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Joel M. Zinberg, MD, JD
Mount Sinai Hospital New York, NY

JAMA. 1994;271(15):1157.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—I agree with Dr Ubel and colleagues¹ that transplant efficacy justifies revising the organ allocation system to direct more organs to primary transplant candidates instead of retransplant candidates. Unlike the authors, I believe Rawls' theory of justice² supports this course. Rawls proposes that people behind a "veil of ignorance" that obscures their current or future conditions will choose a just allocation of social goods. Rational, self-interested persons would want to maximize their chance of receiving a scarce, lifesaving resource (such as an organ transplant) should the need arise. They may be ignorant as to whether they will ever need a transplant, but it is common knowledge that transplantable organs are in short supply. Limiting the number of scarce organs any one person can receive would, as Ubel et al agree, maximize everyone's opportunity to receive a transplant. Rational planners would be willing to forgo potential retransplantation . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Margaret A. Winker, MD, Senior Editor.

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