Rates of organ donation in countries with presumed consent versus those with explicit consent

Here's an illuminating figure from the 2018 paper

Organ Donation and Transplantation in Canada   

Sonya Norris, Legal and Social Affairs Division, 2018-02-14

Figure 5 - Deceased Organ Donor Rates (per million population), Consent Regimes and Number of Donors in Selected Countries, 2015

Presumed consent (opt-out) countries are graphed in yellow, and explicit consent (opt in) countries in blue.  Given the confusing and often confused discussion of those two regimes, it's noteworthy that both regimes appear near both the top and the bottom of the graph, i.e. there are both high and low donation rate countries using each donation regime.

Kidney Exchange: an opportunity for cooperation in North America: Canadian Transplant Summit

I'll be speaking tomorrow  at the 2019 Canadian Transplant Summit, giving two talks.

In the morning, I'll speak at the Canadian Donation and Transplantation Research Program (CDTRP) 6th Annual Scientific Meeting on "Computers and Kidney Exchange."

In the afternoon I'll speak on 
Kidney Exchange: An Opportunity for Cooperation in North America:

State-of-the-Art Opening Plenary Session - Modeling Organ Allocation in Transplantation

 Wed, October 16

 4:30 PM - 5:50 PM

 KC101+103

Session Chairs

Moderator
John Gill, University of British Columbia Division of Nephrology and Centre for Health Evaluation and Outcomes Sciences

Kenneth West, Dalhousie University

Presentations

Kidney Exchange: an opportunity for cooperation in North America

Alvin Roth, Stanford University, Nobel Laureate, Economics

---

Perspectives on organ transplantation as a donor family

Toby Boulet 

Congrats to Banerjee, Duflo and Kremer “for their experimental approach to alleviating global poverty"

The Royal Swedish Academy of Sciences has decided to award the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2019 to

Abhijit Banerjee, Esther Duflo, and Michael Kremer

“for their experimental approach to alleviating global poverty”

From the Nobel press release:

"In the mid-1990s, Michael Kremer and his colleagues demonstrated how powerful this approach can be, using field experiments to test a range of interventions that could improve school results in western Kenya.

"Abhijit Banerjee and Esther Duflo, often with Michael Kremer, soon performed similar studies of other issues and in other countries. Their experimental research methods now entirely dominate development economics."

A kidney exchange chain initiated by a deceased donor, in Italy

 Deceased Donor–initiated Chains
First Report of a Successful Deliberate Case and Its Ethical Implications
Furian, Lucrezia MD1; Cornelio, Cristina PhD2; Silvestre, Cristina MD, PhD1; Neri, Flavia MD1; Rossi, Francesca PhD2,3; Rigotti, Paolo MD1; Cozzi, Emanuele MD, PhD4; Nicolò, Antonio PhD

Transplantation: October 2019 - Volume 103 - Issue 10 - p 2196–2200
doi: 10.1097/TP.0000000000002645

Background. It has been suggested that deceased donor kidneys could be used to initiate chains of living donor kidney paired donation, but the potential gains of this practice need to be quantified and the ethical implications must be addressed before it can be implemented.

Methods. The gain of implementing deceased donor–initiated chains was measured with an algorithm, using retrospective data on the pool of incompatible donor/recipient pairs, at a single center. The allocation rules for chain-ending kidneys and the characteristics and quality of the chain-initiating kidney are described.

Results. The benefit quantification process showed that, with a pool of 69 kidneys from deceased donors and 16 pairs enrolled in the kidney paired donation program, it was possible to transplant 8 of 16 recipients (50%) over a period of 3 years. After obtaining the approval of the Veneto Regional Authority’s Bioethical Committee and the revision of the Italian National Transplant Center’s allocation policies, the first successful case was completed. For the recipient (male, aged 53 y), who entered the program for a chain-initiating kidney with a Kidney Donor Risk Index of 0.61 and a Kidney Donor Profile Index of 3%, the waiting time was 4 days. His willing donor (female, aged 53 y) with a Living Kidney Donor Profile Index of 2, donated 2 days later to a chain-ending recipient (male, aged 47 y) who had been on dialysis for 5 years.

Conclusions. This is the first report of a successfully completed, deliberate deceased donor–initiated chain, which was made possible after a thorough assessment of the ethical issues and the impact of allocation policies. This article includes a preliminary efficacy assessment and describes the development of a dedicated algorithm.
**********

See earlier post:

Monday, April 11, 2016

Using deceased donor kidneys to start living donor kidney exchange chains

Matching markets @ Simons Institute are multi-disciplinary

Two recent blog posts at the algorithmic game theory blog Turing's Invisible Hand remark on the multi-disciplinary nature of modern matching theory and market design, which involves economics, computer science, operations research and mathematics...


Matching Markets @ Simons: Driven by Theory, Driving the Economy by robertkleinberg

"A more notable aspect of matching theory in recent years has been its impact on the design of real-world marketplaces. Over the two workshops, a mix of speakers from academia and industry covered a host of markets, including payment routing, online advertising, kidney exchange, real-estate, public housing, ride-sharing, long-haul trucking, restaurant reviews, school choice, food-banks and many many others. A common theme that emerged was that online marketplaces, with the support of good algorithm and mechanism designers, are slowly taking over the economy."

and

Blind Folks and the Evolving Elephant – by Vijay Vazirani

"The “blind men’’ in this case are entire disciplines which can lay claim to the field of matching markets. Of course, the obvious one is economics – the founders of this field, namely Gale and Shapley, were mathematical economists and the 2012 Nobel Prize in Economics was awarded to Alvin Roth and Lloyd Shapley for work on these markets.

A key enabler was researchers in systems and networking. Their scientific revolutions of the Internet and mobile computing put matching markets on an exciting, new journey and their systems run these centralized markets on powerful computers.

The discipline of algorithm design has had an umbilical connection to matching markets: At the birth of this field lies the highly sophisticated Gale-Shapley stable matching algorithm (1962), whose pivotal game-theoretic property of incentive compatibility follows as a free gift from polynomial time solvability — it was established two decades after the discovery of the algorithm! Yet most researchers, including those in theoretical computer science, are not aware that algorithm design is also a legitimate claimant to this field. Indeed, the very “engine’’ that runs almost each one of these markets is a sophisticated algorithm chosen from the “gold mine’’ of matching theory! Besides stable matching, this includes maximum matching and online matching and their numerous variants."

Medal of Honor

Some months ago I bookmarked a piece in the Wall Street Journal, about the Medal of Honor, the U.S. military's highest combat award.  It talks about life after the medal, for the recipients of this very famous award.  They find they  have some obligations to represent the armed services, the medal itself and the others who have received it, in addition to their own colleagues left behind on the battlefield.  It's a much more complicated honor than other kinds of awards for extraordinary accomplishment, which are also often done in teams, such as scientific awards (which are for happier, less desperate accomplishments that are survived by all the participants).  The article speaks about how previous medal winners support new ones with advice and encouragement on what they should expect. At the time the story was published (in May 2019) there were 70 living recipients of the Medal of Honor.

Here's the WSJ story:

‘It’s a Lifelong Burden’: The Mixed Blessing of the Medal of Honor
America’s highest award for combat valor is both a gift and a constant reminder of what’s often the worst day of recipients’ lives  By Michael M. Phillips.

"For those who earn it, the medal is a loaded gift. It’s a source of instant celebrity, and an entree into a world of opportunity and adulation. It’s also a reminder of what is often the worst day of their lives. And it is a summons to a lifetime of service from those who did something so courageous as young men—so at odds with their own chances of survival—that it was beyond what duty demands."

Followup on Robert Kraft: disappearing sex trafficking in Florida

Vanity Fair has a followup on the widely publicized Florida investigation of sex trafficking that included the arrest of Patriots owner Robert Kraft.  The reporter points out that the trafficking charges have evaporated, and in general concludes that much of the concern with trafficking is in fact simply targeted at voluntary foreign sex workers:

“YOU WON’T BELIEVE WHAT HAPPENED”: THE WILD, DISTURBING SAGA OF ROBERT KRAFT’S VISIT TO A STRIP MALL SEX SPA
After the Patriots owner made two trips to Orchids of Asia Day Spa, where a half-hour “massage” costs $59, he was charged with soliciting a prostitute. What happened next was not what anyone expected.
BY MAY JEONG

"Human trafficking is a serious problem: The Department of Health and Human Services calls it the world’s “fastest-growing criminal industry.” But some anti-trafficking groups, in search of funding, routinely overstate the scale of the commercial sex trade. They frequently claim that 300,000 minors are “at risk” for being sold into sexual slavery in America each year—a number that has been debunked by researchers as wildly overinflated. (The Washington Post dismisses it as a “nonsense statistic.”) In 2018, the FBI confirmed a total of 649 trafficking cases in America, adults included.
...
"Florida’s new sex registry is the latest in a long line of similar laws. One of America’s first laws against prostitution, in fact, was the 1870 Act to Prevent the Kidnapping and Importing of Mongolian, Chinese, and Japanese Females for Criminal or Demoralizing Purposes, intended to protect the public from “scandal and injury.” The law was a precursor to the Page Act of 1875, which aimed to “end the danger of cheap Chinese labor and immoral Chinese women,” which in turn was a precursor to the Chinese Exclusion Act of 1882—the first law to bar all members of a specific ethnicity or nationality from immigrating.

"The raids on Orchids and other massage parlors in South Florida were conducted in the name of rescuing women from sex trafficking. But the only people put in jail were the women themselves. A few, like Lulu and Mandy, managed to post bail and were placed under house arrest. But others were transferred to the custody of ICE. Women who migrated to America in search of work—who chose the least bad option available to them—were being punished for what one of their lawyers calls “the crime of poverty.”
...
"Within weeks of the raids, the state’s case had evaporated. There was no $20 million trafficking ring, no women tricked into sex slavery. The things the state had mistaken as markers for human trafficking—long working hours, shared eating and living arrangements, suspicion of outside authorities, ties to New York and China—were, in fact, common organizing principles of many Chinese immigrant communities. As an assistant state attorney in Palm Beach told the court on April 12: “There is no human trafficking that arises out of this investigation.”
********

See earlier post:

Thursday, March 7, 2019

Prosecuting customers in the fight against sex trafficking of illegal immigrants in American massage parlors

2019 ESA North American Meetings

The 2019 Economic Science Association (ESA) North American meetings will be held in Los Angeles, California at the campus of Loyola Marymount University from Thursday evening, October 10th through Saturday evening, October 12th, 2019. 

Keynote Speakers:

• Yan Chen, University of Michigan
• Emily Oster, Brown University
• James Konow, Loyola Marymount University

Panel on Research Methods:

• Daniel Benjamin, University of Southern California
• Colin Camerer, California Institute of Technology
• Muriel Niederle, Stanford University

Here's the program.

There's a session on Market Design and Matching:

The Important of Cardinal Information in Matching Clayton Featherstone

Why Do Some Clearinghouses Yield Stable Outcomes? Experimental Evidence on Out-of-Equilibrium Truth-Telling Colin Sullivan

Competition with Indivisibilities and Few Traders Weiwei Zheng

Driving to the Beat Sotiris Georganas