the agent is a doctor working in an emergency room. a homeless person or traveler comes to the emergency room, but the doctor learns he is not sick at all. upstairs in the hospital, there are five sick people who need organ transplants. the homeless person is a perfect match for all five. like in the trolley problem, the doctor can kill one person by taking action or allow five people to die by doing nothing. the emergency room case was also in foot's 1967 essay.