Obviously he should. He has the power to save 35 lives with the flick of a switch, arguing that as long as he doesn't touch the switch then he's absolved of guilt and can't do wrong is a seriously chickenshit way of thinking about morals.

This is no different from diverting a crashing plane towards a rural area instead of a city so it hits fewer people, something I think nobody here would ever suggest was some kind of difficult moral choice.

Of course, I could just as easily frame the thought experiment in another way that doesn't jive so well with our instinctive perceptions of right and wrong. A doctor has 40 patients who are perfectly healthy except for specific medical problems in some of their hearts, lungs, etc. The doctor can go out and kill 5 healthy people, getting enough organs to save the 40.

In that case I think the utilitarian logic becomes somewhat terrifying and seems wrong. I think it's because of the idea that any person at any time could be fed to the utilitarian machine, regardless of how careful they are not to stand on the tracks. On the other hand, anyone could go to the doctor and discover some genetic organ defect and die without a donor. Just as horrible, just as random, much more senseless, but less scary because we're used to it.

I think, if I were in perfect hypothetical scenario land, and had a chance to have things run by absolute utilitarian rules in situations like that - I think I would go for it. My chances would be better, simple as that.

Come to think of it, that's another way of considering the thought experiment. If you told a group of 45 men that you would be forced tomorrow to choose between letting one group of 40 die of them die or letting another group of 5 of them die, and you didn't know who would be in which group yet - they would BEG you to kill the 5.