As a note, this is most expressly not my model. In point of practicality - insulin does have differing utility for each diabetic. A note I meant to put in the

As a note, this is most expressly not my model. In point of practicality - insulin does have differing utility for each diabetic. A note I meant to put in the original comment is that utility is considered equally, not equal. So yes, if you have 100 insulin pens they distribute according to need. The point of the original wikipedia article is it is normally always possible to construct a "utility monster" that would take the need to the extreme and suck away all the utility. In the diabetic/insulinpen scenario this might be done by declaring the monster is a giant of epic proportions and failure to take all 100 pens means death, whereas for the others it 'only' means severe complications. It should be noted the point at which insulin is next available alters the practicalities but not the gist; if people will die before more insulin is available, our monster should have more utility than those who die etc. One way to frame the egalitarianism of utilitarianism is as a part of the equity vs equality debate; considering everyone equally but not as equals is fairer.