Who should get an organ transplant?

Case: There is only one organ available for transplantation at this time. Both of the following candidates need this organ, but only one of these people can be the recipient:

Candidate A has a 10-year history of alcohol abuse, but is a reformed alcoholic. In fact, this candidate has been a teetotaler for 16 months.
Candidate A is 47 years old.
Candidate A is black.
Candidate A is an orthopedic surgeon.
Candidate A is an atheist.
Candidate A wants to return to work as soon as possible.

Candidate B has never had a history of alcohol abuse.
Candidate B is 25 years old.
Candidate B is white.
Candidate B is a convicted felon (convicted of robbery and felonious assault) who is due to be released from jail in four months.
Candidate B is a born-again Christian.
Candidate B wants to work for a church dedicated to serving the poor in the inner city.

Among the factors that medical professionals may consider in the process of deciding who gets an organ transplant are the likelihood that the operation will be successful, the ability of the patient to care for his or her own health, the importance of the patient to society, remuneration for medical and surgical services provided.

Not everyone who might get an organ transplant would be willing and able to maintain a healthy lifestyle and take the often extraordinary steps necessary to ensure that the performance of the transplanted organ will meet the expectations of the patient and the doctors.

Some people are more important to society than others. The system that selects people to receive organ transplants should give preference to those whose contribution to society is greater.

Reply: Quantifying 'importance to society' is difficult, if not impossible. The definition of 'importance' varies widely. Various members of society make very different kinds of contributions: elected officials, business leaders, factory workers, parents, teachers, artists, entertainers—all do important jobs. There is no single standard for determining which role in the community is more important than the others. Moreover, individuals who do not make any obvious contribution to society, people who seem to be a 'drain on society', may nevertheless live to make significant contributions later on: every human being has talent that can grow and develop. Denying these people the chance to live longer destroys the chance for them to make noteworthy achievements.

Not everyone who is first on the list to receive an organ transplant will have the ability to pay for it.

Sensitive to the needs of their patients, physicians typically want to avoid prejudice in deciding who gets an organ transplant. Professionals could choose to use some process that does not involve human decision-making and thus could not involve any prejudice.