Who gets the liver transplant? The use of responsibility as the tie breaker

Is it possible to invoke the use of moral responsibility as part of the selection criteria in the allocation of livers for transplant? Criticism has been applied to the difficulties inherent in including such a criterion and also the effect that employing such a judgement might have upon the relationship between the physician and patient. However, these criticisms rely on speculation and conjecture and do not relate to all the arguments put forward in favour of applying moral responsibility. None of the present arguments against using moral responsibility in the allocation of livers for transplant are good enough to warrant its dismissal.