Abstract

This essay argues that considerations of justice that govern the morality of self-defense are also relevant in some cases in which organs are allocated for transplantation in conditions of scarcity. The essay's main substantive claim is that in general alcoholics are morally liable to be assigned a lower priority in the distribution of livers for transplantation because of their own responsibility for their need for a transplant. There are, however, practical obstacles to giving lower priority in the distribution of medical resources generally to those who are responsible for their own illnesses, and it may seem unfair to single out alcoholics but not others for lower priority