Unless there's a ready supply of surgeons, theatre space, and organs on demand, then there will always be examples of "outrageous and obscene utility calculation" in medical pipelines.

That's called triage and there are literally bookshelves on the subject.

Given it was your comment that appeared shocked by "outrageous and obscene utility calculation" you might want to look into a matter that dates back further in time than The Lady with the Lamp dealing with incoming cases in one of the Crimean wars.