What's better, a world where we have X surgeons who will do a good job for everyone, or a world where we have those X surgeons plus Y surgeons who refuse to ope

What's better, a world where we have X surgeons who will do a good job for everyone, or a world where we have those X surgeons plus Y surgeons who refuse to operate on certain people, but do a good job for everyone else? It's not a choice between case 2 and a magical fairy tale case where we get X+Y surgeons who will do a good job for everyone.