|Distribution of Resources: Need and Outcome|
|Source: Kamm - Morality, Mortality (Vol. 1) - Death and Whom to Save from It, Chapter 12|
|Paper - Abstract|
Begins the discussion of organ distribution for transplantation1 presented in the last four chapters of Part III of the book by analysing factors that may be relevant in three situations: true scarcity of resources, temporary scarcity of resources, and uncertainty as to the type of scarcity. The first two sections of the chapter consider the different concepts of need and urgency and their relation to each other: what makes one person needier than another and why is greater need a factor that should give one person a stronger claim to resources? Arguments are presented for and against the view that the younger are needier than the older, and proposals offered concerning a possible diminishing marginal utility of life and diminishing marginal value of life, fairness, and the relation between helping the worst off and equality. The last section of the chapter starts by examining the concept of outcome with an eye to deciding what effects of a transplant2 and differential effects between potential recipients are morally relevant and irrelevant. It then considers the relation between the factors of need and outcome, and presents several rationales for procedures that give outcome more weight relative to need — moving away from the maximin approach (that of aiding the much worse off before the better off).
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