Inaction Bias, The Trolley Problem. The Surgery Problem.

Lago PARANOIA · Post by **Lago PARANOIA** » Sun Oct 23, 2011 7:53 pm

A quick explanation of the inaction bias: all things being equal, people regard the moral choice which requires no activity to be made on the actor's part to be superior.

Because I don't want to just rehash the Trolley Problem, I'll come up with my own scenario. Imagine that you were on a prototype nuclear submarine underneath the Arctic Shelf during the Cold War and you could safely get to the closest civilization in about three or four days.

You accidentally spook an enemy submarine and they fire a torpedo at your boat before going ahead flank and scurrying off. Damage control manages to stop the flooding and regain propulsion, but you're not out of the woods yet; as it turns out five of the technicians in the Aux department are critically wounded. But because MEPS wasn't doing their job properly all five of the technicians have a special kind of blood disease in which they can only take organs and blood transfusions from a certain type of donor, one of which happens to be assistant Corpsman. You the captain head down to what passes as sickbay and see the surgical officer about to cut up the unwilling, screaming Corpsman after strapping him down and applying anesthesia in order to get at his meaty organs and save the lives of the other members.

Now if you ask a lot (I'd go as far as to say most) of people they'd opt to stop the surgical officer. However, change the scenario to this: You the captain went down to sickbay after the officer accomplished the grim task. The assistant corpsman isn't quite dead yet; you could save his life by recovering his stolen organs, at the cost of letting those five men die. A lot (I'd go as far as to say the vast majority, IMX Kantians are rare outside of college) of the people who said that they'd stop the surgical officer in the first one would NOT order the surgical officer to restore the dying corpsman's blood and organs.

That's the heart of the inaction bias. It's an extremely troubling mental and moral flaw and one that bears a lot more examination than it has been getting.

hyzmarca · Post by **hyzmarca** » Sun Oct 23, 2011 9:01 pm

You could potentially save them all by swapping organs around.

The people with good lungs donate one each, the people with good kidneys donate one each, ect. The Corpsman can be used for spares (only one of each redundant organ). Obviously, the one that needs a new heart looses out, but it's a net win.

Inaction bias isn't a bad thing. It serves an important social function. The harvesting of organs from an unwilling patient will have far-reaching consequences and undermine the trust of the crew in the doctor and the captain, ultimately risking far greater harm than a mere five deaths.

You can't really have a coherent ethical discussion without considering the unwritten social contract. Merely by existing within a society you implicitly promise not to kill any other member of that society. Breaking that contract is ultimately harmful to society as a whole in a way that mere deaths are not.

In this case, the Doctor and the Captain have even more rigid social contracts and are explicitly responsible for the well-being as their men. Killing one to save five, though perfectly fine in terms of raw numbers, is effectively a betrayal of that responsibility that will make the entire crew fearful and distrustful, not to mention anger from the friends of the dead Corpsman.

A social unit can only function if everyone is confident that the others won't kill them whenever convenient.

Lago PARANOIA · Post by **Lago PARANOIA** » Mon Oct 24, 2011 12:29 am

hyzmarca wrote: The people with good lungs donate one each, the people with good kidneys donate one each, ect. The Corpsman can be used for spares (only one of each redundant organ). Obviously, the one that needs a new heart looses out, but it's a net win.

This isn't supposed to be your opportunity to be really clever in order to dodge the question, because then it just turns into a pissing match of 'okay, they only have one usable organ' or 'I invent a Medi-Gun on the spot and heal everyone' or 'I undergo complicated negotiations with the enemy submarine and find out they have the spare organs in their fridge' and so-on.

hyzmarca wrote: In this case, the Doctor and the Captain have even more rigid social contracts and are explicitly responsible for the well-being as their men. Killing one to save five, though perfectly fine in terms of raw numbers, is effectively a betrayal of that responsibility that will make the entire crew fearful and distrustful, not to mention anger from the friends of the dead Corpsman.

Okay, so then what is the Captain supposed to do once he stumbled in on the sickbay after the surgical officer completed the surgery and the five men will live on their own and the corpsman will die? Wouldn't that be an even greater breach of the social contract?

That statement of yours, while trying to weasel out of it, ironically just highlights the inaction bias all the more. Unless you're trying to make a Kantian absolutely morality argument and saying that once the task was done, it was the Captain's responsibility to put the organs back into the assistant Corpsman, but that's a whole 'nother can of worms.

CatharzGodfoot · Post by **CatharzGodfoot** » Mon Oct 24, 2011 12:35 am

Lago, there can be no bias of any sort if you don't have the opportunity to act.

hyzmarca · Post by **hyzmarca** » Mon Oct 24, 2011 1:16 am

Lago PARANOIA wrote:

This isn't supposed to be your opportunity to be really clever in order to dodge the question, because then it just turns into a pissing match of 'okay, they only have one usable organ' or 'I invent a Medi-Gun on the spot and heal everyone' or 'I undergo complicated negotiations with the enemy submarine and find out they have the spare organs in their fridge' and so-on.

And that's why such contrived scenarios aren't really applicable to real-world morality. Binary problems are extremely rare. There are often many possible solutions with varying likelihood of success. Doing nothing and hopping for the best is among them, though the probability of success is very low.

Okay, so then what is the Captain supposed to do once he stumbled in on the sickbay after the surgical officer completed the surgery and the five men will live on their own and the corpsman will die? Wouldn't that be an even greater breach of the social contract?

The captain's duty according to the social contract is to refrain from committing murder. The fact that the doctor violated the social contract doesn't change this. At best it means that the Captain would be justified in giving the Doctor's organs to the corpsman, but that's really stretching things and probably isn't viable.

That statement of yours, while trying to weasel out of it, ironically just highlights the inaction bias all the more. Unless you're trying to make a Kantian absolutely morality argument and saying that once the task was done, it was the Captain's responsibility to put the organs back into the assistant Corpsman, but that's a whole 'nother can of worms.

No, I'm not trying to weasel out of it. I'm simply stating that the inaction bias is a good thing.

Orion · Post by **Orion** » Mon Oct 24, 2011 5:45 am

Orion wrote:Fuck it, it looks like this thread turned into the Trolley Problem thread anyway. Frank, I have to disagree with you. When it comes to deciding how to behave in a crisis situation, what's much more important than saving as many lives as possible is making sure that you don't do so in a way which spreads panic and fear, undermines the social construct and erodes the ability of humans to work with other humans. I am certain that a fireman or other emergency worker is never going to decide that the duties of his position require him to assault me and hurl me bodily to my death. Because of that certainty, I am willing to share whatever information I have with rescue workers and to follow their instructions during a crisis. If I am aware that they may be sending me to my death in the name of some greater good, I will have incentives to conceal information and try to create a secret escape route for myself. I'm surprised that you don't get this actually because it's a huge part of what makes the 40K Imperium so incredibly destructive. Chaos and the Tyranids and other bad guys are such incredibly bad news that there are times when nuking a planet probably saves more lives than it kills. But the knowledge that the Empire will nuke your planet if the mood strikes them degrades the populace's incentives to collaborate.

DSMatticus · Post by **DSMatticus** » Mon Oct 24, 2011 6:38 am

Lago wrote:Okay, so then what is the Captain supposed to do once he stumbled in on the sickbay after the surgical officer completed the surgery and the five men will live on their own and the corpsman will die? Wouldn't that be an even greater breach of the social contract?

You really should have stuck with the trolley problem. Do you mean to say the captain was previously unaware of it, and now he has stumbled into the sickbay and found out what has been done by some surgical officer, and he has the chance to order it reversed? Because not ordering it reversed is totally consistent because it doesn't violate the social contract. The captain hasn't done anything. His only obligation in this case is to restore faith in the social contract by punishing the doctor.

Having a scapegoat to blame it on is usually enough to justify action: (trolley and fat man problem) more people will pull the lever to trade 5 victims for 1 victim than will push the fat man in the way. Because in the former case, they can turn around and blame the villain for putting the victim there: the social contract in people's mind is less threatened by this.

And yes, the blame game has really arbitrary results, and gets hazy, but ultimately you need to keep in mind this is about satisfying people's irrational and selfish behaviors so they continue to have faith in a society instead of abandoning it. So the solutions are going to look irrational.

RobbyPants · Post by **RobbyPants** » Mon Oct 24, 2011 5:33 pm

hyzmarca wrote:
Lago PARANOIA wrote:

This isn't supposed to be your opportunity to be really clever in order to dodge the question, because then it just turns into a pissing match of 'okay, they only have one usable organ' or 'I invent a Medi-Gun on the spot and heal everyone' or 'I undergo complicated negotiations with the enemy submarine and find out they have the spare organs in their fridge' and so-on.

And that's why such contrived scenarios aren't really applicable to real-world morality. Binary problems are extremely rare. There are often many possible solutions with varying likelihood of success. Doing nothing and hopping for the best is among them, though the probability of success is very low.

Yeah, this reminds me of a similar example: a group of Jews hiding in an attic from Nazis, and a young child starts crying (possibly alerting the Nazis). Do you:

- Kill the child and save the group, or

- Leave the child alone and let the group get captured.

As soon as I heard this, I immediately started thinking of ways to subdue the child without killing it. I heard this question posed on the radio, and callers were similarly calling in with different Option C approaches, only to get repeatedly shot down by the hosts. It's like they want the child to die, or something. That, or they aren't good at coming up with airtight scenarios that actually make any sense.

BearsAreBrown · Post by **BearsAreBrown** » Mon Oct 24, 2011 8:38 pm

Is inaction bias supposed to describe actual behavior or abstract ethics?

sabs · Post by **sabs** » Mon Oct 24, 2011 9:03 pm

Most people really wouldn't make the doctor put the original crewman back together again?

Parthenon · Post by **Parthenon** » Mon Oct 24, 2011 9:05 pm

A psychological test was done to see what people actually do in this sort of situation. Random members of the public were brought in and sat in front of a virtual reality program where they could control a lift going between two floors from a sideon view. There are 5 people on the top floor and 1 on the bottom. Another guy comes in and wants to go up the lift so the participant takes them up the lift.

At this point the new guy stands on the lift, pulls out a gun and starts shooting. The participant can either leave them there to kill all 5 people or they can bring them down the lift to only kill 1 person.

This is pretty interesting because its not so much an ethical debate but what people actually did immediately in reaction to a Trolley problem.

Video about it is here, and the pdf of the study is here. The results showed that the participants were likely to sacrifice the individual, but also in the post experiment questionnaire they were much more likely to use utilitarian reasoning than is normal for the general population.

hyzmarca · Post by **hyzmarca** » Mon Oct 24, 2011 9:56 pm

BearsAreBrown wrote:Is inaction bias supposed to describe actual behavior or abstract ethics?

Actual behavior.

Any of us could save countless lives by systematically murdering people who have agreed to be organ donors, but we don't do it. That's inaction bias, there.

Likewise, anyone could help a lot of innocent people by robbing a bank and giving the money to charity. Yet no one does it. In fact, most people would say that such a bank robber was immoral. Again, that's inaction bias.

This is most obviously highlighted when talking to liberals who support increased taxes to fund social programs but oppose Robin Hood style robbery schemes despite the fact that the direct result (the bank looses money and poor people get some support) are the same.

BearsAreBrown · Post by **BearsAreBrown** » Mon Oct 24, 2011 10:04 pm

hyzmarca wrote:This is most obviously highlighted when talking to liberals who support increased taxes to fund social programs but oppose Robin Hood style robbery schemes despite the fact that the direct result (the bank looses money and poor people get some support) are the same.

Why do you have to take a shot at liberals? It's the same as conservatives being okay with death penalty but not being okay with vendetta murder.

Anyways, I asked that question before I brought up Bystander Effect to be sure if they were similar. That is an example of Inaction Bias, right?

hyzmarca · Post by **hyzmarca** » Mon Oct 24, 2011 11:08 pm

BearsAreBrown wrote:
hyzmarca wrote:This is most obviously highlighted when talking to liberals who support increased taxes to fund social programs but oppose Robin Hood style robbery schemes despite the fact that the direct result (the bank looses money and poor people get some support) are the same.
Why do you have to take a shot at liberals? It's the same as conservatives being okay with death penalty but not being okay with vendetta murder.

Anyways, I asked that question before I brought up Bystander Effect to be sure if they were similar. That is an example of Inaction Bias, right?

Similar and related, but distinct.

In the case of the Bystander Effect, people usually believe that someone should intervene but they don't take that responsibility on themselves.

The sort of bias Lago is talking about is when people believe that inaction is morally correct even when it produces a less desirable outcome.

Bystanders are unlikely to tell you that they felt intervention would be immoral. Most of them will say that they were simply afraid to intervene or that they were confused and didn't understand what was actually happening.

Chamomile · Post by **Chamomile** » Mon Oct 24, 2011 11:42 pm

hyzmarca wrote:Any of us could save countless lives by systematically murdering people who have agreed to be organ donors, but we don't do it. That's inaction bias, there.

If we systematically murder organ donors on any kind of significant scale, it will discourage people from becoming organ donors. The amount of skill needed to consistently murder organ donors and get away with, and further to not allow people to catch on to the pattern of our kills, is beyond the average person by a wide margin. Further, you must be certain you're saving more lives than you're taking and on top of that there are other variables to be considered, like whether murdering people who agreed to be organ donors in order to save people who need organs is actually going to be best for the world, on balance. The first group will probably be biased in favor of better people, after all.

Let's look at this another way. A crazed serial killer is about to murder five people. For whatever reason, you have a gun, and are a good enough shot to kill the crazed serial killer without harming those other five people. Do you take the shot? Who wouldn't say yes? And yet, that's taking action. It's not taking action that bothers people, it's sacrificing random innocents to some greater good, because we can intuit that this sort of thing will wreck society entirely and ultimately cause far more harm than good.

RadiantPhoenix · Post by **RadiantPhoenix** » Mon Oct 24, 2011 11:47 pm

Chamomile wrote: It's not taking action that bothers people, it's sacrificing random innocents to some greater good,

Because it was the best excuse he could find to sacrifice a planeswalker to power a bomb.

PoliteNewb · Post by **PoliteNewb** » Mon Oct 24, 2011 11:49 pm

You make the doctor put the corpsman back together, and then you court martial the doctor.

Is this supposed to be a hard choice?

Yes, it sucks that those 5 guys died...but you, the captain, did not kill them. Whatever fucker on the other sub who launched that torpedo did.

Look at it this way: what if there was NO ONE on board who could have donated parts to save those 5 guys? Are you to blame for letting them die? Of course not. If the only choice that could save lives is an immoral choice (as it is when the choice is "murder an innocent person"), you simply act as if that choice were not available.

Declaring certain choices to be off-limits is exactly what moral systems are for.

Count Arioch the 28th · Tue Oct 25, 2011 12:35 am

Also, I'm pretty sure organ transplants don't work like that. My dad had a liver swapped out some years ago, and it was described to me as literally the second most complicated surgery possible.

You are killing the corpsman to perform a surgery that someone in critical condition won't survive. So you add one death to the pile.

Seriously, you picked a really bad example this time.

EDIT: Standard disclaimer that I'm not a doctor applies, but until more expert testimony comes along I feel I should keep my opinions.

Neeeek · Post by **Neeeek** » Tue Oct 25, 2011 4:22 am

Umm... If I'm understanding the scenario correctly, the captain's options are 1) let the doctor kill some guy in order to save the sub or 2) not do that. The captain has a duty to order the doctor to do it and threaten to kill him if he fails to compile.

Sorry, if killing you saves everyone else, and not killing you means we all, including you, die, you are dead. There is nothing remotely immoral about killing you. It's tragic, but not wrong.

Chamomile · Post by **Chamomile** » Tue Oct 25, 2011 5:25 am

Saving the five wounded crewmembers will not save the sub, because the sub is not in any greater danger in the first place. It's just those five and corpsmen who are on the line.

PoliteNewb · Post by **PoliteNewb** » Tue Oct 25, 2011 5:35 am

Neeeek wrote:Umm... If I'm understanding the scenario correctly, the captain's options are 1) let the doctor kill some guy in order to save the sub or 2) not do that. The captain has a duty to order the doctor to do it and threaten to kill him if he fails to compile.

Sorry, if killing you saves everyone else, and not killing you means we all, including you, die, you are dead. There is nothing remotely immoral about killing you. It's tragic, but not wrong.

I don't think you're understanding the scenario correctly, though I could be misunderstanding it. I took it as "kill 1 guy to save 5", not "kill 1 guy to save a shitload of guys".

That said, even if it IS kill 1 guy to save 200 guys...the only reason it's moral is because the guy is dead anyway (since the whole sub will die if you don't do something). If there's any chance of survival without killing him, I don't hold it moral to kill him (unless he volunteers).

DSMatticus · Post by **DSMatticus** » Tue Oct 25, 2011 5:46 am

Neeek wrote:Umm... If I'm understanding the scenario correctly, the captain's options are 1) let the doctor kill some guy in order to save the sub or 2) not do that. The captain has a duty to order the doctor to do it and threaten to kill him if he fails to compile.

Lago mentions technicians, so I was thinking the same thing at first: "does he mean to say these people are essential to repairing the sub and everyone not dying?" But he doesn't actually say that, so presumably the technicians are not critical to the sub's survival. The sub is fine, or they're non-essential (he did say 'aux,' right? Not sure).

hyzmarca · Post by **hyzmarca** » Tue Oct 25, 2011 7:58 am

Chamomile wrote: It's not taking action that bothers people, it's sacrificing random innocents to some greater good, because we can intuit that this sort of thing will wreck society entirely and ultimately cause far more harm than good.

Exactly.

Username17 · Post by **Username17** » Tue Oct 25, 2011 2:21 pm

Count Arioch the 28th wrote:Also, I'm pretty sure organ transplants don't work like that. My dad had a liver swapped out some years ago, and it was described to me as literally the second most complicated surgery possible.

You are killing the corpsman to perform a surgery that someone in critical condition won't survive. So you add one death to the pile.

Seriously, you picked a really bad example this time.

EDIT: Standard disclaimer that I'm not a doctor applies, but until more expert testimony comes along I feel I should keep my opinions.

You got that one right. Organ transplantation really isn't "kill a dude, save five", it's much much worse than that. Of course, your scenario is a damaged nuclear submarine, so you could very easily make the situation actually work as intended.

For example: pressure is building up in the nuclear reactor, and automatic release valves are about to vent it into a compartment where five people are. But with a quick action, you can have it vented into a different compartment with only one person. Or you could override the vent entirely and everyone dies. That's a simple and reasonably plausible scenario. After all, if the compartment you are in is filled with pressurized, super heated radioactive steam, I think we can all agree that is a death sentence.

Carving up people for their organs is basically never going to be moral. By the time we get organ implantation working well enough to even give it serious consideration, we'll be growing organs for the purpose and we still won't chop up random dudes. But situations where you can take a voluntary action to murder someone to definitely save someone else (or more than one other person) are actually quite conceivable and real.

Actual medical ethics questions mostly have to do with allocating resources. "Do you perform a life saving operation, knowing that it is going to tie up a six person surgery team for 14 hours and use a lot of expensive materials that could potentially be used to save more than one person with problems that are just as deadly but less labor and materials intensive to deal with?" Because if you're somewhere in the third world, the answer to that is clearly "no".

-Username17

tzor · Post by **tzor** » Tue Oct 25, 2011 4:05 pm

sabs wrote:Most people really wouldn't make the doctor put the original crewman back together again?

First and foremost, the example is a very cleverly disguised strawman. The necessary and primary assumptions would break suspension of disbelief in any casual observer.

First primary assumption: The doctor performed this action because these men were somehow necessary to the survival of the ship. That's CRAP right there. These crewmen will still be out of comission for weeks, if not months, and now you have a corpsman DEAD.

Second primary assumption: The option of a retransplant is considered a simple and clearly viable procedure. I'd love to know the survival rate of getting back an organ you just suddenly donated, but I'm guessing the stress on the organs is going to play a major factor. So it's not just a 5 die and one live question; you could easily have all six die anyway.

This doesn't count on the ironies. The guy who needs to do this is the one who did the transplants in the first place. (Never mind that this wackjob of an insane bastard did major transplant surgery in the middle of serious conditions occuring on the vessel at the time, when things like simple power failures could have FUBARed the entire series of operations, (and how the fuck does he get room for six operating tables for this bizzare procedure on a vessel).) And arrest is problematic because you are going to need to have someone take care of the five people in post op.

This is where the inaction comes in, because the action is not as cut and dried as it is made out to be so when you get to doing nothing verses possibly savig someone, as opposed to definitely saving someone, the math gets too complex to really think about.