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Here's a scenario for you. Five people come to you and they all need a new heart or they'll die, but you only have one. They are all the same age and are all male. How do you determine who gets the heart? Just let them all die?
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You will start by giving them the choice to sacrifice their own life for another.
If more than one patient remains, you start factoring in their worth. By that I do NOT mean the monetary worth of their combined assets. Assess their contribution to the world. Ask will this person be able to save other human lives if he/she is to receive the heart? Who will they leave behind? Do they have other life threatening condition asides from the obvious heart problem? How much of a burden will fall on their family if they are to pass away?
Our worth as a living being is not defined by how much we make. Giving the heart to the richest will not be the least damaging in every case.