Quick response! What's the best thing to do on a lifeboat with one too many people on board? Should one throw a mortally injured person overboard to ensure definite survival for everyone else, or refuse to act and ensure certain death for all individuals in the boat?
The person with damage to their prefrontal cortex lacks empathy - that emotional aspect that allows us to identify with the pain or injury to others - and so they can easily decide that granny's got to go to save the rest.
So is the ability to quickly make such a rational judgment a blessing? The most moral act in that scenario is probably to volunteer to sacrifice yourself - thus you make the utilitarian decision and the most noble. Maybe next best would be expressing the opinion that it would be best for someone to go, but letting that someone volunteer. Tossing an individual overboard unwillingly feels a lot like murder, even if they were going to die soon anyway. And being the person to make that assessment isn't likely to endear you to others (although perhaps the survival instinct has already overridden their usual moral revulsion to such a suggestion).
I guess that's what makes the lifeboat situation a moral dilemma, at least until the boat founders under the weight of moral indecision.
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