General Comments:
I am seeing alot of people wanting to
Take A Third Option in this thread by justifying their decision based on practical concerns. That's not what this thread is about. You should treat each of these cases as an idealized situation, one where the fundemental crux of the issue is the actual ethical dilemma, not the vagaries of some specific situation that you've constructed in your head to justify your choices. Assume that you're working in the
least convenient possible circumstances, the ones that force you to really decide. Feel free to also post what you would do in real life, of course, but this sort of exercise is best done if you also consider the idealized case.
Also, moral relativism is a terrible system of ethics and nearly everyone that espouses it is objectively a bad person.
First Dilemma:
In an ideal circumstance of perfect knowledge that this new personality is distinct from the old personality, and that no relapse will take place, then it would be wrong not to release the man as soon as we were aware of his new personality.
In more realistic circumstances, this sort of brain damage is sufficently unlikely that I would argue instead for life in prison. Of course, I would argue for life in prision even if he
hadn't gained a new personality, as it is wrong to kill prisoners regardless of what they did.
Second Dilemma:
In the ideal case, where I know for a fact that this man will die with a probability of 1 and that my spouse will live with a probability of 1 if and the reverse happens if I don't, then it makes
no difference if I act or not. The fact that I think that my spouse is the best person ever and that this man is an utter pillock does not matter. Everybody's life with worth something, regardless of who they are.
In slightly ideal circumstances, where the probabilities are less absolute but still perfectly known, the moral thing to do is to maximize the sum of P(person A lives) and P(person B lives), since the lives of any two humans are morally (if not emotionally) interchangable. I'd be an emotional wreck if that means that my spouse doesn't get help, but that doesn't change what the right thing to do is.
In completely realistic circumstances where the probabilities are neither absolute nor known, it is wrong to kill one person to save another, as humans have a well known bias towards overestimating the good of their own actions and underestimating the harm. Since I cannot be sure that I'm
not just rationalizing the murder of innocents for my own gain, I'm not going to kill him.
In either of these three cases, I'm encouraging everyone involved to sign up for cryonics, of course. It's a good policy regardless of your current health.
Second And A Half Dilemma:
Interestingly, my response is the same in both cases: Give the medicine to whoever would bring about the greater sum of P(survival) and, in the case of a tie preference to my loved ones and, more importantly, deference to the wishes of any of the potential patients that wants to give up their chance at the medicine to help others. I tell the looser that I flipped for it to spare them the anguish, and the winner (once out of earshot of the unmedicated individual) that I saved them specifically.