[cedws]

The fairest way to do it I feel is a FIFO. Yeah you might give an organ to a 70 year old on their last legs, but they don’t have any less of a right to live than anyone else. After the Horizon scandal, public trust in complicated computer systems are at an all time low. It shouldn’t be an opaque system making such important decisions. Everything should be in the open and explainable.

[danpalmer]

With FIFO the difficulty simply moves to whether you go on the list or not. What should the threshold be for being on the list. If you make it too high then people die without ever being given the opportunity for a liver, if you make it too low then too many people die waiting.

It also creates a weird scenario where all of the worst cases past some level will have no hope of getting a transplant. I.e. if the wait time is uniformly 3 years, then anyone with <3 years of expectancy has little hope despite being the ones who need it most, meanwhile everyone with >3 years expectancy can happily hang out on the list waiting for their transplant.

Simplified a little, but you get the idea. It’s arguably fairly obvious that livers should be assigned based on urgency in some form. I absolutely agree that this should be open and explainable though.