This is the key word, Milk. The two are not identical. In the train example it is imagined (rightly or wrongly) that it is evident that death cannot be avoided, so the choice is purely based on the greater good (a statistical choice, minimizing harm). (You can make this even more interesting by changing it to a family member -- most would then condemn the 5!-- and you could then vary the related-ness of the single relative, e.g. child to third-cousin-who-you've-never-met). In the hospital example there is no real suggestion that someone has to die (or be killed), therefore to minimize the harm you refrain from actively murdering someone and 5 people pass away as a consequence (essentially passive euthanasia). That, at least, seems to be my reasoning on the topic.
So combining the two subjects on this thread.....who would stop having a tug on the train to save the 5 fellow fans?
