> I'm not against utopias or their living well, just their living well at anyone else's obvious "expense".

One might wonder at how much current societies are 'utopias' when you look at the child labour etc etc etc that goes into supporting their current lifestyles... But I, too, have sympathy for not taking the little pill.

> it's not in whether one should do something; one is doing something in both instances; killing the six by deciding to do nothing. That's an action, that decision. So what one does isn't as important to me as the humanity behind it. In the first case it's lesser of two evils; if there was a third choice where I could stop the train by killing myself, the "driver" I'd do that.

I have sympathy.

There is a distinction that comes up in the euthenasia literature sometimes between 'killing' and 'letting die'. The distinction is problematic, but the general thought is that 'letting die' might be acceptable in cases where 'killing' isn't. For example, failing to resuscitate would be 'letting die' whereas injecting with a lethal dose of morphene would be 'killing'. The distinction is problematic, though. I tried to construct the cases such that case A was 'letting die' (the 6) and 'killing' (the 1) and case B was 'killing' (the 6) and 'letting die' (the 1). I aimed for that a-symmetry because sometimes people try and justify their different decisions in the two cases on the grounds that 'letting die' is alright but 'killing' isn't. But maybe... I didn't pull this off so well.

In the first case the idea is that if one doesn't move a lever then 6 die and 1 lives.
If one does move the lever then 1 die and 6 live.

In the second case the idea is that if one doesn't operate on the man then 1 die and 6 live.
If one does operate on the man then 6 die and 1 lives.

I do think this might be a promising line for justifying the relevant moral difference (perhaps)... But I'm not quite sure how to pull it off...

Why aren't both the first and second case of the 'sacrifice the one to save the many' form??? I guess they strike me as being similar... But then I don't think the doctor should fail to operate to harvest the organs either... Maybe the trouble is that the implausibility of the second case f's up peoples intuitions, rather... Perhaps...