Sacrificing one to save many.
Attempts to solve the Trolley Problem by means of a single principle have proved unpersuasive. Nor can the intuition about Transplant be adequately grounded in the hypothetical dissent of rational contractors. It is explained by the initial liability principle, that loss should lie where it falls unless there is sufficient reason to shift it. If we did not think we should accept misfortune in such cases and thought that minimising loss of life was sufficient reason to shift the loss we should not be according others the minimum respect and treatment we feel is their due. The intuition about Trolley is explained by the affinity of that case to the pure case where the choice is between saving many and saving fewer, where minimising misfortune is the only credible option. But these considerations are not yet enough to accommodate the cases that lie between the extremes of Trolley and Transplant. We can handle the intermediate cases by attempting to assimilate them to one or other paradigm and to one another with a sensitivity to morally relevant and irrelevant differences that seeks initially to be faithful to the values reflected by our moral intuitions. Those intuitive judgements are unlikely to survive such an examination wholly unmodified.