This essay does not directly address organ transplantation or even issues of justice, fairness, or equality in access to organs for transplantation. Instead, it engages a higher-order question: the justice of coercively and globally imposing any particular contentfull view of justice, fairness, and/or equality under circumstances that would violate peaceable, consensual choice. It is argued that state coercion, as in the prohibition of the sale of organs or the coercive imposition of equal access to transplantations or health care, is unjust (...) when there are insufficient grounds to establish with certainty the canonical normative character of the particular account of justice, fairness, or equality, as well as the warrant for the use of coercive force to impose such an account. (shrink)