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February 03, 2009


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Should we assume that neither Tom, Rick nor Harry will release me from my promise, or consent to have the anesthetic given to another? It seems clear to me that in this case I should seek forgiveness for double-promising, and try to find out if either Tom or Harry and Rick will take the hit on the behalf of another. Barring this "neither A nor B" option, I guess I'd vote B.


Yes, we are to assume that neither Tom, Rick nor Harry will release Smith from his promise, or consent to Smith's giving the anesthetic to another.

One thing that would impact my choice would the order in which the promises were made. Other things being equal, if Smith promises Tom the double-dose BEFORE he promises Rick and/or Harry their doses, my inclination is for first-promise priority.


Assume that Smith makes the promises simultaneously by sending out simultaneous emails to Tom, Rick, and Harry.

Oh, I thought we were supposed to think he made the promise to Tom first. Now I can't figure out why I thought that.

(I also thought it was irrelevant, so my misreading didn't affect my answer.)

For once in my life, I have the most popular intuition!

Wouldn't Kantian ethics suggest that smith shouldn't be making a decision for 3 patients?

Which is contradictory to Utalitarianism which would suggest option b, which creates a utility of +1 (no pain + no pain + pain, where pain = +-1)

this question is broken. i choose c.

Can we have a fourth choice? Smith should [do either (a) or (b)]? I'm worried that your third option is satisfied if one does not give the drug to anyone.


Good point. The third choice should have read: it is neither the case that Smith should do (a) nor the case that Smith should do (b). But it's too late now. Hopefully, this error isn't significant enough to make the data useless.

I assume that none of the operations can be delayed until more anesthetic becomes available.

But suppose that Rick's and Harry's operations could be moved up to Friday. If Rick and Harry had their operations first, would people who opted for anesthetizing Tom be more inclined to anesethize them?


As stated in the above description, you are to assume: "If Smith gives Tom a double-dose of anesthetic on Saturday, then Rick and Harry will suffer terribly during their operations. If Smith doesn’t give Tom a double-dose of anesthetic on Saturday, then Smith will give each of Rick and Harry a single-dose of anesthetic right before their operations on Sunday."

Right—that's exactly why I assumed that the operations can't be delayed. I was just making explicit an implication of those conditionals. And the proposal to reschedule Rick's and Harry's operations isn't meant as a way to cope with the present predicament, but rather as a separate scenario about which some people might have different intuitions.

Given those imperfect options, I would suggest another: Give Big Tom one dose and Rick and Harry each a half-dose, and let them all agonize equally. That's the democratic way.

Hi Chuck,

I'm afraid that's not an option. The doses are indivisible.

This is quite the dilemma. If I were Smith I would have to order the surgeries by how critical they were and then give them to the one with the most urgent need first. Given the options as the are, that the surgeries are of equal urgency, the promise of anesthetic was delivered at exactly the same time and that additional medication is unavailable I have to go with option B, but Im not happy about it.

Thanks for the clarification. I read (as Jamie did) that the promise was given to Tom first, and to the other two afterwords. I voted for a (assuming the priority of first-promise) but I would probably shift my vote to c, upon clarification.

My real intuition, outside of those choices, would be a coin flip because I don't see a compelling reason (numbers included) to choose a or b, but I also don't like the inactivity of c.


Why assign priority to first-promises?


I think the priority of the first promise comes from an intuitive commitment to the 'first-come, first-served' ideal. If Smith was foolish enough to make incommensurable promises to three patients, and if the promises were made at different times, then the only other justification one could give would be that Promise A is less important than Promise B. From my perspective, it's hard to justify telling Tom that his promise (A) is less important that the Rick/Harry promise (B) simply because more people will suffer as a result of keeping promise A over promise B. Again, this is assuming a reasonably chronology of the promises. As I see it, part of the point of promises is to try to avoid making incommensurable promises, but if you can't, it's not clear why only the consequences (who will suffer and how much) should be the adjudicating factor.

My intuition, also, may be tempered by both an intuitive and theoretical inclination to reject most consequentialist reasoning. :)

At the risk of being argumentative, why would we let Smith make the decision given the mess he has made of things? Assuming that we would not let Smith make the decision then if we are to assume that the doses are indivisible and the needs are equal as to needing the operation at the given time in order to survive, etc., then I would choose option B and get Tom really drunk.

If booze is not permitted then I would choose C and flip a coin. It is not Tom, Rick, or Harry's fault that Smith got them into this mess and assuming that there are threats to not having the surgeries as planned then flipping a coin seems to be the fairest option. Another option would be to put the names in a hat and give one dose each to the two names that are drawn. If Tom get one dose he will suffer, but not as terribly as he would wihtout any doseage. This might be the fairest option.


We could ask what others should do, assuming that there is something that they can do, to influence Smith's behavior. But we can also ask what Smith should do in his current circumstances. I'm asking what Smith should do in his current circumstances.

Why would what Smith should do be any different then what anyone else should do? If flipping a coin or putting the names in a hat solve the problem then it matters not who does it. If we agree to the process then the outcome is fair.

You have misunderstood. You asked why "we should let Smith make the decision." Doug is pointing out that while that may be an interesting question, it is a question about what we should do, whereas Doug was asking about what Smith should do.

Do you get it?

Thanks, Jamie.

Like the majority, I have voted for (b). In my case, it's because (in spite of my being an ardent non-consequentialist) I strongly believe in aggregation, and so I think that breaking two serious promises to two people is worse than breaking a serious promise to one person. (Compare how Aristotle says, "Achieving the good life for an individual is a fine thing, but it is even finer to achieve the good life for a whole city....")

I don't think that the time difference between Saturday and Sunday matters in itself: it only matters if it is correlated with differences in the degree of certainty (or probability) of the various possible outcomes. In voting for (b), I have assumed that Smith is absolutely certain that there is no chance that he will get any more doses of this anaesthetic between the time of Tom's operation on Saturday and the time of Rick and Harry's operations on Sunday. If there were some chance of his getting more doses of this anaesthetic between the two times, that might tip the balance in favour of giving the double-dose to Tom on Saturday.

It has just occurred to me that on my own official view, absolutely all reasons for action are time-relative as agent-relative. So why don't I think that the difference between Saturday and Sunday matters in its own right...?

I guess that this is because I was assuming that in this case, Smith was aware of both of these courses of action at the same time t (where t is earlier than both Saturday and Sunday), and was deciding at t about which of these courses of action to take. Given this assumption, then on my official view, the relevant reasons for and against these two courses of action are all relative to t -- even though one of the courses of action can only be carried out on Saturday, while the other course of action can only be carried out on Sunday.

So, even though I view all reasons for action as time-relative, I can still say that in this case, the difference between Saturday and Sunday is irrelevant when it comes to deciding what to do.

Jamie (and Doug), I do get it! That is why I asked if there is a difference in what Smith should do from what we should do if we were making the decision. It seemed like a fair question at the time in so far as many commentators are saying what they would do. But I did give an answer as to what should be done.

I will recast my answer so that it is what Smith should do. The promises cancel each other out. It seems to me that the choice situation requires that we act as if no promises were made. Giving priority to one over the other would create a disequilibrium in the thought experiment as set up by Doug which is not permissible given the conditions that Doug sets forth when he states "Everything else is equal. For instance, the amount of pain that Tom will suffer if he doesn’t get the double-dose on Saturday is equivalent to the amount that Rick will suffer if he doesn’t get the single-dose on Sunday. And the same holds for Harry."

If everything is equal then either outcome is fair as long as the procedure determining which outcome to pursue does not favor one over the other. Smith should flip a coin.

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