In order to maintain Utilitarinism, it is necessary to think about how to maximize the ultimate happiness. We have to commit that we ultimately will kill people. Thus, compared with killing five people, why not just kill one? For us, it is kind of an easy option. The moral decision to save five in order to sacrifice one is preferred to be correct for Utilitarianism.
In patients’ view, the lives are decided by the surgeons. Their only choices are waiting until their final fate.