Abstract

The implementation of a new kidney allocation algorithm by Eurotransplant was a ‘rule choice’ with serious ethical, legal, and political implications. Eurotransplant made that choice in view of a careful analysis of empirically predictable consequences of alternative rule specifications. This paper studies in a stylized way how the decision on the allocation algorithm emerged. Hopefully an understanding of central features of the described successful case of initiating improvements may be helpful in other cases with a similar structure.