Contractualist justification requires that a principle not be reasonably rejectable by those subject to it.

For the contractualist, justification to others provides the standard that determines which considerations count decisively against particular actions. In transplant cases, the contractualist question is whether the possibility of saving lives via transplant justifies an exception to the general duty to aid one’s patients. Scanlon argues that it does not do so, because a principle permitting such an exception could reasonably be rejected by prospective patients. If doctors withhold treatment bec