[binary132]

So, if I as a 38-year-old had a mild liver impairment which could reduce my life expectancy to 60 (22 years from now) I should get priority over a 60-year-old with a debilitating, excruciating condition which will end his life in six months, merely because his life expectancy with the transplant may only be 70?

That’s an outrageous and obscene utility calculation to propose and it should be obviously so to just about anyone.

[rainforest]

The NHS does this calculus routinely using Quality Adjusted Life Years. Treatments that get more are favoured which is also how NICE decides what drugs the NHS should offer. There's obviously some utilitarianism in the decision to use QALYs but to some (including me) it seems a reasonable proxy metric to maximise.

Ultimately a sacrifice must be chosen, but I am not sure a discussion about how that should be made is necessarily fit for HN (though I'd be interested in how you'd resolve your proposed scenario).

[JumpCrisscross]

> if I as a 38-year-old had a mild liver impairment which could reduce my life expectancy to 60 (22 years from now) I should get priority over a 60-year-old with a debilitating, excruciating condition which will end his life in six months, merely because his life expectancy with the transplant may only be 70

No. Because it's mild and could reduce your life expectancy. Once it becomes worse and a will, yes--you should.

[defrost]

> That’s an outrageous and obscene utility calculation to propose

Welcome to the reality of triage .. all decisions are bad from some PoV or another, some are arguably less bad.

Oh, to live in a world of infinite matching organs and unlimited theatre slots on demand.

[binary132]

what’s your point?

[defrost]

Just the obvious one ..

Unless there's a ready supply of surgeons, theatre space, and organs on demand, then there will always be examples of "outrageous and obscene utility calculation" in medical pipelines.

That's called triage and there are literally bookshelves on the subject.

Given it was your comment that appeared shocked by "outrageous and obscene utility calculation" you might want to look into a matter that dates back further in time than The Lady with the Lamp dealing with incoming cases in one of the Crimean wars.