In 1841 the William Brown struck an iceberg in the North Atlantic. The doomed ship sank with 31 passengers. The remaining passengers scrambled onto lifeboats. In one of the lifeboats, the 41 escapees were so heavy that the first mate feared that the boat would sink. He instructed his eight crewmen to “go to work, or we shall all perish.” Sixteen passengers were thrown overboard.1

A couple of weeks ago, some GPs contacted a clinical ethics committee. They cited guidance issued by the Royal College of General Practitioners, the BMA, and the Department of Health: “Every GP practice must identify the person in the practice who will act as the practice lead on flu pandemic issues.”2 Once in the front line, this flu doctor may be more exposed to flu patients than his or her colleagues. Perhaps unsurprisingly, none of the GPs in their practice wanted the job. The question, admittedly oversimplified, was who should they throw out of the boat to be the flu lead? The guidance did not specify how the lead should be selected.

The optimal way to resolve …