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banana comments on Ego syntonic thoughts and values - Less Wrong
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Tossing a coin would arguably be better. I expect I wouldn't have any kind of trouble with that arrangement if played against someone similar to myself in that respect. With someone sufficiently like myself, I can imagine even discussing the question of whose life should be retained and coming to an agreement (I'm not sure about the potential for a severe psychological backlash from this method of decision-making, but it's probably a less significant consideration than the difference between a better and worse choice for who to save).
(This is an isolated remark unrelated to the topic of the post.)
I automatically assumed that John and Lisa were boyfriend/girlfriend. Comparing it with me and my wife - of course she should be the one to take the antidote. Although I am not sure that I am intelligent enough to have thought of shoving it down her throat without this prompting (or her disagreeing) though.
On the other hand with some one else, who has the same "right to live" as me (my interpretation of your "similar" - ie same sex, same number of kids etc) a coin toss still has problems. I would prefer that we put the antidote and lookalike into a bag and random draw then drink our selected bottles at the same time so that there was no time between knowing who had "won" and being able to do something aout it.