Abstract

The selection and balancing of values for the Eurotransplant kidney allocation algorithm poses both practical and ethical challenges. The paper argues that any allocation algorithm can only be justified by reference to some substantive conception of a good life that reflects our value preferences regarding the allocation of scarce donor kidneys. It is concluded that the criterion of HLA compatibility maximizes overall rather than individual utility. The paper emphasizes that good pragmatic arguments for maintaining the primacy of HLA matching can never replace a more systematic, independent ethical justification. As neither the selection nor the balancing of the different allocation criteria are based on an explicit ethical justification, the paper concludes that the choice of the Wujciak-algorithm was rather a product of pragmatic compromise than moral consensus.