To me the statement "have to choose who lives and who dies" doesn't carry the meaning that the decision will be taken in a capricious way. In the end it's a hor

To me the statement "have to choose who lives and who dies" doesn't carry the meaning that the decision will be taken in a capricious way. In the end it's a horrible responsibility to decide somebody doesn't get a chance to live so that somebody else gets that chance. But that's the situation. How would you write that, then?