This paper takes up the topic explored by Wolfgang G. Müller in this volume and discusses the various forms in which Carneades’ thought experiment was conceptualized and employed in philosophy, science, and law, as well as literature and film of the 20th and 21st centuries. Of course, it will not be possible to address all instances – in particular in popular culture, where the dilemma raised by Carneades resurfaces in ever new metaphorizations – and I will have to focus on some theoretical aspects, a few practical cases, and a variety of patterns and motifs that emerge in literary works or films. In some variants, the elements of the thought experiment have changed to a certain degree, but the underlying dilemma is still clearly recognizable. Of particular importance in recent discussions is the so-called trolley problem and research into cognitive responses to the dilemma. A second approach can be found in evolutionary theory and the discussion of altruism and self-sacrifice, both of which do not seem to be compatible with the struggle for survival as described in Darwinism. In the realm of law, the case of Mary and Jodie Attard forced a court decision on whether a human being should be killed in order to save the life of the conjoined sibling: similarly, but on a different scale, controversial discussions following the aftermath of 9/11 have involved the question as to whether a plane with possibly hundreds of passengers should be shot down to prevent an even larger catastrophe. Each of these theoretical concepts and their very real considerations have had their impact on literature and cinema, and this paper offers a survey of the most important narrative patterns and examples.