I believe it is fair because of the fact that numbers and lab work are used to figure out someone's place on the list. In my case my mother and I both had transplant due to autoimmune reasons out bodies just decided it didnt like our livers. The meld score is used to give each person a number. Its based on 3 different blood test so someone can be showing more symptoms but be lower on the list than someone because of the way each person responds to liver disease.
You have not defined "fair", nor have you stated why "fairness" is the Federal government's business with regard to organ transplants. Why do you believe
I should not decide who receives my liver?
I do not see an ethical issue with people signing up to be a organ donor because 118k people are waiting. I read somewhere and i cant find the proof right now that most people signup to be a organ donor when they get their drivers license but do not inform the family of their choice. Thus once they pass the family says no.
Voluntary organ donation is a noble thing, but that's not what we're talking about here. You said "More people
need to sign up for organ donation", which is stating an
obligation.
I am not saying to force people to sign up to be a organ donor.
No, you're not. By using the phrase
"(they) need to", you are stating a belief that others are obliged to do something you want.
"Forced to" and
"obliged to" are different things. See the difference?