All the same harms apply if the moral agent lets the five die. They still must cope with the knowledge that their decision resulted in deaths, in fact, more deaths. Indeed, PTSD is brought on by experience with horrific death regardless of whether or not the sufferer caused the death [1] .  [1] Martynowicz, Daniel, ‘Afghanistan PTSD Worse Than Vietnam’, News By The Second, 1 July 2010,