Article's logic is dumber than a sack of hair.
Which is a controversial position, but not stupid exactly. I would call it misguided, and certainly not a very utilitarian position. And given the options I personally would vote for the utilitarian answer: Save five people even if the one who dies wasn't otherwise threatened.
I think it would fail utterly in practice. The per-person incentives are all wrong. You're less likely to get picked if you ruin one of your kidneys, for example. "Donors" are going to be unwilling in general, and that will cause a lot of trouble and turmoil. Lots of protesting. Not to mention any abuse of the system would be kind of horrifying.
But the general idea of substituting "bad luck you got a disease" with "bad luck you lose the lottery", when there's only half as many lottery losers as there were disease losers... maybe that's not so bad. When it comes to trolley problems, you also have to imagine yourself on the track. Do nothing and there's a 5/6 chance you die. Throw the switch, and there's a 1/6 chance you die.
No, obviously I don't advocate that we go around arbitrarily murdering people to potentially improve the lives of others. But there's a huge difference between searching out and selecting specific people and killing them and simply changing the number and identity of people who will be killed by random events.
It's the difference between premeditated murder and a no-fault accident. Policy/law decisions must necessarily make choices like this, flipping the switch from tracks that typically have five or five hundred people standing on them to tracks that typically have one, for the good of the five or five hundred.
Like air bags that kill some people but save thousands more. Or vaccines that kill (a very small number) of kids (typically with allergies) but save millions.
The fundamental conceit that you can add and subtract lives, or happiness, or the like as though they were values in a formula is core to consequentialism, and I don't think that people are actually willing to follow through with the implications of that when it stops being at a safe remove.
I don't understand the bright line you're drawing between "murder someone by pointing a runaway trolley that would otherwise absolutely miss them in their direction" and "murder someone by harvesting their organs."
You can (and, I'd argue, should) believe that air bags are a good idea without believing that the reason that air bags are a good idea is that you can add and subtract lives. For example, you could say, "If YOU get into an accident, it is far more likely that an airbag will save you than it will kill you," which is a different thing than saying, "An air bag will kill YOU, but it will save two other people." And there are many other moral theories which would suggest that air bags are good for reasons other than that "I killed Bob but saved Alice and Charlie" is a generalizable rule for moral good.
The difference is key to understanding policy decisions like this.
You absolutely use math with lives when you're making policy. Right down to calculating lives with dollars.
If there is a fixed budget of $100M to apply to saving people's lives, you ideally will divvy the money around in such a way that the most people live. You don't extend one person's life by 1 month using extreme measures that cost $50M and let a hundred die who would could have had their lives extended by years for $50k each.
To some degree the original question is a real-world policy example of the trolley problem: Do we allow companies like Tesla to save thousands of lives, possibly your own, in exchange for indemnifying them against the (ideally) few lives lost (also potentially your own) when the technology fails? That sounds identical to the air bag policy: In both cases the life saved could be yours. You might not even get into an accident if there were enough self-driving cars, so not only would you live where you might have died, you might even avoid an inconvenience.
I'm not talking about seeking out people and killing them. That is committing murder for an alleged "greater good", and the ends don't justify the means. I'm talking about redirecting a trolley that is going to kill five random people and instead making it kill only one random person. And we can talk about focusing on further advances to make sure that one person doesn't die (statistically speaking) either, but I think that throwing the switch, in a policy sense, is always the right first step.
I think the moral argument that flipping the trolley switch is wrong is bankrupt, and that it does map onto the real world and real world policy decisions like requiring mandatory air bags. Flipping the switch isn't murder. Not flipping the switch when you have the opportunity is murder.
Each day when we drive we assume a certain degree of risk and implicitly acknowledge that we may be hurt. We make the decision to put ourselves in danger, whereas in the trolley problem we are led to assume that all parties are not responsible for their present situation. This distinction may be very important: if all parties in the trolley problem had entered into a covenant acknowledging that they may be killed, would more people opt to kill the one and save the five?
The logic is: "People are not able to drive. Thanks to X, they now are, but have probability Y of dying. Given that Y > 0, X should not be granted."
With X = driving license, and Y = human car fatalities, that logic concludes that driving licenses should not be granted.
The Trolley problem is an interesting ethical question because it is not a daily occurrence. This scenario, on the other hand, is.
To me, the critical factor is that the risk of death is equal or reduced statistically, which so far seems to be the case.
Another scenario, imagine you are driving on a freeway but a couple people decide to hop onto the freeway and cross it on foot. Would you rather just run them over or ram your own car and kill yourself just so that 2 people aren't harmed?
Who would say no to this?
Expect people to be highly resistant to that change at the beginning.
My experience with people who are afraid of planes is that they know planes are safer than cars, but none the less feel a visceral, non-rational fear of the airplane that makes flying deeply uncomfortable for them. Kind of like how you might feel if you were covered in insects, even if you knew that the insects were non-venomous, non-disease carrying, and clean.
I am all for self driving cars, but the common statistical argument (lower number of deaths than humans) for them is just silly for a number of reasons.
If you're going to go the utilitarian route, you need a more complex utility function. Otherwise you end up with really weird badness.
Unfortunately people prefer the current way of implementing things: pretend to make everyone happy because people can't think 5 seconds ahead of time or even imagine that their actions affect others.
It's so easy to sell everything for the small, immediate benefits while ignoring the bigger picture.
Other reasons here: