There is at present a divide in the geographical literature between those interested in distributive justice as a social value and those who seek to implement distributive plans on the basis of efficiency of resource use. The former are 'social geographers' interested in equity as a social value, and the latter are 'practical' economic and locational geographers. This divide mirrors one existing elsewhere in social science between Rawlsian liberalism and utilitarian planners. Here we argue that equality and efficiency are related (...) values that cannot be separated easily in the analysis of practical problems. Data on the distribution of transplantable human organs are considered in a practical consideration of this approach. The case-study suggests that inequality of distribution appears to effect adversely the general organ supply. Stated positively, the data suggest that, to the extent that equality of service is an objective, that goal may positively impact on organ supply. More generally, the conclusion argues for a conjoining of theoretical and practical geographical approaches where a scarce resource must be allocated across a dispersed population. (shrink)