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The author describes four general approaches to choosing among potential candidates for heart and liver transplants: the market approach, the committee selection process, a lottery scheme, and the "customary" approach of leaving the decision to the physician. Annas maintains that a socially acceptable approach must be fair, efficient, and based on the values of human equality and respect for life. He proposes a combination scheme in which there would be an initial medical screening of candidates, perhaps with review of the initial decision by an ethics committee that has significant public input. Selection from the candidate pool would then be made on a first-come first-served basis, with provision for individuals in imminent danger of death to "jump" the queue.
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George J. Annas (1985) studied this question.