ABSTRACT
Organ allocation policy involves a mixture of ethical, scientific, medical, legal, and political factors, among others. It is thus hard, and perhaps even impossible, to identify and fully separate ethical considerations from all these other factors. Apart from special cases of directed donation to named recipients, donated organs belong to the community, the public, and not to procurement and transplant teams. Justice, which may be defined, as rendering to each person his or her due, includes both formal and material criteria. The formal criterion of justice involves similar treatment for similar cases or equal treatment for equals. Even though principles of justice permit rationing under conditions of scarcity, they rule out allocation criteria that are based on morally irrelevant characteristics, such as race or gender. However, it is much easier to agree on what is unjust, such as distribution by gender or race, than on what is just.
