In hypothetical sacrificial dilemmas, efficient kill-save ratios promote utilitarian responses to moral decisions. Currently, the mechanism behind this effect is unknown. The empathy altruism hypothesis proposes that empathic concern and personal distress are motivational states that affect altruistic behaviour. We investigated a possible mediating effect of empathic concern and personal distress on kill-save ratio effect. Participants (N = 418) recruited via social media accessed an online survey, and were randomly presented with either an efficient (kill one to save 500) or inefficient (kill one to save 5) version of five possible hypothetical dilemmas, indicated whether they would sacrifice a hypothetical victim, then rated levels of empathic concern and personal distress about the victim. We predicted that participants presented with efficient kill-save ratios would make, on average, more utilitarian responses than those who were not, mediated by lower levels of empathic concern and personal distress in utilitarian responders. Although the kill-save ratio effect was significant, it did not affect empathic concern or personal distress. Follow-up ANOVAs showed higher empathic concern and personal distress in utilitarian responders. Empathic states appear to behave counter to trait empathy in utilitarian decisions as shown in previous studies, and do not mediate the kill-save ratio effect