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1 Lifeboat Ethics and the Case of the William Brown Health Care The William Brown The Gulf Stream A Constructed Tale The Trial Lifeboat Ethics Redux The Titantic 2 The Scales of Justice: Principles and Practice Distributive Justice Scarcity Justice Rationales Critiques Transplantation A Geographical Approach 3 Scarce Goods: The Contexts of Solid Organ Transplantation Transplantation: The Early Years Cyclosporine: Transforming Scarcity A National System National Organ Transplant Act Regionalization An Example Discussion 4 The Scale of Justice: Theories and Realities Perspective and Scale Global/Interational Scales Hemispheric Perspective Justice and Scale 5 Disappearing States: The Scale of the Nation Regional Inequalities Centers of Excellence Distant Cities Redistricting Travel Time (Distance) Discussion 6 The Scale of the City: Distant Communities and the Problem of Supply Rural versus Urban Care OPO Performance Demographics and Membership Poverty and Race A Sense of the Game Application: Southern California Discussion 7 The Lifeboat's Choice Lifeboat Seats Results Q-Analysis Discussion 8 Justice in Ethic's Lifeboat Dimensionality Participation Philosophical Concerns Reasons and Persons The Scarcities We Create Afterword Holmes' Legacy Abundance and Scarcity