Are Alcoholics Less Deserving of Liver Transplants? when Does Behavior Trigger a Lesser Claim to Medical Resources? when Does Chronic Drinking, For Example, Mean That One has a Lesser Claim to a Liver Transplant? Only when One's Behavior Becomes a Callous Indifference to Others' Needs--when One Knows the Consequences of Heavy Drinking and Knows That by Drinking One May End up Depriving Someone else of a Liver‪.‬

As many studies show, Americans tend to think that an illness has a morally weaker claim to medical care when it is caused by personal conduct that is known to put health at risk. More specifically, many Americans believe that health-risky conduct can make for a significantly weaker claim to scarce medical resources. According to one study, for example, "respondents were 10 to 17 times more likely to allocate liver transplants or asthma treatment to patients they deemed not responsible for their illnesses than to patients they deemed responsible for their conditions." (1) My goal in this essay is to see if there are conditions under which this belief may be justified. I want to see where--if anywhere--this belief touches defensible moral ground. Broadly speaking, one could examine two different issues. When, if ever, is it morally appropriate to make some agents pay at least part of the extra cost of medical care for illness that is due to their voluntary, health-risky conduct? And when, if ever, is it morally appropriate to make it more difficult to gain access to medical resources--and so in effect sometimes to deny access--for illness that is due to an agent's voluntary, health-risky conduct?