Separate hypothetical kidney-allocation model

There is one donor kidney and three compatible fictional patients. Patient A has waited four years. Patient B is nineteen and otherwise healthy. Patient C is stipulated to decline fastest without a transplant. These facts make priorities compete; they do not predict how long a transplant would work for each patient.

For this classroom case, I would give expected benefit substantial weight and also consider waiting time. This is my proposed priority, not a clinical ranking of A, B and C.

The case supplies one kidney, three compatible patients and their different circumstances. A's wait, B's age and health description, and C's expected decline give reasons to discuss competing priorities. They do not supply rejection-risk results or individual transplant-outcome estimates.

My proposed rule makes expected benefit and waiting time explicit values. As a separate thought experiment, fifteen years of kidney function would be a longer-lasting outcome than two years. Those durations are not forecasts for these patients, and longevity alone does not settle fairness.

The case does not provide the individual medical evidence needed to estimate benefit or rank these three patients. Sickness or urgency alone does not establish rejection risk or how long an organ would function. Real U.S. allocation uses organ-specific policies, medical matching and several priority factors; this classroom rule is not that algorithm.

A most-need rule gives priority to the person at greatest immediate risk, which is a serious fairness concern. My proposed rule could leave that person waiting, and I must acknowledge that cost. I would need individual medical evidence before ranking these three patients.

Notice the five labeled parts: claim, evidence, reasoning, limitation and rebuttal. The writer states a value, uses only supplied facts and acknowledges a cost. Different rules can be defended when their values and limits are made clear.

Use that structure for your own test-allocation CER. Do not turn the kidney case into a second submission, a real clinical recommendation or evidence about the hypothetical clinic.

• HRSA: ethical principles in organ allocation.
• HRSA: how organ allocation works.
• NIDDK: kidney transplant.

These optional sources provide background. They are not patient outcome data or additional required assignments.