Just like Charlie...
Charlie the Consequence Calculating Computational Cluster was calculating consequences slowly.
Like the rest of him, the name of 5C (as he was known to the hospital administration) was a joke. Charlie was no expensive cluster, but rather a decrepit old laptop wedged sideways into a server rack. A med student with bad programming skills had set it up as an entertaining game for the other junior doctors.
Each time one of them saved or lost a life, Charlie was fed some data from the patient history. The doctors were awarded points based on the occupation of their patients; a cured banker deducted a point, while killing a teacher got you a five point penalty.
The highest score so far belonged to the original programmer. When he saved another junior doctor from choking he adapted the program code to give him all the points amassed by his very nearly expired colleague.
Twenty years later 5C was calculating consequences much faster. Now he was housed in a much larger, and much more expensive computer. If it had been possible for a program to be happy, he would have been so.
His original programmer was now the hospital chief of staff and had ordered that Charlie be expanded by a much more competent team. The computer was automatically fed patient data to calculate the scores for each doctor. Fairly often he was asked to advise on medical decisions; if two patients couldn't both be saved he could calculate who had the best point outcome.
The highest score was still the original programmer's. He had made a small alteration so that he was awarded all the points that Charlie 'saved' by picking the highest value patients to treat.
Another twenty years later and Charlie was no longer a joke. He was now a real computational cluster at last. He hummed gently at amazing speed in a stack of machines as high and as wide as a very cuboid man.
His creator was now Minister for Health, maker of medical decisions for the state, and he had dictated that Charlie would make all decisions about who to treat. He had direct access to information on everyone, tied directly into the national identification database. Who you knew was valuable information when working out how much you were worth, so for tricky cases like expensive drugs he was even allowed access to the CCTV network.
Scores were still kept for doctors, and in fact every person these days had their own score based on who they taught, served or helped. Everyone knew that trying to overtake the minister for health was pointless; his invention of Charlie had made him the man with the highest social utility score in the whole country.
Five years later and the Minister was a sick man. His illness had struck suddenly and he had been whisked off to a special government run hospital for those with the very highest scores. His attending doctor knew who the great man was and right away tapped in, on his tablet, the computer command to release the drugs that were needed.
Charlie denied the request. The Minister didn't have permission for a bandage, let alone stroke medication.
Within fifteen minutes a team of crack programmers were in Charlie's data centre trying to find out what was happening. They worked out the problem rapidly; Charlie had fungus growing on his circuit boards from a bad air conditioner. An easy problem to solve, they just needed some fungus killer, and every hospital had the right stuff to use on athlete's foot.
They called back to the Ministry of Health for permission to access the fungicide. The team at the Ministry who took the call were not used to making decisions, especially about medical chemicals normally controlled by Charlie, but even to them the answer was obvious. They told the maintenance team to ask 5C if he should be treated.
The lead programmer tapped in the query to the master console. For what seemed like the longest time there was no answer, as the question ran into subtly corrupted fungus covered logic, but then Charlie spat out an answer.
The programmers queried the answer with the Ministry, but they were ordered again to defer to 5C, who always knew best. In accordance with their instructions the maintenance team withdrew without treating Charlie and some short time later both he, and his creator, died.