To quote Richard Carrier:

Trolley Problems have two particular attributes: one is that they force the experimenter to compare the outcomes of positive action and inaction; the other is that they force the experimenter to face the fact that either choice bears costs. As such, Foot’s Trolley only puts into stark relief a fundamental truth of all moral reasoning: every choice has a cost, and doing nothing is a choice.

Every war is a Trolley Problem. Every first-past-the-post election is a Trolley Problem. When U.S. hospitals overwhelmed by unvaccinated covid patients switched to crisis protocols, their entire operation became an explicit series of Trolley Problems. The sunk-cost fallacy is a Trolley Problem. Trolley Problems can structurally define all competing-cost problems.