For patients suffering from renal failure, cadaveric donor kidneys are a scarce and valuable good. In 1996, the Eurotransplant International Foundation implemented a new kidney allocation. system. The aim of this paper is to identify and discuss issues of distributive justice in kidney allocation, with an emphasis on the basic features of the new Eurotransplant system. Particular consideration is given to waiting time and medical success.

We characterize seniority rules, also known as lexical dictatorships, under weak consistency constraints on the group’s choice function. These constraints are base triple-acyclicity in the case of binary choices and rationalizability (although not rationality) in the case of choices between an arbitrary number of alternatives. Existing results on these weakened constraints remain silent on the treatment of the group’s most junior individuals and therefore do not yield a complete characterization of seniority rules. We also impose a universal domain, binary strict (...) Pareto optimality, binary Pareto indifference, binary independence of irrelevant alternatives, and the newly introduced condition of conflict resolution. The latter condition requires a social choice rules not to remain indecisive between alternatives for which individuals have conflicting preferences. (shrink)