On the morning of December 4, 2024, a grainy, 32-second clip showing an incident involving UnitedHealthcare CEO Brian Thompson outside the New York Hilton was uploaded on social media. The video instantly sparked a digital debate on corporate brutality and when Luigi Mangione — a well-educated young man from an upper class background — was identified as a suspect, heated arguments arose both in the court of law and public opinion: Was Luigi justified?
The outrage that Mangione’s sympathizers expressed did not emerge from a vacuum. United Healthcare, the United States’ largest private insurer, posted more than $14 billion in profits in 2024 alone. All the while, patients and physicians continued to suffer from systemic delays and denials of healthcare which optimize costs for the insurers. One of United Healthcare’s most criticized policies is Prior Authorization, which requires physicians to request permission from them before prescribing medications or initiating medical procedures. According to the American Medical Association, 29 percent of physicians reported that Prior Authorization led to “serious adverse events,” with nearly 10 percent noting these delays resulted in “permanent bodily damage, congenital anomaly/birth defect or death.” The company also faced criticism for using faulty AI algorithms, such as nH Predict, which allegedly had a 90 percent error rate. Consistently prioritizing profit over people has contributed to widespread suffering. Under these circumstances, it’s understandable why some might see Luigi’s actions as morally justified.
This case brings to mind “Tomás Nevison,” a 2021 novel by acclaimed Spanish author Javier Marías. The book narrates the life of Tomás Nevison, a former MI5 agent tasked with a mission involving an ETA terrorist who has a high likelihood of causing significant harm. Through Nevison’s story, Marías weaves a philosophical exploration of moral justifications and the weight of extreme actions. Marías introduces his book by mentioning Friedrich Reck-Malleczewen, a German doctor and writer who despised the Nazi regime and once found himself face-to-face with Adolf Hitler in a Bavarian restaurant in 1932. Reck-Malleczewen, who always carried a loaded revolver, had the means to prevent the atrocities that would later unfold, but chose not to act. In the novel, Bertram Tupra, Nevison’s former MI5 superior, tasks him with deactivating one of three potential subjects. While MI5 was certain that this subject would involve herself in crime again, the investigators had only been able to narrow their conclusions down to three potential subjects. Nevison’s mission was very simple: to pull the trigger before it was too late. In that moment, without having the certainty of what was to come, would you have dared to act?
Through this lens, Luigi Mangione’s actions may be viewed as a way to “save” many from the suffering perpetuated by United Healthcare’s corporate greed. You may have heard about the train dilemma, where pulling the lever and diverting the train saves five lives at the cost of actively ending one. These are all utilitarian justifications, where wrong actions are weighed against the greater evil. In this context, Marías may say that killing may be “neither so extreme nor so difficult — nor so unjust — if you know whom.” In other words, the most extreme of actions becomes easy with the certainty that circumventing them causes a greater evil. In Nevinson’s case, Marías successfully corners Nevinson into a moral maze of unavoidable tragedy. But in most real-life cases, many of these justifications fall apart. In Hitler’s case, we could say that Reck-Malleczewen should have pulled the trigger. But there was still no materialized greater evil to judge him against. On top of that, Hitler’s early death could have been seen as a case of political martyrdom and become more fuel for Nazi rhetoric. In Luigi’s case, I believe that he had many more dramatic alternatives before deciding to take Thompson’s life. Despite his corporate greed, Thompson is a human being. And in spite of the present evidence of evil, it is one thing to kill a character in a book, and another to do so in real life.
