 By way of illustration, suppose that a doctor plans to use a healthy patient to obtain a heart and lungs for transplant, that is, to extract them from him in an operation that would kill him. We can imagine that the patient has many ends, for example, that of attending his daughter’s wedding. According to the hypothetical imperative, it would be irrational for him to pursue this end at the same time he was pursuing the doctor’s end of getting from him a heart and lungs for transplant. The account implies that the patient cannot share the doctor’s end if he would be unwilling to give up his end of attending his daughter’s wedding against the background of an awareness of the likely effects of the doctor’s successful pursuit of his organs (e.g., his life being lost and other lives being saved).