According to that radiolab show, and some Harvard dude, I can outthink 99% of the population. This is not news to me.
This is about the intent to kill another human being.
In all the given choices action means that you decided to kill another human being, period. It was not a reaction, it was not an emotion, but you clearly knew that your actions would result in the death of a human being.
This scenario was an interesting read but I see it different. In the case of a healthy patient that the doctor
You're a doctor and you have a dying patient. This patient is dying from something operable
The 5 other patients surgeries are easier, higher chance of success, and you can do all 5 surgeries before they die.
The original patient's surgery is complicated, takes many hours, and by the time you were done doing that surgery all the other patients would be dead.
Let the original patient die
This one is harder to answer, but seems a better analogy to the train tracks than having a healthy sleeping patient.