> As the hypothetical trolley controller, how many 50-year-olds would you kill to save one 16-year-old? And would you kill the 16-year-old to save a one-week-ol

> As the hypothetical trolley controller, how many 50-year-olds would you kill to save one 16-year-old? And would you kill the 16-year-old to save a one-week-old baby? Organ donation prioritization does this analysis all the time. They don't publish the exact rules they use for matching but the most important are urgency, compatibility, locality, and survival benefit. Survival benefit is almost literally expected quality life years (QALY) from an organ transplant. A 98-year old will not get an organ that could give a 50-year old another 20 years of life, but a 20-year old that can survive for another year will not get an organ that the 50-year old needs this week. Compatibility and locality are the biggest problems apart from basic availability (too few organ donors, too many patients needing transplants). Once we can print/grow organs the calculus will reduce to prioritization on urgency and then QALYs if supply is still constrained in some way.