Each year over 1,500 individuals in the United States die while waiting for a liver transplantation. Another 1,500 candidates are removed from waiting lists because they are deemed too medically frail to receive a liver. Some reformers believe that these figures can be reduced by changing administrative procedures used to determine how organs are distributed. Others believe that these changes would have detrimental effects on certain regions of the nation. Central to this discussion is our underlying ethical obligation to maximize benefits across a population while assuring a minimum level of duty and fairness to each individual.

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