In 1962, Seattle’s Swedish Hospital began offering kidney dialysis to outpatients. Because the program could accept only 17 patients, it turned to an “admissions and policy committee” made up of largely of laypeople: a minister, a lawyer, a housewife, a labor leader, a state government official, a banker, and a surgeon.

In order to narrow the field of applicants, the committee considered whether a candidate was employed, had dependent children, was educated, had a history of achievements, and had the potential to help others. In its deliberations it would also evaluate the candidate’s personality, his personal merits, and the strengths and weaknesses of his family. “The preferred candidate was a person who had demonstrated achievement through hard work and success at his job,” wrote sociologists Renée Fox and Judith Swazey, “who went to church, joined groups, and was actively involved in community affairs.”

As word spread, observers raised questions about the ethics of the program. In spring 1963, the Seattle Times presented a picture of nine dialysis patients on its cover, with the heading “Will These People Have to Die?” A committee member protested, “We are picking guinea pigs for experimental purposes, not denying life to others.” But in 1972 Congress established federal support for anyone needing dialysis, partly in response to these concerns, and today the “Seattle experience” is remembered as a formative case in bioethics.