The Survival Lottery

I hadn't come across this before (you may need to click to embiggen. You may even need to click-and-zoom to embiggen. It's the first paragraph that intrigues me):

My first thought was: Ishiguro! Except, of course, the Never Let Me Go situation is not a lottery (save in the specialised sense that it's a cosmic lottery whether we're born rich or poor, exploiter or exploited and so on). But Ishiguro's novel does, intentionally or otherwise, and presumably otherwise, pinpoint one of the problems with the original thought-experiment here. It's supposed to be a way of framing the question 'if one person's death can save four or five lives, is moral to keep that person alive?' But organ transplant will work best if young, healthy organs are transplanted. If I've signed up to this Lottery and then drunk my liver into collapse and smoked my lungs into tarry deseutude, I don't want organs transplanted from a similarly dissolute decades-of-smoking-and-drinking type, now, do I. This 'lottery' would not guarantee the optimal results. No, we need something that slants the 'donor' ticket towards the young, and the 'recipient' ticket towards the old ...

In other news: Tarry Deseutude is the name of my next band.