Allocating Livers — Devising a Fair System

Abstract

Because there is a wide gap in the United States between the number of patients on waiting lists for organ transplants and the number of organs available for transplantation, any system of allocation is likely to seem inequitable from the viewpoint of patients who may die while waiting for an organ to become available. A lottery might seem better but abdicates responsibility. The limited number of organs can be provided to the maximal number of beneficiaries only through a coherent and efficient system. The choices are difficult — for example, whether to assign the highest priority to the sickest patients . . .