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Ethical dilemma · Health systems1
Clear filtersCompeting duties with no perfect answer: consent, confidentiality, fairness.
- Practice this question nowEthicsAdvancedMMI station MD, DO
One liver, two patients: a 60-year-old surgeon who drinks, and a 25-year-old who overdosed. Who gets it?
Equity and access · Critical thinking · Health systems
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Sample answer outline
- Say who really decides: transplant teams follow set criteria, not one doctor's judgment of who deserves it.
- Name those criteria: medical urgency, likelihood of benefit, compatibility, time on the list, and the ability to follow through after transplant.
- Reject social worth: being a surgeon doesn't earn a liver. Be careful about blaming either patient for their illness.
- Note that an overdose, such as acetaminophen, can cause acute liver failure with top urgency, while alcohol use may raise questions about relapse.
- Conclude that you'd follow the criteria and support both patients.
What makes it work
- It moves the question from "who deserves it" to "how fair systems decide".
Avoid
- Choosing by age or profession alone.
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