Castro is adamant that big data is the answer to figuring out a fairer, less error-prone model for assessing priority, but he also recognizes that relying too heavily on any one factor is also asking for ethical trouble:

“Better prediction means that we will get the answer wrong less frequently, but it does not mean we will ask the right question. For example, should we allocate organs to those who have waited the longest, those who are most likely to die while waiting for a transplant, or those who have the highest chance of survival? And what happens if the rules systematically exclude certain individuals? Underserved populations who receive inadequate information about transplants may not be added to the waitlist until long after their diagnosis.

I’m not envious of people who have to make such decisions, and I assume most people who work with regular business or web data aren’t either.

The advent of big data has made it easy enough to quantify aspects of our lives, build models around them and assign scores, but I doubt it has made ethics easier. The doctor telling a patient she won’t be getting a transplant, or a manager having to fire an employee, can always say “Sorry, it’s the numbers.” That must be hard, but someone upstream had to play god and decide what numbers matter.

Numbers don't make decisions. People do.