Another child is much more ill but listed for 6 months. Currently, if the transplant in question is a liver, the second child will receive it based on need. If the transplant is lungs, the first will receive it based on equal share and fairness. Justice theories select and emphasize one or more of the material principles. Egalitarian theories emphasize equal access, Marxist theories emphasize need, Libertarian theories emphasize a persons rights to social and economic liberty on the basis of contribution and merit.
Utilitarian theories use a mix of criteria to maximize public and private utility.
Public policies involving distributive justice are frequently built on material principles i.e. that of need. Such a policy might suggest that persons of equal need would be treated equally but would allow people of unequal need to be treated differently. Three people need treatment for pneumonia. One has private insurance. Some things are not fundamental needs.