 One of the apparent ethical advantages of CEA is its commitment to equality and impartiality: everyone’s health needs are considered equally, irrespective of race, gender, or income level. But as the aggregation problem suggests, we intuitively believe that saving a person’s life is ethically more important than improving their appearance. More generally, it is an open ethical question whether we should skew our distribution of health resources towards those who are worst off or whose health needs are more significant or urgent; and if we do so, it is not clear how much extra weight these considerations should have in our assessment. An additional open question, to which we will return below, is whether the “worst off” should be defined in terms of health state or some other disadvantage as well. One version of the underlying intuition at work here is the often cited “rule of rescue”: since saving a life is arguably of infinite or at least indefinite benefit, we should always rank allocations that save a life the highest. For example, if a community spends a substantial part of its yearly health care budget on rescuing a small child who has fallen down a well, this is ethically justifiable, according to the rule of rescue, although patently inefficient (see the debates in Hadorn 1992; Jonson 1986; Cookson &amp; Dolan 1999: Nord 1999; and Ubel 2000).