The idea that a healthy lawyer is a more worthy citizen than a sick alcoholic is inherently biased and unacceptable in our society. Often, as in the keratoplasty case, there are legitimate reasons for wanting to give a rare, valuable transplant to a healthy individual rather than to a sick one. The alcoholic would appear a waste of time in the eyes of the medical system if he is denied the transplant because of his poor health. On the surface it seems that precious medical dollars should be devoted to patients who show the most promise for success after the transplant.

If money and resources are precious and limited, then those resources should be wisely invested. In the keratoplasty case it would appear that the lawyer is a wiser investment. However, patients are not investments. They are people: they have equal rights in the law and should also have equal access to medical care. That alcoholic might have been a prominent lawyer who fell on hard times; there is no clear reason why he is any less deserving of the care he needs. It is highly likely that the man can stop drinking and reform his life after receiving the transplant: which would make him just as much of a potential success case as the lawyer. The lawyer's operation might result in complications and lead to his death. Ultimately all citizens have an equal right to the same quality and kind of medical care no matter what their current state of health might be.

2....

Both health and social class status are superficial and illegitimate reasons to support preferential treatment in the health care system. The patients in the keratoplasty case come from opposite ends of the social spectrum: the one is a lawyer who is most likely well-heeled. The other is a "street person" who is most likely homeless. The patients' social positions are just as compelling as their health differences in this case. If a street person does not or cannot benefit society, why should that person receive society's resources as rare and valuable as the cornea transplant? The prominent lawyer, on the other hand, would continue to contribute to society via his work and his contributions to the economy and even via donations to the hospital. Thus, many health care workers would be tempted to offer the lawyer preferential treatment.
What if receiving the keratoplasty changed the man's life, causing a profound emotional transformation that caused him to quit drinking and devote all his time to helping poor people in Third World countries? Then doctors would readily approve the keratoplasty and even bypass the healthy lawyer. Even when there are clear-cut reasons why one patient is more likely to succeed with a transplant, our medical system cannot give preferential treatment and still abide by the laws embedded in the Constitution. Therefore, giving preferential treatment to patients can become severely problematic and completely unethical.