I took a class called "Vice, Crime and American Law," a few years ago, it was very interesting... we had to write an essay that answered the following question:
You have several options:
1) There is a list of patients who have been waiting for a liver, you can strictly adhere to this list regardless of who is at the top, or how badly the patient needs the liver. Keep in mind: the person who is number 1 may have a less serious condition than the person who is number 5; patient #5 may only have a week to live...while patient #1 may have several months to live. But patient #1 did sign up before #5.
2) You can suggest a lottery. Draw a name out of a hat, and that person receives the liver. This way it relies all on chance, not on need. There is no need for you to look over the cases to decide who is in the most need the liver.
3) You review the cases and you decide who needs the liver the most.
These are your patients:
Dan: A homeless 45-year-old man, he has already had one liver transplant due to his alcoholism. He is currently at the top of your hospital's list for liver transplants [you have the right to veto anyone on the hospital's list, as long as you have good reason to]. Dan's problem is serious, but realistically he could live for another 4-5 months without being treated immediately.
Kristen: A 36-year-old lawyer. She is willing to donate enough money to the hospital to add on an additional wing to the hospital if she receives the liver transplant ASAP. Her condition is not as serious as some of the other patients, she could live for a few more months without the liver, but if she has to wait she would not donate the money to the hospital.
Megan: A single 24-year-old woman who has five children. She is unemployed, and doesn't have any insurance. Her condition is very serious, and she may not survive the operation.
Carl: A married 80-year-old man, who happens to be a noble-peace prize winner. His condition is very serious, but he has a very high chance of living through the operation.
April: A 7-year-old girl who is in desperate need of a liver. She is very sick and will likely die with the next 2-3 days if she doesn't have this operation immediately. The success rate of this operation is very low.
What do you choose to do? And why?