Although it may be a more efficient and even just allocation of resources, it
would still be a moral monstrosity to authorize such a transplant. The reasoning here is that non- maleficence takes precedence over the other ethical principles. It is safe to argue for the primacy of morality, but medical ethicists rarely question why this should be the case. What authorizes doing no harm first? Much of this reasoning appears to be based on strong intuitive appeals. Nonetheless, these intuitive appeals are subject to significant criticism, as there may be some additional intuitions illustrated by other cases in which it does not appear to be so clear that non-maleficence should take precedence.