Okay so I am here today to deflate the too common notion that Arthas was correct in purging the city of Stratholme. Not only was this an unethical choice, it was a strategic failure that hastened the fall of Lordaeron. In this thread I will address the reasons why this is, and what alternatives would have been taken.

Regardless of the actions of Arthas or Uther, Stratholme was doomed. It is implied that a majority of the populace consumed the plagued grain, and it was unlikely that an concerted effort to save the rest could be achieved while still quarantining the city. A new undead army was already forming here, and a massive one at that. In a desire to save his people from undue suffering, and to prevent the Scourge from growing, Arthas elected to kill everyone in the city before they turned.

We can safely assume that Stratholme could not have been saved, but Arthas could have been. This act damned Arthas every bit as much as taking up Frostmourne, and as we know that was the true goal of Mal'Ganis' scheme in Stratholme. His choice to compromise his morality here paved the way for greater compromises, culminating in him becoming a death knight. Through Arthas killing his father and assuming the crown the Lich King destroyed centralized resistance against the Scourge, and took control of the capital.

What could have been done differently? Use the royal army and the Silver Hand to hold back the undead to buy time for the Kirin Tor to quarantine the city. Maybe it would have worked, maybe it would not have, but what it would not have done is make Arthas personally slaughter defenseless people. Though he externalizes the trauma of this in the form of rage against Mal'Ganis, we can assume that this act deeply effected his psyche. Arthas as we see becomes fanatically committed to ending the Scourge after this, no doubt in part to make sure his actions at Stratholme were not in vain.

I posit that had Arthas not have purged Stratholme he would not have then subsequently sailed to Northwind to give away his entire army and himself to the Scourge. Without Arthas the LK could not destroy Lordaeron's leadership and taken the capital, at least not so easily. The war would be longer and with that the possibility of reinforcement more likely, tilting the balance somewhat. All that being said: Lordaeron would have either been destroyed, or crippled, by the Scourge no matter what happened. If Hillsbrad survived I'm tempted to say that under this scenario that more may have been saved as well, but ultimately I think the end result is a stronger Theramore.

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Edit: Its important to note that I am not trying to complain about the Culling as being bad storytelling, just the opposite in fact. Part of the tragedy of Arthas is that there was another way, he just was not able to see it.