Even though A.A doesn't publish stats on who successful gets rid of their addiction and those who do not, independent studies show that only about 5% of those who say they will quit, actually manage to in the time frame they said they would. For most addicts, I'm pretty sure they fail the first 5 times they try to quit. They might succeed after numerous attempts, but the first few attempts at trying to quit are almost always doomed to failure.
So, you might say, give the transplant to an alcoholic who has a history of fighting their addiction. But usually, the longer you've been addicted, the less likely you are to receive a transplant.
In the interests of not being completely cruel and heartless, an recovered addict should be given a transplant, ONCE they have proved themselves capable of going cold turkey for at least a month (if they have that long to live). And I'm talking total surveillance here, and checks on their fridge and hospital room to see what they have. And if they can do that, give them the transplant, but also tell them if they trash their organ again, they get nothing.
An alcoholic or a drug user is still a person, and anyone has the POTENTIAL to quit. Maybe they will, maybe they won't. Experience and statistics say they usually won't. But USUALLY won't doesn't equate to ALWAYS won't.
You can say that they drank of their own free will and thus "deserve" what they get. Well, technically, eating a lot of red meat raises the risk of certain cancers. Do you want to be refused treatment because you had a crummy diet? I eat a LOT of red/white meat (mostly white meat), and I don't want to be refused treatment.
Now, I'm a teetotaler. I drink no alcohol at all. Never have, never will. So you might think I'm the sort to condemn those that do drink. Well, I'm not going to. I'm willing to give people a shot. It is true that 95% of people cannot quit. But how will you find those 5% that can, if you aren't willing to trust?
Even if 99% of people in this world are bad (and I don't believe that by the way, it's more like 30% of people in the world are bad), you can't find the good 1% (or 70% in my case), if you aren't willing to trust someone. And even if you never find someone good, you can be confident in the knowledge that you were a good enough person to try to trust.