Any public medical authority faced with unlimited demand and finite resources has to face up to the unenviable task of making tough decisions about who should get treatment first and how best to organise resources.
Yet, when a points system used to decide who should get a kidney transplant has to consider, among other criteria, whether the patient lives in the same area as the donor, something seems amiss.
So is a proposal to shut down a liver transplant centre - where bureaucratic inertia had led to the wastage of a donated liver in June - on the grounds that one such centre would be enough for Hong Kong.
No doubt the Hospital Authority must have taken great pains to devise what it believes to be the fairest way of deciding which kidney patient should get a transplant when one such organ is available.
And the consultants hired to review how best to organise liver transplant operations must have drawn on their expertise in making their recommendations.
Yet, for the public, particularly patients directly affected by the decisions, they cannot help but wonder what is going on. They are entitled to know the basis on which key decisions are made about operations that may save their lives. Yet, it appears patients' rights groups have not been consulted.