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Symetric cases are almost impossible. I have to choose between my children, Sophie's Choice etc.
Culturtal relativism: Some believe abortion is murder. Those who perform abortions do not. So its only would be mothers with a dilemma.
"Good is a simple notion, just as yellow is a simple notion. Just as you can not, by any manner or means, explain to somebody who does not already know it, what yellow is. So you can not explain what good is."
--G.E. Moore
This view makes good undefinable to anything but your own intuition. And thus different people withe the same dilemma respond differently.
Most cases are between two morals of your own. Do I kill a suffering person, save them pain, but become a murderer?
On the opposite end, if there is absolute morality, how can a moral dilemma even exist? There would be one true path.
Moral Relativism: "If to save one man, you run the risk of letting 10 die, it is reasonable to sacrifice him. We can only ask that such decision not be taken hastily or lightly and that the evil it inflicts be less that that which was forestalled."
Even to a utilitarian, the less of two evils is a long way from the greatest good for the greatest number.
"The quiet conscience is an invention of the devil."
--Albert Schweitzer
So, if you damned if you do and damned if you don't, just make the best choice you can.
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