Ah, I was hoping someone would bring this one up. My answer there is no, because it's not a zero-sum issue like the points on the train track. Let's analyze the differences. For consistency, I'll assume the version of the train track problem where 5 people are going to die if I do nothing and let the train continue on its present course, vs 1 if I reach out and actively switch the train onto a different track. (There are other versions of the problem but this has the most similarity to the transplant problem.)
Now it's true that if I divert the train I'm actively choosing to end the life of the single person on track B in order to save a greater number of people on track A. But the key difference is the external force of the train; it's going to hit someone, so we might as well ensure it hits as few as possible. In the transplant situation, you have 5 patients who are dying from 5 different illnesses of their own; they're not going to die because they're in hospital, they're in hospital because they're going to die. Likewise, they won't be saved by the death of the healthy patient, but by the harvest of his healthy organs. And this harvesting would have to be conducted by the transplant surgeon - and getting killed by an overzealous surgeon is qualitatively very different from getting killed by liver failure or whatever.
Oddly, nobody ever seems to consider the possibilities in letting one of the mortally ill patients die and then sharing out that person's organs among the 4 remaining patients, which is obviously a less good result than saving all 5 of them but also much less troubling than murdering patients who aren't planning on donating their own organs.Assuming they needed 5 different organs and were all equally close to death (such that we couldn't wait around for one of them to die at random and save the other four), then you run into the question of whether it's morally acceptable to kill one of the terminally ill patients in order to save the other four (again assuming imminence of death and perfect knowledge of outcomes and so on, which is rarely the case in the real world). Most people would still say no, but I'd be inclined to say yes.
Now it's true that if I divert the train I'm actively choosing to end the life of the single person on track B in order to save a greater number of people on track A. But the key difference is the external force of the train; it's going to hit someone, so we might as well ensure it hits as few as possible. In the transplant situation, you have 5 patients who are dying from 5 different illnesses of their own; they're not going to die because they're in hospital, they're in hospital because they're going to die. Likewise, they won't be saved by the death of the healthy patient, but by the harvest of his healthy organs. And this harvesting would have to be conducted by the transplant surgeon - and getting killed by an overzealous surgeon is qualitatively very different from getting killed by liver failure or whatever.
Oddly, nobody ever seems to consider the possibilities in letting one of the mortally ill patients die and then sharing out that person's organs among the 4 remaining patients, which is obviously a less good result than saving all 5 of them but also much less troubling than murdering patients who aren't planning on donating their own organs.Assuming they needed 5 different organs and were all equally close to death (such that we couldn't wait around for one of them to die at random and save the other four), then you run into the question of whether it's morally acceptable to kill one of the terminally ill patients in order to save the other four (again assuming imminence of death and perfect knowledge of outcomes and so on, which is rarely the case in the real world). Most people would still say no, but I'd be inclined to say yes.