I guess the difference between this and the trolley dilemma is that at least in the trolley dilemma the rail with two people on it are alive.

Janeway killed one living being, who was crying on the ground pleading not to be murdered, to resurrect two that no longer existed.

So yeah, a bit more complicated than the trolley dilemma.

To be blunt, if Tuvix wasn’t kinda ugly and weird looking, I suspect people would be less ok with his murder.