Should Organ Recipients Be Chosen on Merit?


If a school teacher and a murderer are both on an organ-recipient waiting list, the teacher should receive an organ, even if the murderer has been on the list longer.

Q1 Analysis

This may be a Q1 violation if you do not have consistent criteria for deciding among multiple candidates for a donor organ.

Q2 Analysis

This is a Q2 violation if you would not want merit to be a factor if you were on a waiting list, and might be a violation if you did not like how someone running such a waiting list defined "merit." It may also be a Q2 violation if your criteria for deciding among candidates is arbitrary.


Although it might seem more fair to assign organs to people on a waiting list by seeing who is most deserving, setting up non-arbitrary criteria for determining merit is exceptionally difficult. In the case of the teacher and the murderer, what if the teacher has inoperable cancer and is not expected to live more than a year even after the transplant, and the murderer is a man in his 30s who committed the crime when he was sixteen and is repentant? Would that change your opinion of who was more deserving?

And how would you settle cases where the determining criteria was hard to compare? For example, is there a fair, consistent criteria you can use to arrange the following candidates in order from most to least deserving?

This is such a complex issue that almost any attempt to construct a meaningful way of judging merit will either violate Q1 or contain an arbitrary component that risks violating Q2. For this reason, you may have to settle on a means of selecting recipients — such as a first-come, first-served waiting list — that is easier to define, even if it is less satisfying to your sense of justice.

You are encouraged to leave your answers to the questions posed in this post in the comments section. This post is based on an excerpt from Ask Yourself to be Moral, by D. Cancilla, available at and See the 2Q system page for details of the philosophical system mentioned in this post.

Posted on November 16, 2010 at 9:43 pm by ideclare · Permalink
In: 2Q

2 Responses

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  1. Written by ff42
    on November 17, 2010 at 7:32 pm
    Reply · Permalink

    Shouldn’t the organ donor, or his heirs, be allowed to pick (or for that matter sell to) the recipient?

  2. Written by Onanymous
    on December 10, 2010 at 6:51 am
    Reply · Permalink

    I would argue against ff42 as such a practise furthers an organ market that includes extortion, organ theft, threats, pawning and so on and so forth. There is serious potential for harm.

    I would say anything but a completely anonymous list sorted only by necessity of the organ to ensure survival of the individual is a violation of Q2.

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