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Ask HN: Are Covid vaccines an instance of the trolley problem?

13 points by low_tech_love ↗ HN
Disclaimer: I don’t have any hidden ideological goal with this question (I’m personally very much pro-vaccine). Considering that the people who are adversely affected by a COVID vaccine are not the same as those who might die from the virus, are we simply pulling the lever?

22 comments

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byoung2
Maybe the person choosing to get vaccinated is controlling the switch and one track has a group of people tied up and the other track has the person's pride
starwind
In the absence of a legally enforceable vaccine mandate that does not allow for medical exemptions, no. It's more of "at your own risk."

In a broader sense, I don't think anything is actually an instance of the trolley problem. It's a pathological thought experiment that has literally no options except to kill a certain number of innocent actors who have zero agency themselves. Maybe if you have exactly one organ, two patients, and it's known that there's zero chance of another one coming available in time, but even that seems farfetched to me

low_tech_love
I'd say "no options except to kill a certain number of innocent actors who have zero agency" is a quite accurate description of the situation. We don't know who dies, but some people will certainly die from COVID in the near future, and we know (apparently) that the vaccine does reduce that number. We also know that a very small amount of people will (or already) have adverse effects and potentially die from the vaccine; probably a much, much smaller group. So yeah... sounds accurate.
raxxorrax
You can save people and still be a murderer. Less absolutist positions would ask who could decide that fate for others.
vannevar
Considering that the people who are adversely affected by a COVID vaccine are not the same as those who might die from the virus...

That is not a given. There is such an infinitesimally small number of serious adverse vaccine reactions even reported, let alone confirmed, that I don't think any conclusions can yet be drawn about who is likely to have an adverse vaccine reaction. So no, definitely not the trolley problem, where the risk of death is the same (100%) for all potential victims.

Gibbon1
And define adversely affected. For children there are large numbers of adverse affects beyond death. Like the death of a family member from covid. Isolation from grandparents. There are also positive things like reduced anxiety that comes from vaccination. And prosocial rewards for helping their community.
low_tech_love
Yes, I should've written "supposing", I guess. But although the number is small, it is probably not zero, and thus I think the philosophical thought exercise remains interesting. The trolley problem doesn't have to be necessarily 5 vs 1; the fact remains that "we" (as a society) take the risk of killing a (small) number of people (who might not have died of the virus otherwise) in order to save another (large) number. Even if one single person ever died due to a vaccine in order to save everyone else, the problem would still remain. If someone dies of covid, it isn't "anyone's fault" so to speak, and there lies the moral problem.
thehappypm
No. The trolley problem indicates Person A making a decision (pulling a lever, or not) that impacts either Person B or Person C. Person A is not at risk in the trolley problem.

Taking a vaccine is Person A’s choice. In this case, the lever is:

Option 1: Get vaccinated and steer the COVID train away from myself and all the people I may infect if I get covid, but also steer the risk of myocarditis or whatever towards me.

Option 2: keep the COVID train pointed at me and also the people I might infect, but also steer the myocarditis train away.

low_tech_love
I was thinking more in a broad sense, like the government (or "society") is pulling the lever.
reportgunner
There are people who can't make the decision to get the injection or not - children, mentally impaired, unconscious etc.
PaulHoule
Beats me.

I got Moderna and a Moderna booster. The side effects of the vaccine were like the flu, I got a fever, took a day off from work, etc. The booster made my arm sore but that was it.

I got Omicron three weeks after the booster and had a sore throat and slight cough, maybe one loose stool. No fever.

The vaccine didn't stop 3 out 3 family members from getting Omicron but it may have modified the course of the disease. Certainly the vaccine reaction I got was worse than the disease I experienced. When it was all planned nobody knew the Omicron variant was coming. I know people who got previous variants and got a lot sicker. I know quite a few people who got Omicron and it was no big deal, but one of them wound up in the hospital with double pneumonia.

I don't like the trolley problem as a paradigm because even though it approximates real situations it distorts them enough that it obscures rather than reveals real moral dilemmas.

I am struck by this. The mRNA vaccines can be developed, tested and deployed at "warp speed" compared to any vaccines in the past. Yet, Omicron was discovered around Thanksgiving and exploded such I (presumably the median person) got it less than two months later.

I'd imagine that an mRNA vaccine targeted for Omicron would be super effective. The experts started working on an updated vaccine within a few days of the discovery but even working at "warp speed" it seems that Omicron will have run its course by the time a vaccine is ready -- a completely different situation from the previous variants.

jinpa_zangpo
The trolley problem is often misunderstood. The point of the problem is that two actions have the same consequence (pushing a lever and pushing a person off a bridge) but many peoples' moral intuition is that one action is moral and the other not. It is an argument against consequentialism, the belief that what makes an action moral or not is its consequences. The consequential view of morality is that authorizing the use of a vaccine is moral if it saves more lives than it costs. One deontological view might be that the government has a responsibility to completely test all vaccines before it releases them. Thus the early release of a vaccine on the theory that it would save more lives would be correct from the consequentialist view, but not on this deontological view. This would be the reverse of what the trolley problem is arguing.
Sohcahtoa82
> The trolley problem is often misunderstood.

I misunderstood it for so long because I took it quite literally. When you present The Trolley Problem at its most basic level, nearly everyone will say that the most moral thing to do is pull the lever and redirect it to the single person.

But then I was watching a TV show that presented it in another way. Imagine you have five people about to die from various illnesses, but that each of them can be saved by an organ transplant, and each one needs a different organ. Would it be immoral to sacrifice someone else's life against their will to harvest their organs to save the other five? Nearly everyone would likely say yes, it's incredibly immoral.

But it's really the Trolley Problem. You do nothing, five people die. You take an action, you sacrifice someone against their will to save the original five.

muzani
That's a good way of putting it. I feel like there's some detail left out of this, but I can't find it.

Perhaps when you sacrifice someone, you are the murderer, the knife wielder, but with the trolley problem, the trolley is the murderer.

exodust
> nearly everyone will say that the most moral thing to do is pull the lever and redirect it to the single person.

But can moral principles be a numbers game? I don't think so. Otherwise a serial killer who murders 9 people could claim higher moral ground than a killer with 10 kills to his name.

throwaway889900
No, because multi-track drifting cannot be used to solve the problem in a funny way.
muzani
The trick to multi track drifting is to pull the lever right when the first wheels are already on one track. So you hesitate long enough that some people are dying and then you pull the lever.
dc-programmer
Every policy has winners and losers. The best we can hope for is to maximize the benefits while minimizing the costs (and setting a floor for the losers if possible). In that sense every policy can formulated using the popular conception of the trolley problem, but I’m not sure how useful that is
low_tech_love
It's probably not very useful, and I agree with you that most policies will have side effects (I kind of came to that conclusion after I posted it). I don't think the point here is to have any concrete/right answer, but as a thought exercise it is interesting. Thinking about it from this perspective made me become a bit less judgmental against those who think not pulling the lever is the right thing to do. In the end, both sides have their arguments (but I still think the pros far outweigh the cons).
RedBeetDeadpool
I think this is what OP is getting at. Its a question of maximizing the number of saved persons vs saving the individual.

Mandating vaccines is a case of choosing to maximize numbers over saving a person.

You might say they are the same thing, but they are not. Mass vaccine administration is done in order to save as many lives as possible, as in to reach a high score, a number. The other, which is no mandate, but with optional vaccination, is provided in order to save the individual person, not necessarily to reach a high score number.

And that is to me inherently what the ethics of the trolley problem was about. Given the option, do you treat people like numbers or do you treat them as individuals?

RedBeetDeadpool
Yes. It's incredible narcissism on the part of those that propose vaccination of other people for their own protection, or in the name of protecting others.

If someone wants to protect themselves from the virus, let them take the vaccine, but don't impose it on others as a proselytization of salvation. Even if they are truly doing it to keep other people around them safe, or truly do have someone's best interest at heart, nothing justifies the forceful baptism of another individual.

If anything, learn from stories online about children abused by narcisstic parents. Stories of having parents who think they know better for you than what you know for yourself, to have parents who demand encroaching power over their children's personal space, to have parents that want to abuse you and your body for their own psychological issues. What is going on is undeniable narcissism charading as "I know what's best for you" / "I do it because I love you".

Even if we had undeniable proof that vaccines work 100% of the time, even if we knew vaccines took our souls to heaven, even if we knew undeniably that vaccines would save us from brimstone and fire, no amount of state power should be allowed to exert that much control over an individual.

So yes, it is a classic trolley problem, in the sense that it is a decision to save the highest number than to save an individual. And those in support of vaccinating others not themselves are deliberately choosing to save the number 5 over an individual, which as I've ranted on you, is incredibly narcissistic. Because if they really cared about someone else, they would let them choose their own path, regardless of salvation or damnation.