Chapter

Distribution of Resources: Need and Outcome

F. M. Kamm

in Morality, Mortality Volume I: Death and Whom to Save From It

Published in print July 1998 | ISBN: 9780195119114
Published online November 2003 | e-ISBN: 9780199872244 | DOI: http://dx.doi.org/10.1093/0195119118.003.0013

Series: Oxford Ethics Series

 Distribution of Resources: Need and Outcome

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Begins the discussion of organ distribution for transplantation 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 transplant 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).

Keywords: age; aiding the better off; aiding the worst off; diminishing marginal utility of life; diminishing marginal value of life; equality; fairness; maximin approach; morality; need; need of old vs young; organ distribution; outcome; scarcity of resources; transplantation; urgency

Chapter.  20415 words.  Illustrated.

Subjects: Moral Philosophy

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