And I agree, but isn't that a strong indictment of medical ethics? If medical ethicists would rather let a fire burn out of control than risk the lives of firefighters to put it out, they're not optimizing for the right thing.

I don't see why it is a strong indictment of any sort of ethics. Waging war is wrong, and saying that it's perfectly acceptable to do so is entirely missing the point.

Firefighters are a separate issue altogether, because the subject being discussed is a lot more ambiguous than firefighting (where the problem is clear, and the consequence for sending a firefighter is a positive result).