new heart, and a fifth a new pineal gland.

Each of the five patients is a tremendously important, much-loved person whose death

would bring a great deal of grief and actual physical discomfort to a great number of

people. Sam’s death, on the other hand, would be mourned by no one (except possibly his

aunt in her lucid moments). The top members of the hospital administration, all strict

utilitarians, lure Sam into an operating room, remove all his vital organs, and distribute

them to the other needy patients, thereby operating (literally) in accordance with the

principle of utility: the greatest amount of happiness for the greatest number of people.”

Donald Palmer, Does the Center Hold , pg. 270-71

https://www.csus.edu/indiv/g/gaskilld/ethics/utilitarianism%20notes.htm

Utilitarianism doesn’t seem so appealing now, does it? The reason this example is so

disquieting is that it appears to go against our intuitive sense of justice. However, since

this example is clearly compatible with utilitarianism, either something is wrong with our

intuitive sense of justice or something is wrong with utilitarianism.

Which do you think it is

Answer:

I recognize this problem, and have created a distinction between “act utilitarianism” and

“rule utilitarianism”
Act utilitarianism:

Act utilitarianism is the traditional form. It necessitates that one perform the specific act

that will produce the greatest amount of happiness for the greatest number of people. In

other words, the Calculus of Felicity is utilized to discover what specific acts should be

done.

Rule utilitarianism:

Rule utilitarianism argues that the Calculus of Felicity should be utilized to determine

the rules that, if followed would produce the greatest good for the greatest number Even

if a particular self-serving lie may go undetected (and therefore causes no one

unhappiness), it is nevertheless not appropriate because lying and deceiving in general

cause more unhappiness than happiness.

Under rule utilitarianism, lying and deceiving, generally cause more unhappiness than

happiness. Also in view of rule utilitarianism, the hospital administration cannot proceed

as the sam desire because the rule governing their acts would be some thing like this: “If

the lives of a number of people (or even a few exceptional people) can be saved by

sacrificing an innocent bystander, the sacrifice should be performed.”

In my opinion, the case does not consider the intuitive sense of justice and it
does not satisfy the rule utilitarian. In rule utilitarianism, an action can be
justified if it follows the moral codes of justice. However, it does not mean
that there is something wrong with utilitarianism theory because Sam can
sue the doctors for failure to adhere to rule utilitarianism.