Canada

Actually smokers who haven’t quit don’t get lung transplants either. Same with alcoholics who keep drinking, they are not put on the waiting list for liver transplants. There is a whole list of requirements you need to follow before you are even considered for a transplant. One of them is being fully vaccinated.

Should we keep people from dying from lung cancer because they smoked? Should we not try to help people dying from liver disease because they're alcoholics?

When the smoker/drinker fully admits they have zero intention of quitting, I would much rather give my lung/liver to someone who isn't going to get a full, healthy life out of it, rather than someone who clearly would rather continue abusing it and burn through it in a couple years.

Organs are a limited resource, that's why there is a list - and we should absolutely dedicate limited resources to doing as much good as possible

We respect those who have given life as their final act by making sure their organs aren't wasted.

Those going through organ transplants are immunocompromised and it is especially important that they be vaccinated. Giving someone who is rejecting medical advice related directly to the transplant and it's aftermath isn't something we can do while there's an organ shortage.

You have to remember that anyone that receives an organ is another that don't. doctors are very strict to not give organs to ppl that can suddenly stop taking meds to keep a thing so important working, receiving an organ is not a right, is a gift from someone that died to keep another alive.

If you were in the wilderness with only 1 dose of Narcan and you had to choose between administering it to a drug addict dying from a bender, or their 8 year old that accidentally got into what was causing their parent to OD who would you give the single dose to? That is the kind of decision being made here.

Your example of narcan doesn't even make sense - no one has to die for there to be more narcan. They just make more. So yeah, obviously we should give people narcan even if they're making bad choices. People dying of lung cancer or liver disease require someone to die (or at least permanently give up part of an essential organ, in the case of livers), and we can't just go to the pharmacy and pick up some spare organs just in case. It's part of the deal that you don't get an organ if you don't meet a whole bunch of criteria, like being sober, getting vaccines, generally doing as much as possible to ensure the success of the transplant, because there's someone else who will. Maybe they can't change the past behavior that got them in the situation, but choosing not to change current/future behavior is absolutely grounds for denial.

If they plan to continue smoking or heavily drinking, then yes we should skip over to the next person on the list.

If they refuse to take up the lifestyle changes or follow medical advice, the organ should be used for the next person on the list.

People who've got transplants need to take immunosuppressants to reduce risk of rejection. Making them much more vulnerable to COVID. If the person is adamantly refusing the vaccine for bogus conspiracy theory reasons - it doesn't give me much confidence that they would even follow through on other medical advice to prevent rejection.

There's a finite number of organs at play here, that's why all the conditions.

That comparison makes no sense lol. You can get a vaccine for zero downsides at any point in time with next to no inconvenience. And you compare that to someone dying of lung cancer?? Especially when lungs are extremely limited and they are clearly showing they don't care. You can't say the same about the other comparisons you've made and that's why it makes no sense.

Should we not give narcan to OD'd drug addicts

A lot of people would say no to this. From a personal perspective I'd say "depends on the circumstance but not repeatedly of signify continues to use".

As for smoking/alcohol and transplants... yes they did and those are already exclusionary factors.