Just Deserts?(Letters) (Letter to the Editor‪)‬

To the Editor: In his article, "Are Alcoholics Less Deserving of Liver Transplants?" Daniel Brudney (Jan-Feb 2007) discusses a position I first developed in 1981 pertaining to the moral relevance of voluntary, health-risky behavior. The same position was later applied to the role of alcoholism in setting liver allocation priority. I and others have claimed that such behavior is morally relevant to fair organ allocation. Brudney proposes we narrow and refine the analysis. He claims that the "drastic consequence" of lowering someone on the liver waiting list is not warranted unless, in addition to voluntarily engaging in risky behavior, one also knows that the behavior will put others at risk for not getting a liver and nevertheless engages in it "deliberately or negligently," with "callous disregard for the well-being of whoever will not receive a liver" if the alcoholic receives one.