Saturday, October 24, 2020

Medically assisted dying, at any age, in the Netherlands

 The NY Times has the story:

Netherlands to Allow Doctors to Help End Lives of Terminally Ill Children--Hugo de Jonge, the Dutch health minister, said that “incurably ill” children ages 1 to 12 should be able to die with the help of a doctor.  By Maria Cramer and Claire Moses

"The Dutch government announced plans this week to allow doctors to end the lives of terminally ill children who are under 13 years old, a decision that is bound to inflame the debate over physician-assisted death.

"The Netherlands already allows doctors to facilitate the deaths of people who are over 12 or less than a year old as long as parents have given their consent.

"In a letter to parliament on Tuesday, the Dutch health minister, Hugo de Jonge, proposed expanding the law to include children between the ages of 1 and 12 who are dying and suffering.

“In a small number of cases, palliative care isn’t sufficient,” Mr. de Jonge wrote. “Because of that, some children suffer unnecessarily without any hope of improvement.”


"Three other European countries — Luxembourg, Belgium and Switzerland — allow physician-assisted death, though the laws differ in each country. Belgium allows children to die with the help of a doctor, but in Luxembourg, the law is restricted to adults with an incurable medical condition.

"Canada, parts of Australia and Colombia have also legalized physician-assisted death for adults in certain cases.


"Eight states and Washington, D.C., have laws that allow mentally competent adults with a terminal illness and six months or less to live to obtain prescription medication that will hasten their deaths, according to Death With Dignity, an Oregon-based nonprofit that supports such laws."


The first link above is to this Gallup Poll report:

MAY 31, 2018,  Americans' Strong Support for Euthanasia Persists  BY MEGAN BRENAN

"72% say doctors should be able to help terminally ill patients die

"Fewer, 65%, express support when the question includes "commit suicide"

"54% think doctor-assisted suicide is morally acceptable"

Friday, October 23, 2020

Information for those in need of a kidney donor, from Harvey Mysel, founder of the Living Kidney Donors Network

Here's an announcement from Harvey Mysel, the founder of the Living Kidney Donors Network, about information available for people in need of a kidney transplant.

 Living Kidney Donors Network has released its new FREE online program Having Your Donor Find YOU! for those who need or will need a kidney transplant. That may seem like an unusual title, but that’s what really happens. You get the word out and someone will be motivated to help you…your donor finds you. 

The program’s 3 goals are to:

  1. Motivate someone in need to pursue a living donor
  2. Overcome the myth that you need to ASK someone to donate
  3. Explain that it’s all about sharing YOUR STORY and the importance of having advocates share it too.

 Having Your Donor Find YOU! consists of 9 videos, each under 3 minutes with Supporting Resources that helps you develop the campaign that’s outlined in the videos. The program will soon be available in Spanish

 Should you be involved with an organization that would like to offer the program to your patients or followers, you can have your own URL: Here’s an example: 

Thursday, October 22, 2020

Open letter by economists opposing re-election of current U.S. president

 Open Letter: 690 Economists Oppose Trump's Re-Election

Don't forget to vote.

NBER market design meeting today through Saturday on Zoom

The NBER market design conference is on Zoom this year, today through Saturday, starting each day at noon Eastern time (9am Pacific time).  I'll be speaking today at 2:45 EST (11:45 PST), about a new proposal for global kidney exchange using chains that begin overseas and end in the U.S., and about the background and history to this proposal, which initially met with considerable opposition.

2:45 pm
Mohammad Akbarpour, Stanford University
Afshin Nikzad, University of Southern California
Michael A. Rees, University of Toledo Medical Center
Alvin E. Roth, Stanford University and NBER
Global Kidney Chains

The full schedule, with links to papers, is here:

Market Design Working Group Meeting

Michael Ostrovsky and Parag A. Pathak, Organizers

October 22-24, 2020, on


Wednesday, October 21, 2020

Ned Brooks interviews me at the National Kidney Donor Organization virtual conference (video)

 For easy access, here's the video of my talk at the National Kidney Donor Organization virtual conference, about which I blogged this morning.  We talked about kidney exchange, global kidney exchange, and repugnant transactions...

National Kidney Donor Advocate Conference, on YouTube

 Here's an announcement I received from Ned Brooks, the founder of  NKDO, National Kidney Donation Organization (formerly Donor to Donor).  If I understand correctly, the different talks and interviews will be available at the link after first streaming in conference style, starting at 9am Pacific time. It includes a video of Ned interviewing me.

I'll update this post as necessary. 

"This Wednesday, October 21st, NKDO, National Kidney Donation Organization (formerly Donor to Donor) will release the virtual National Kidney Donor Advocate Conference. This event is designed to give volunteer living donor advocates the information they need to be more effective advocates for living donation. Transplant industry experts across the country will be presenting to you and delivering invaluable advice about their area of expertise.

The conference will stream on our YouTube channel beginning at 12:00 noon Eastern this Wednesday. The conference will be in segments and accessed through the “playlist”, either streaming as one event or accessed at different points in the conference. The link is , which will go live at noon Eastern on Wednesday.

- Have you ever wondered about the transplant surgeons who do the surgery? What they are thinking and what they would like you to know? Dr. Joshua Mezrich, transplant surgeon at UWMadison and author of “When Death Becomes Life: Notes from a Transplant Surgeon” talks about his experience with organ donors and recipients.

- Are you a living donor or a transplant recipient, or expecting to be one? Do you remember the experience of being evaluated at the transplant center and listening to all the information, and maybe feeling a little overwhelmed? Living Donor Coordinator Marian Charlton and Patient Coordinator Janet Hiller are two of the most respected voices in transplant, and they will tell you what they want you to know to better understand the process. Anyone who goes through this experience or has a loved one in transplant will want to see these segments.

- Living kidney donors deserve all protections available, from reimbursement for out-of-pocket costs and lost wages to medical coverage for medical issues that may arise months or years after donation. Garet Hil, founder and CEO of the National Kidney Registry, talks about the suite of protections available to living donors through Donor Shield.

-  Are you a kidney patient in need of a donor? Harvey Mysel, a two-time kidney recipient and founder and CEO of the Living Kidney Donor Network, talks about how to have your kidney donor find you.

- Professor Alvin Roth won the Nobel Prize in Economics for his work creating the algorithms that contributed to the creation of the “kidney chain”, a development that transformed kidney transplant procedures. Prof. Roth discusseshis work and the business known by the intriguing moniker of “repugnanttransactions.”

- All kidney patients will benefit by watching nephrologist Dr. David Serur talk about kidney disease and what every kidney patient and advocate needs to know to be properly informed about how to deal with renal disease. 

- Non-directed, or altruistic, donors are a rare breed, though we are trying to change that. No one knows the brain of the non-directed donor better than Professor Abigail Marsh, who has been studying non-directed donors for years. If you want to better understand why someone will happily donate a kidney to a stranger, this presentation will help answer that question.  Prof. Marsh is the author of “The Fear Factor: How One Emotion Connects Altruists, Psychopaths, and Everyone In-Between.”

- If you listen to podcasts, you are probably familiar with “Freakonomics” and its creator, Stephen Dubner. It was the Freakonomics interview with Prof. Roth that set Donor to Donor and NKDO into motion, and our interview with Mr. Dubner will interest anyone who understands “the power of the pod”.

- Jim Gleason is a heart transplant recipient and the president of TRIO, Transplant Recipients International Organization. Mr. Gleason is a motivational speaker who asks the question, “Are you a cookie monster?”

Here's the video of my video

Tuesday, October 20, 2020

Surgery Grand Rounds at UCSF. "Kidneys and Controversies: Kidney Exchange Within and Across Borders" Oct 21 (7am PST)

 Tomorrow at dawn I'll give a seminar to the surgeons at UCSF, about kidney exchange, and the controversies it has overcome, and is overcoming.

Surgery Grand Rounds | Kidneys and Controversies: Kidney Exchange Within and Across Borders

Date: October 21, 2020 Time: 7:00am-8:00am Place: Webinar

Rishwain Visiting Speaker: Alvin E. Roth, PhD

Al Roth is the Craig and Susan McCaw Professor of Economics at Stanford University and the George Gund Professor Emeritus of Economics and Business Administration at Harvard University. He shared the 2012 Nobel memorial prize in Economics. His research interests are in game theory, experimental economics, and market design. In the 1990’s he directed the redesign of the National Resident Matching Program (NRMP) and currently is a member of the Board of Directors. He has been involved in the design and organization of kidney exchange, which helps incompatible patient-donor pairs find life-saving compatible kidneys for transplantation. He is on the Advisory Board of the National Living Donor Assistance Center (NLDAC). His work on kidney transplantation led him to become interested in repugnant transactions, and more generally how markets, and bans on markets, gain or fail to gain social support.

The University of California, San Francisco School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.  CME Course MGR21045

UCSF designates this live activity for a maximum of 43 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

*The above credit is inclusive of credit for all Fiscal Year 2020-2021 Department of Surgery Grand Rounds.

Disclosure declaration – No one in a position to control the content of this activity has a relationship with an ACCME-defined commercial interest. Planners  Wen Shen, MD, Julie Ann Sosa, MD, MA, Lygia Stewart, MD, and Ryutaro Hirose, MD, have stated that they have no relationships to disclose. Speaker Roth has stated that he has no relevant relationships to disclose.

This activity is supported by the Department of Surgery’s Howard Naffziger Endowment Fund.

Join Webinar: 

Monday, October 19, 2020

Censoring repugnant words by algorithm

 Some people like to say things that other people think they shouldn't say.  In the age of the internet, politeness can be (somewhat) automated, by banning certain words.  But of course, words have contexts. Here's a funny story from the Guardian:

Overzealous profanity filter bans paleontologists from talking about bones--A virtual conference was thrown into confusion when the platform hosting the event came with a pre-packaged ‘naughty word’ censor by Poppy Noor.

"Participants in a virtual paleontology session found themselves caught between a rock and a hard place last week, when a profanity filter prevented them from using certain words – such as bone, pubic, stream and, er, beaver – during an online conference.

"The US-based Society of Vertebrate Paleontology (SVP) held its annual meeting virtually this year due to the pandemic, but soon found its audience stifled when they tried to use particular words.

"Convey Services, which was was handling the conference, used a “naughty-word filter,” for the conference, outlawing a pre-selected list of words.

"“Words like ‘bone’, ‘pubic’, and ‘stream’ are frankly ridiculous to ban in a field where we regularly find pubic bones in streams,” said Brigid Christison, a master’s student in biology attending the event


"Some discovered bias in the algorithm, too. Jack Tseng, a vertebrate paleontologist from the University of Berkley pointed out that the filter had banned the common surname Wang but not Johnson – even though both are frequently used as slang words to describe a man’s genitals."


Here's Dr. Tseng's tweet:

Z. Jack Tseng, @Tseng_ZJ

"Wang" is banned but not "Johnson" (both used as slangs). This western-centric filter erasing the surname of 90+ million Chinese but not <2 million people of European descent is unexpectedly on brand for 2020,  ! My PhD advisor is X. **** by the way. "


Previous related posts:

HT: Muriel Niederle

Sunday, October 18, 2020

Breast milk and the marketing of breast milk substitutes during the pandemic


Here's an article in the Lancet:

Marketing of breastmilk substitutes during the COVID-19 pandemic by Christoffer van Tulleken, Charlotte Wright, Amy Brown, David McCoy, and Anthony Costello, October 08, 2020DOI:

"It is of concern that the US$70 billion infant formula industry has been actively exploiting concerns about COVID-19 to increase sales, in violation of the WHO International Code of Marketing of Breast-milk Substitutes (the Code)1 and national law in many countries.

"Globally, infants who are not exclusively breastfed are 14 times more likely to die than infants who are exclusively breastfed.2 Lockdown measures have diminished household income, and the UN World Food Programme estimates that by the end of 2020, 265 million people may be facing food insecurity,3,  4 making breastfeeding even more important. Public bodies that are independent of industry influence, including WHO5,  6 and the Royal College of Paediatrics and Child Health,7 have unanimously asserted that no evidence exists to suggest breastfeeding increases the risk of infants contracting COVID-19, and that skin-to-skin contact remains essential for newborn health and maternal health.

"By contrast, large manufacturers of breastmilk substitutes have inappropriately positioned themselves as sources of public health expertise, and suggested various unnecessary hygiene measures, the use of expressed breastmilk, and the separation of mothers from their babies. Such recommendations undermine breastfeeding and thus increase the risk of infant death. Baby Milk Action and the International Baby Food Action Network8 have documented numerous infringements of both the Code and laws associated with COVID-19."