The “driver’s dilemma” presents an ethical conundrum in Highly Automated Vehicles (HAVs), where a decision is made between saving ten pedestrians or the vehicle’s passengers in life-or-death situations. This study delves into the driver’s dilemma by assessing respondents’ beliefs on whether passengers should be sacrificed to save pedestrians, as well as their willingness to purchase such vehicles. We conducted an original survey that collected approximately 7,000 responses, taking into account factors such as ethical identities, technology familiarity, and practical HAV benefits. Using structural equation models, our findings emphasize the driver’s dilemma, with utilitarianism and co-ridership significantly affecting the decision. Altruists generally favor saving pedestrians; however, altruistic individuals who believe that saving family members in vehicles over ten pedestrians is ethical are more inclined to purchase HAVs that prioritize their family members’ safety, even if it means sacrificing pedestrians. Nonetheless, the majority view protecting pedestrians as the ethical choice, and our results indicate that a social consensus on pedestrian safety could encourage the adoption of ethical HAVs. Our study underlines the need to balance individual preferences with socially desirable outcomes in HAV policy.