Whom Should We Save First?

Whom to save?

This seems to be the question of the moment as a result of two well-known events, one recent and one 86 years ago.

The recent event was the Feb. 28, 1997, Los Angeles Police Department killing of two bank robbers--one of whom, some charge, could have been saved had the police desired to do so. The controversy revolves around the official rescue policy that stipulates saving people in order of severity of wound. Was this policy violated by first saving less severely wounded innocent people before attempting to save the mortally wounded bank robber?

The older event raised similar questions and has preoccupied millions of people since the release of the film “Titanic.” With a ship sinking with far fewer life boats than passengers, whom do you save? Women and children? The young? First-class passengers? Those chosen by lots?

The questions raised by the North Hollywood shootout and the sinking of the Titanic are disturbing because they force us to confront a disturbing idea: Some people’s lives are more valuable than others’. But we cannot turn away from these questions because increasingly we will have to confront them. For example, should we spend the same amount of money on health care for the very elderly as we should on the young?

The money supply is not endless. Thus we also have to determine which diseases should receive more research money than others. Should we spend more researching AIDS or cancer and heart disease? Those who argue for AIDS say that unlike many cancers and heart disease, AIDS is almost always a death sentence, and it is killing many millions of people in the prime of their lives around the world. Those arguing for more cancer and heart disease research say that AIDS is entirely preventable, while cancer and heart disease are not.

Increasingly, we cannot avoid having to choose whom to save. As much as we are repelled at having to do so--inasmuch as it seems to imply the unspeakable, that we deem some people more worthy of life than others--there will be times when we have to make this choice.

While good people can differ as to what criteria to use in making such choices, most people might be able to sign on to at least four guiding principles:

% Rarely are there morally perfect answers. The Titanic provides the clearest example. No criteria would have been fair in choosing whom to save from the sinking ship. In our egalitarian age, many may scoff at saving women and children, but what would have been fairer? Casting lots? What if a mother won but not her 5-year-old child? Would saving the youngest have been a better choice? Why is a 30-year-old single person more worthy of saving than a 45-year-old mother who is raising three young children?

% Politics or any other extraneous concern must never be allowed to intrude into this sacrosanct moral debate. There may well be powerful emotional arguments for America’s having chosen to give considerably more funds per capita into research on AIDS than into cancer and heart disease, but the fact is that it has been the political clout of gay people, not apolitical moral concern, that has determined how much this country spends on AIDS research.

% No law can replace common sense, human decency and a working moral compass. A rule that in all cases effort must first be made to save those most seriously hurt is morally untenable. There are too many examples when morality and common sense would demand its violation. If a murderer is mortally wounded and a civilian whom he shot was “only” paralyzed, should rescuers really first tend to the murderer?

In the North Hollywood incident, two men who had just robbed a bank left the bank firing AK-47 and M-16-type automatic weapons in every direction. They injured 16 police officers and civilians, and it was little short of miraculous that some innocent people were not slaughtered by these would-be murderers. Would it really have been immoral to save every civilian first?

Don’t common sense and fundamental morality suggest that sometimes we ought to distinguish first between guilty and innocent rather than between severely and less severely wounded? And as much as it offends the pacifistic and egalitarian temptations of our age, is our society really a morally inferior place because a man died of the wounds he suffered in his attempt to murder as many innocents as possible?

% Not all ethical and moral questions can be codified. Our society attempts to solve every problem with a law or policy. Yet from sexual harassment to whom to save first, laws and policies often cause more harm than good. Sometimes decent people with common sense simply must be left to make decisions. It is messy, but life is often messy, and a mature society recognizes that.