In 1975, philosopher John Harris published an essay titled “The Survival Lottery”. In it, he imagined a future where every person holds a number, and when organs are needed for transplants to save the lives of two or more people, someone is selected at random, killed, and their organs are shared among those in need. Is it madness to imagine such a thing? Perhaps. However, it can be demonstrated that this mechanism offers a better life expectancy than any current health plan.
A Proposal That Challenges Our Morality
Some ideas, though solid from the perspective of pure logic, can seem completely far-fetched. About 35 years ago, philosopher John Harris proposed a mechanism by which we could significantly increase our life expectancy. When one is offered a system that could raise global life expectancy by five or ten years, one feels tempted to say "yes, I want it" immediately. However, despite working perfectly if put into practice, Harris's system has not gained many followers.
Harris called his method “The Survival Lottery”, and it basically consists of turning us all into forced "organ donors". Every human on Earth would be assigned a number, and when two or more people need a transplant essential for survival, a number would be chosen at random. The "lucky" holder of that number would be conveniently killed and their organs distributed among those on the waiting list. Put that way, it seems like a horrible idea. However, in practice this system saves more lives than it truncates.
Mathematically Sound, Morally Troubling
From a mathematical standpoint, Harris's idea is impeccable: if A and B (at least) save their lives by "sacrificing" C, in the long run we obtain a global benefit. Two lives for one. Of course, to support his idea, the philosopher assumes that transplant operations are always successful and, most importantly, that there are no practical or moral differences between "killing" and "letting die". Indeed, for something like the survival lottery to be implemented, we need the act of letting a person die whose life could be saved by a transplant to be exactly the same as killing a healthy person. With this condition, which would require a logic worthy of a Vulcan like Spock, there would be no objection to exchanging one life for two or more. However, it is very likely that C, with senses dulled by human weakness, would raise some objection at the moment of being turned into a corpse.
The lottery, assuming our technology allowed successful transplant operations, would save more lives than current health policies. Naturally, a good number of objections can be raised against a health system based on the murder of healthy people. For example, one could argue that the survival lottery would undermine our individual security (in case we come out "favored"). However, this is not true: we have a greater chance of living a long life with the lottery than without it, since it can be statistically shown that any individual is more likely to receive an organ than to become a donor.
Others have objected to the system because it treats A, B, and C as "interchangeable things". Those who defend the theory assure us that current health systems also do so, since often A and B lose their lives because C is not able to help them. So from that point of view, we are currently also treated as "interchangeable things", but using a logic less effective than that of the lottery.
Another point of view to oppose Harris's system is that the survival lottery involves us in the death of healthy people, while current systems only relate us to letting sick people die, and "killing" is worse than "letting die". However, many object that this is also not true: if we do nothing to save A and B, then we are killing them in a way as brutal as if we shot them.
Would You Accept It?
It is evident that, at least for now, a health system like the one proposed will not be implemented. Not because it wouldn't be effective, but because our very human nature would prevent us from killing a healthy person. However, it could save many more lives than it truncates. And you, what would you do?
For more information, see The Survival Lottery on Wikipedia.
