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kilobug comments on On accepting an argument if you have limited computational power. - Less Wrong
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I think the biggest problem with killing someone is that you're likely to get arrested, which prevents you from saving hundreds of lives.
In general, the best way to get something done is to pay someone who's better at it than you. As such, you can fairly accurately simplify it into thinking about how to earn money, and thinking about where to donate that money. These are generally things you can think about once, rather than think about on a case-by-case basis.
That specialization of labor does a lot of help doesn't mean that extreme specialization still does a lot of help. There are so many issues involved with letting someone else do something for you (finding/chosing the person, trust, explaining what you have to do, moving the person to the place, schedule/calendar issues, negotiating the price, legal issues, ...) that for many things, it's less efficient to pay someone to do it than to do it yourself, even if for the core of the task, a specialized person would be more efficient.
Also, you've to consider willpower/akrasia/enjoyment related issues. For example, many people will feel much more motivated when fixing your own house than when fixing someone else house, so even if you need more time to do it than a professional, you could still fill better doing it yourself, than working (even less) extra hours in your job and paying someone to do it. Oversimplifying things like that just doesn't work in real life.
And finally, you've to consider emergency situations. Trolley like situations are emergency situations, like if you see someone being mugged, or someone drowning of whatever, in those, you just don't have the option to pay someone to act for you.
There would be vastly more things like this if specialization wasn't normal. That's what I meant when I said that it works better the more it's done. There are things it's better to do yourself, but most things aren't like that.
The benefits from a situation not covered by the rule I gave earlier are very small. If you're in a situation where acting would be remotely dangerous, don't. If acting would be perfectly safe, go ahead. If it would be very slightly dangerous, then you're likely to be better off doing a Fermi calculation.