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Y and Z Are Not Off the Hook: The Survival Lottery Made Fairer

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Mark T. Nelson, Y and Z Are Not Off the Hook: The Survival Lottery Made Fairer, The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine , Volume 35, Issue 4, August 2010, Pages 396–401, https://doi.org/10.1093/jmp/jhq030

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In this article I show that the argument in John Harris's famous “Survival Lottery” paper cannot be right. Even if we grant Harris's assumptions—of the justifiability of such a lottery, the correctness of maximizing consequentialism, the indistinguishability between killing and letting die, the practical and political feasibility of such a scheme—the argument still will not yield the conclusion that Harris wants. On his own terms, the medically needy should be less favored (and more vulnerable to being killed), than Harris suggests.

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• DOI: 10.1017/S0031819100059118
• Corpus ID: 3585860

The Survival Lottery

• John Harris
• Published in Philosophy 1 January 1975

103 Citations

On the survival lottery, fairness, utility and survival, tinkering with the survival lottery during a public health crisis., utility and the survival lottery, the dead donor rule., harris's modest proposal, organ donation: mandatory organ donation declaration, as sure as shooting, what is so wrong with killing people, rationing — basic philosophical principles and the practice, related papers.

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The survival of the survival lottery

Affiliation.

• 1 Department of Philosophy, The Queen's University of Belfast, Belfast, UK.
• PMID: 12599345
• DOI: 10.1111/j.1468-5930.1996.tb00153.x

In his paper 'The Survival Lottery' John Harris suggested that there could be situations where the rational thing to do would be to kill a healthy person and harvest his organs for transplantation, thereby saving several lives at the cost of one. Anne Maclean claims that such a proposal, far from being rational, does not qualify as a moral proposal at all since what it suggests is 'plain murder'. I argue that she is correct to claim that the proposal is not uniquely rational and that doctors could quite rationally reject it, but that she overreaches herself when she holds it not to be a moral proposal at all.

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• A suggested solution to the trolley problem. Sheng CL. Sheng CL. J Soc Philos. 1995 Spring;25(1):203-17. doi: 10.1111/j.1467-9833.1995.tb00065.x. J Soc Philos. 1995. PMID: 15027434 No abstract available.
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Response to “The Survival Lottery”

I would object to the idea of “The Survival Lottery”. The proposal of the survival lottery mainly centres on the claim that there is no difference between killing and letting die, and that leaving Y and Z to die without any interventions would be the same as murdering them. Thus, instead of killing both Y and Z, the doctor should kill A, a third-party, and save both Y and Z’s lives, because such action would result in a total of one death instead of two.

Since it would be begging the question to argue whether if there is a difference between killing and letting die, we, at this time being, can assume that they are the same. It may seem that utilitarians ought to be in favour of this proposal as it result in maximum utility. However, my concern is that the calculation in total amount of happiness might not be as simple as it appears to be.

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Such calculation involves two acts, one in which causes pleasure (saving 2 lives), and one which causes massive pain (taking an innocent life away); in this case, pain is unavoidably involved, and we have the duty to minimize the pain. Y and Z may argue that the pain of killing A is obviously much less than killing both Y and Z, which result in an extra death. Yet, this calculation does not take into consideration of the massive disturbance of the society in general if the lottery system is in tact.

Since every persons fundamentally has a desire to live and feel secure, this means that with the lottery system, every single healthy person alive would be living in fear and uncertainty every day of either they will be forced to give up some of their organs, or their lives, without wills to do so. This loss of security or terror in society is a form of pain that is not taken into the calculation, and this effect is too massive as it would disturb the great amount of populations, and thus, outweighs the happiness that is resulted from saving the lives of Y and Z.

Y and Z might argue that this is discrimination against the unhealthy patients as it takes consideration of the healthy population (assuming that they would not want to give up their lives to save the unhealthy) above the needs of the unhealthy; where it does not consider the feeling of uncertainty and fear in the unhealthy units—they are living in an even greater amount of terror knowing the impending death.

Secondly, they might argue that based on the number of healthy population, the chance of being called upon is very slim; moreover, healthy units could at some point in their lives be in need of the transplant as well, and in that case, the society in general should feel more secured because whenever that they need a transplant, they know that their chance of survival would be much greater with the lottery system in place, so everyone, at some point, would benefit from this system.

To answer Y and Z’s first argument, it is really begging the question to argue whether the healthy population would have greater suffering or the unhealthy population would have greater suffering, one cannot simply argue that the amount of fear in the unhealthy population is greater than that of the healthy population (that would be discriminating the healthy); we must look at all population equally.

Second, human beings should have their rights to make the decision regarding their chances of survival. Even though the chance of being called upon to sacrifice is slim and the chance of survival when one does get sick is greater, it is up to each individual’s choice to take such chance.

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Cherepovets , city, southwestern Vologda oblast (region), northwest-central European Russia . Cherepovets lies on the right bank of the Sheksna River where it flows into the Rybinsk Reservoir of the Volga River .

The city’s iron and steel plant, established in 1955 and enlarged several times since, is one of the largest in Russia. Shipbuilding, fertilizer production, and timberwork are also important. The rebuilding of the Volga-Baltic Waterway , of which the Sheksna River is a part, has enhanced Cherepovets’s trading function. Pop. (2010) 312,310; (2014 est.) 316,758.