 The final concern is actually at the heart of all of the above concerns since it points to the underlying ethical tension between aggregate goodness and fairness—between the utilitarian approach of CEA and the deontological or egalitarian concern for fairness. The aptly named “fair chances” approach is grounded on our basic intuition that people deserve equal concern and respect, and so an equal chance at benefiting from an allocation scheme. If two people need a heart transplant to live, and one will live twenty more years with the new heart but the other only two years, is it really fair to use CEA and give the heart to the first? Is that truly giving both people an equal or fair chance to the health resource? Or again, if two people need a surgery to repair a torn cartilage in their knees, and one of these also has serious asthma, is it fair to prioritize the surgery to the first because the overall QALYs benefit of the person with asthma is lower? 