Ventilator allocation ethics debate

Parallel case (NOT tonight's prompt): A transplant center has one donated kidney available and three patients on the waiting list who are all medical matches. Using the same position format we will use tonight, here is a worked model on a different scarce-resource problem so you can see the structure, not the answer.

My position: When one donor kidney must go to one of several matched patients, I would allocate it primarily by expected graft survival, meaning how many years the transplanted kidney is likely to keep working in that patient.

Ethical criterion: Expected benefit from the organ, because a donated kidney is a rare and non-renewable gift, and directing it to the patient who is likely to keep it functioning longest produces the most total years of healthy life from that single organ.

Tradeoff I acknowledge: This criterion can push older patients or patients with other health problems lower on the list, even though their need may be just as urgent and their lives just as valuable. Choosing the patient with the best long-term outcome can therefore feel like ranking people by how useful their bodies are rather than by fairness or by who has waited longest. That tension between getting the most benefit from a scarce organ and treating every waiting patient as an equal is the hardest part of allocation.