 Next, the application of the principles ought to range across all the stages of transplantation. Details vary from place to place and organ to organ but in general the pathway to transplantation can be thought of as having these steps: being referred for assessment; being assessed and then listed; and receiving an organ once listed. People may be halted at each step, perhaps for medical reasons, perhaps because they cannot pay (the so-called “green screen”) or because the public system will not pay. Principles need to range over all steps. For instance, scrupulous fairness to those on a waiting list may obscure injustice in access to the list.