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Sign up as an organ donor, and if you ever need a transplant yourself, you’re guaranteed a better place in the queue.

It’s one of the eye-catching options being canvassed this week in an attempt to get more names on the register; and it’s born, it seems to me, out of an acute sense of frustration that lives are being lost because people haven’t got around to filling in a card.

The director of the NHS body responsible poses the question starkly: ‘Is it fair to take if you won’t give?’ To which only one answer seems possible. Why expect to receive someone else’s heart or kidney, if we’ve been unwilling to make our own spare parts available when we’ll have no more use for them?

Is it fair? Certainly not. Does it mean that doctors, charged with dreadful life or death choices about who gets a transplant, should factor into their calculations the patient’s perceived generosity of spirit or lack of it? That’s another question entirely.

We might debate whether scarce resources should be used to care for people who’ve ruined their livers through alcohol, or their lungs with nicotine, gorged on fatty foods and resisted even minimal exercise. They’ve contributed to their ill-health, for sure...

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