>“the needs of the many outweigh the needs of the few.”

The brewer, the baker and the candle stick maker need a new kidney, liver and heart. Thank you for volunteering to be killed so we can harvest your organs and keep the many alive.

Alternatively don't base your world view on a TV show from the 1960s.

There was a story in Analog a few years ago called "Dibs" if I recall the title correctly about a world that worked like that.

Whenever someone could be saved by a transplant they would find possible donors and send them a notification that one of their organs could save someone. Usually after a few weeks the potential donor would get notification that the person who needed the organ has died. During the time between those two notifications the dying person was said to have dibs on the organ.

Occasionally someone would get a second notification about someone having dibs on another one of the organs while someone already had dibs on one of their organs. Again what usually is that those people would die soon and the person would go back to nobody having dibs on any of their organs.

Sometimes though a person with people having dibs on two of their organs would get notified that a third person now had dibs on one of their organs. That was enough that the needs of the many thing kicked in and they were required to give up those organs, which would usually be fatal.

Even in the movie's own terms, that's an ethical aphorism spoken by a character to justify his act of self sacrifice, and to comfort a great friend that he's coming to his unfortunate end on his own terms and for his own reasons and, in Spock's way, as an act of love, in a sense.

It's not, like, "go shit on minorities if it makes the majority's utility-units increase".