Sunday, March 18, 2018

Child marriage in the U.S., and in India

Is 13 too young to marry?  If pregnant??

Not yet in Kentucky.
Vote on bill to outlaw child marriage in Kentucky delayed after opposition from conservative Family Foundation

"A bill outlawing child marriage in Kentucky had been expected to receive a vote in the Senate Judiciary Committee on Thursday, but that vote has been delayed due to last-minute opposition by the conservative Family Foundation of Kentucky, according to the bill’s lead sponsor.

"Sen. Julie Raque Adams, R-Louisville, filed Senate Bill 48 on the first day of this year’s session of the Kentucky General Assembly, which would prohibit anyone under the age of 17 from marrying and only allow 17-year-olds to marry with a judge’s approval.

"Under the current law in Kentucky, 16 and 17-year-olds can marry with their parents’ permission, and a girl of any age under 16 can marry as long as they are pregnant and marrying the expectant father. Likewise, a boy of any age can marry a woman that he impregnates under the current law.

"Adams filed the bill after media reports detailing how Kentucky has the third-highest rate of child marriage in the country — with more than 10,000 children married from 2000 to 2015"

And from Tennessee
Child marriage in Tennessee: Lawmakers take action to close legal loophole

"Two Democratic lawmakers have introduced bills to prevent marriages in Tennessee where a party is under 18 years of age, after a national nonprofit cited three cases in the state where 10-year-old girls were married to adult men.

"Sen. Jeff Yarbro, D-Nashville, who is sponsoring the legislation with Rep. Darren Jernigan, D-Old Hickory, said at a press conference Monday that while many Tennesseans believe the minimum age to marry is 18, a loophole in state law actually allows a judge to waive the age requirement and does not state a minimum age.

"The State Department views child marriage in other countries as a human rights abuse, yet it’s something that happens with frequency in Tennessee and across the country," Yarbro said"

And India: Uphill Battle Against Child Marriage Is Being Won in India, for Now
"Data released by Unicef on Tuesday found that a girl’s risk of marrying before her 18th birthday in South Asia fell by more than a third in the last decade, from nearly 50 percent to about 30 percent, in large part because of progress in India.
Child marriage here is finely threaded with other practices, including the exchange of a dowry from the bride’s family to the groom, and sometimes with sex trafficking, making it difficult to tackle any one issue without addressing others. Social workers said there are no easy solutions.
"Though India’s numbers are promising, a recent analysis of census data highlighted another disturbing finding. In pockets of India, incidents of child marriage are decreasing in rural areas, but increasing in urban settings.
Researchers involved with the study say it is unclear what is causing that phenomenon. One hypothesis is that an uptick in migration from villages to cities could mean that these weddings have simply been redistributed."

Saturday, March 17, 2018

When an academic conference can save lives (market for interventional cardiologists)

The Chronicle of Higher Ed has the story:
Academic Conferences May Save Lives — by Keeping Big-Name Doctors Busy

Here's the medical paper on which it is based:
Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings
Anupam B. Jena, Andrew Olenski, Daniel M. Blumenthal, Robert W. Yeh, Dana P. Goldman, John Romley,
Journal of the American Heart Association. 2018

"Thousands of physicians attend national scientific meetings annually. Within hospitals, the composition of physicians who attend scientific meetings may differ from nonattendees who remain behind to treat patients, potentially resulting in differences in care patterns and outcomes for patients hospitalized during meeting dates. A quasi‐experimental evaluation of outcomes of patients hospitalized with acute cardiovascular conditions during the American Heart Association (AHA) and American College of Cardiology (ACC) annual meetings compared with identical nonmeeting days in the surrounding weeks found that, within teaching hospitals, patients admitted with cardiac arrest or high‐risk heart failure during meeting dates had lower adjusted 30‐day mortality compared with similar patients on nonmeeting dates"

Friday, March 16, 2018

Match Day for medical residents--NRMP results announced

Today is Match Day: later today, graduating American medical students, and quite a number of other young doctors will learn where they will work next year.

Here's one description: The Final Countdown: Match Day 2018.

Here's another:
NRMP Match Week will Reveal Future for Thousands of Resident Physician Applicants
NRMP Main Residency Match continues to grow, with 2018 Match expected to be largest in history.

And here's my all time favorite, courtesy of Hogwarts.

Thursday, March 15, 2018

Last minute bidding on the New York Stock Exchange

The WSJ has the story (the url is better than the headline:

What’s the Biggest Trade on the New York Stock Exchange? The Last One
"The NYSE operates between 9:30 a.m. and 4 p.m., but much of the action has moved to the final moments, thanks to index funds and others that flock to the day’s closing auction"
"Last year, 26% of all trading activity on the NYSE’s flagship exchange took place in the last trade of the day, up from 17% in 2012, exchange data shows. Last year, trades at the close accounted for more than 8% of trading volume in S&P 500 stocks, nearly four times what it was in 2004, according to Credit Suisse .

"While individual investors may follow the market through the day, especially in the past turbulent weeks, it is likely they own funds that track major stock indexes like the S&P 500 whose values depend on prices determined in the closing auction.

"In this auction, traders electronically send transaction orders to the NYSE, home to more than 2,000 companies that include such blue-chip names as Boeing Co. , Walt Disney Co. and Exxon Mobil Corp. The exchange’s computers match the millions of buy and sell orders, with human traders on the NYSE floor sometimes stepping in to help.

"At least $10 billion worth of shares are traded in the NYSE’s closing auction on an average day, with a final tally of stock prices typically listed by 4:05 p.m.

The “close,” as traders call it, has grown in importance as investors pour into index-mutual funds and other vehicles that passively track various stock-market indexes, including exchange-traded funds, or ETFs. "

Wednesday, March 14, 2018

Drugs in sports

An editorial in The Guardian reminds me of the heyday of bicycle racing.
The Guardian view on drugs in sport: a deep corruption: "A devastating report from a parliamentary select committee shows a culture of studied evasion around the abuse of performance-enhancing substances in professional sport"
"Over in the world of professional cycling, Team Sky, founded to “win clean”, turns out to have had a terrible problem with asthma among its athletes. Sir Bradley Wiggins apparently suffered from an asthma that could only be treated with a steroid which has the side-effect of allowing endurance athletes to lose fat rapidly while maintaining muscle mass. This is legal provided a doctor has certified that the drug is needed to treat the asthma. "

Here's the parliamentary report: Combatting doping in sport

Summary: "There is overwhelming evidence of the widespread use of performance enhancing drugs in sport. Some are illegal in any respect; others are legal, but are used in suspicious ways. Whether permitted for selective use or banned outright, performance enhancing drugs can have serious consequences for the integrity of sport and the wellbeing of individual athletes. The huge increase in financial rewards for successful sports men and women carries the increased risk of incentives to use drugs to cheat. Our long inquiry has relied on detailed oral and written evidence, academic research, investigative journalism, and whistleblowers, to uncover this covert and pervasive activity across different sports. The inquiry studied both agencies responsible for policing the use of performance enhancing drugs, and the programmes that, as our report will demonstrate, have used them in questionable ways. In particular, our inquiry has found acute failures in several different organisations in athletics and cycling: a failure to share appropriate medical records with anti-doping organisations; a failure to keep proper internal records of the medical substances given to athletes; and a failure to outlaw the use of potentially dangerous drugs in certain sports. All of these failures have occurred in an under-resourced national anti-doping infrastructure, which has had neither the financial means nor powers of enforcement. Some steps have been taken to alleviate this context and the failures it has permitted, but these measures have come too late. We call on those bodies identified in this report to pay serious attention to our recommendations; we cannot afford to allow these same failures to happen again."

Tuesday, March 13, 2018

Duke switches to random roommate matching

Is it a good idea to allow college students to choose their own roommates?  Duke University returns to administrative matching of first year roommates, with Dean Random making the match.

Inside Higher Ed has the story (and the url makes for an informative headline: 

Here's the actual (pithier) headline and subhead
Random Roommates Only
"Duke University takes away from first-year students the ability to pick their roommates. This move goes against recent trends -- and raises questions about diversity, tolerance and the college experience."

"Duke University has removed from students what has become one of the most significant aspects of matriculation at many colleges: picking a first-year roommate

"Beginning with the Class of 2022, the roommate-selection process will be entirely governed by the university, with assignments largely made at random -- a shift, officials said, meant to stem the recent movement of students self-selecting peers with similar perspectives and backgrounds to their own, fueled by social media connections made before arriving on campus."

Monday, March 12, 2018

Transplant diplomacy between China and the Vatican

The Global Times, a publication of the Chinese Communist Party, reports on further discussion with the Vatican on organ transplantation, in connection with an anticipated agreement on the appointment of Catholic Bishops in China:

China to attend Vatican organ trafficking meeting
Beijing, Holy See exchanges promoting mutual respect
By Li Ruohan Source:Global Times Published: 2018/3/11 2 

"Chinese scholars will join an anti-organ trafficking conference in the Vatican on Monday and Tuesday, to share the country's experience and boost people-to-people exchanges between Beijing and the Vatican. 

"This is the second time China has been invited by the Pontifical Academy of Sciences (PAS) to attend a meeting in the Holy See, as China's reforms on organ transplant have increasingly received papal and global recognition.


"In 2017, more than 5,100 deceased Chinese citizens had voluntarily agreed to donate their organs after death, saving, or improving the lives of more than 16,000 people, according to official data obtained by the Global Times on Sunday. 

"China criminalized unauthorized trading of organs in 2011, a crime for which the death penalty can be handed down in severe cases. From 2007 to 2016, 174 people were arrested in China for organ trafficking.
"China and the Vatican have no diplomatic relations. Lately there has been widespread speculation the two sides are close to a consensus on the appointment of bishops in China, a positive sign for improving relations between Beijing and the Vatican."

HT: Frank McCormick

Here's a story in the Washington Post about the larger diplomacy:
A Catholic bishop and his rural Chinese parish worry about a deal between Beijing and the Vatican   

By Emily Rauhala March 11

Sunday, March 11, 2018

Tax credit for organ donors in Maryland

The Baltimore Sun has the story:
Maryland House passes bills on organ transplants, sponsored by speaker who was saved by a liver transplant

"The Maryland House of Delegates on Thursday unanimously passed two organ donations sponsored by House Speaker Michael E. Busch, whose life was saved by a liver transplant last year.

One would provide a $7,500 tax credit for living donors to help defray their costs of donating all or part of an organ.
"Gov. Larry Hogan has announced his support for the bill.

"The second Busch-sponsored measure would treat vehicles delivering donor organs or medical personnel en route to a transplant operation as emergency vehicles. That would allow them to use flashing signals and permits them to speed or go through traffic signals if they can do so safely.

"The two bills now go to the Senate, where passage is expected."

Saturday, March 10, 2018

Cat meat in India

Here's a somewhat complicated story from Chennai, which focuses on cat meat being sold as mutton and other deceptions, and on pet cats being killed. But what caught my eye is that there is an ethnic group that enjoys eating cats:

In Chennai, a debate about cat meat after NGO’s crackdown on nomadic community
The Narikoravar are a marginalised group, traditionally known to kill feral cats for meat.

"The Narikoravar are a dwindling community. There are only around 200 families left in Chennai now, said Rajkumar, former president of Tamil Nadu’s Narikoravar community. They originally lived in forests and were hunters. Now, Rajkumar said, most of them make a living collecting paper and plastic from garbage cans and selling them to waste paper shops, earning less that Rs 100 a day. In 2016, the community was included in the list of Scheduled Tribes in Tamil Nadu.

The Narikoravar are traditionally known to kill feral cats and eat their meat. “Now they have moved to the city, so them killing domestic cats isn’t justified,” Pereira argued. “It is not categorised as food in India. Slaughter that happens anywhere outside a slaughter house is illegal. And more than anything, it’s an act of cruelty. Cats are trapped, kept in little cages and gunny bags.”

HT: Mostly Economics blog, by Amol Agrawal.

Friday, March 9, 2018

New York Stock Exchange fined for market design flaws

The WSJ has the story:
NYSE to Pay $14 Million Over 2015 Trading Malfunctions
Settlement covers series of glitches that disrupted trading on three occasions that year

"The New York Stock Exchange agreed Tuesday to pay $14 million to settle regulatory investigations into a series of market malfunctions and technical errors that disrupted trading on three occasions in 2015.

"The settlement represents the first case in which the Securities and Exchange Commission accused a stock exchange of violating rules established to prevent outages of critical market infrastructure. The SEC also faulted NYSE for using unapproved “price collars” to damp price swings during a wild trading session on Aug. 24, 2015, which had the unintended effect of exacerbating volatility.
"Chaotic trading on the morning of Aug. 24, 2015, exposed flaws in the way U.S. stocks and exchange-traded funds trade and prompted criticism of the NYSE’s unusual market design, in which human traders on an old-fashioned trading floor coexist with electronic trading. Critics of NYSE’s model said human traders, given discretion to set the opening price of stocks, made things worse.

"The many price swings that morning triggered nearly 1,300 halts of stocks and ETFs. Many shares didn’t formally open for trading until 9:45 a.m. or, in some cases, after 10 a.m., as the NYSE’s market makers struggled to find valid starting prices for stocks.

"During the upheaval, dozens of ETFs traded at sharp discounts to the sum of their holdings, worsening losses for fundholders who sold during the panic."

Thursday, March 8, 2018

Solidarity between doctors and nurses in Quebec

Canadian doctors--at least some of them--are different.
The Washington Post has the story.

Hundreds of Canadian doctors demand lower salaries

"In a move that can only be described as utterly Canadian, hundreds of doctors in Quebec are protesting their pay raises, saying they already make too much money.

"As of Wednesday afternoon, more than 700 physicians, residents and medical students from the Canadian province had signed an online petition asking for their pay raises to be canceled. A group named Medecins Quebecois Pour le Regime (MQRP), which represents Quebec doctors and advocates for public health, started the petition Feb. 25.

“We, Quebec doctors who believe in a strong public system, oppose the recent salary increases negotiated by our medical federations,” the petition reads in French.

"The physicians group said it could not in good conscience accept pay raises when working conditions remained difficult for others in their profession — including nurses and clerks — and while patients “live with the lack of access to required services because of drastic cuts in recent years.”

"A nurses union in Quebec has in recent months pushed the government to address a nursing shortage, seeking a law that would cap the number of patients a nurse could see. The union said its members were increasingly being overworked, and nurses across the province have held several sit-ins in recent months to push for better working conditions."

Wednesday, March 7, 2018

Kidney exchange for cats

When you read about a kidney transplant for a cat (see below), you might wonder about the kidney donor.  It turns out the transplant involved a living-donor kidney donation in exchange for a home and a life saving rescue from an animal shelter (in which un-adopted animals are euthanized):

Here's the Baltimore Sun:

A $19,000 kidney transplant for a 17-year-old cat? His Baltimore owner says it was money well spent

"Not quite four months ago, Betsy Boyd spent 41 percent of her annual salary on a kidney transplant for her ailing 17-year-old cat, Stanley.

As a condition of the $19,000 surgery, she also adopted the kidney donor, a 2-year-old tabby named Jay"

Tech Times tells us more about the donor Jay:

"Boyd was able to save the life of Stanley, but in the process, also saved the life of another cat.

"One of the conditions of the kidney transplant procedure was that Boyd would have to adopt the cat that donated the kidney to Stanley. The cat was named Jay, a 2-year-old cat who was rescued from the streets and was in a shelter.

"We are just as concerned with the life of the donor as the recipient," said Dr. Lillian Aronson from the Ryan Veterinary Hospital at the University of Pennsylvania. "They are saving another animal's life and we owe it to them to save their life and give them a good home."

Boyd not only gave Stanley more years at life, but she also gave Jay a new home."
I don't know if there are journals that publish papers on Veterinary Ethics, but if there are, I anticipate heated discussion of the ethics of kidney donation in exchange for being saved from a shelter.  (Authors will speak with certainty both for and against.)

The fact that most shelters euthanize animals who don't find a home fairly quickly is another issue that arouses some repugnance and controversy: e.g. here's a statement from PETA on why they support that practice:
 ‘No-Kill’ Label Slowly Killing Animals

Tuesday, March 6, 2018

Another New Federal Law Clerk Hiring (Pilot) Plan

Future law clerks who are already in their second or third year of law school have already been hired, but here's a plan to defer the hiring of those who just entered law school this year.  It will have implications for hiring starting in 2019, and again in 2020, after which it will be reviewed. (This will be the seventh such attempt to halt unraveling in this market since 1983.) The attempt to ban exploding offers is new...

The DC Circuit publishes the following announcement:
Notice of Adoption of the New Federal Law Clerk Hiring Plan
February 2018

"Federal Law Clerk Hiring Plan

Starting with students who entered law school in 2017, the application and hiring process will not begin until after a law student’s second year.

For students who entered law school in 2017 (graduating class of 2020): Judges will not seek or accept formal or informal clerkship applications, seek or accept formal or informal recommendations, conduct formal or informal interviews, or make formal or informal offers before June 17, 2019.

For students who enter law school in 2018 (graduating class of 2021): Judges will not seek or accept formal or informal clerkship applications, seek or accept formal or informal recommendations, conduct formal or informal interviews, or make formal or informal offers before June 15, 2020.

A judge who makes a clerkship offer will keep it open for at least 48 hours, during which time the applicant will be free to interview with other judges.

This is a two-year pilot plan. Participating judges will reconsider their participation after June 2020. A copy of the plan will be posted on the OSCAR website at"

And it is now indeed on the OSCAR site: Federal Law Clerk Hiring Pilot
[OSCAR--the Online System for Clerkship Application and Review-- is a web based platform for the law clerk job market.]

HT: Kim Krawiec

Monday, March 5, 2018

Unrecognized Single-Gender Social Organizations (USGSO) at Harvard

Harvard has taken steps to express its repugnance to single-gender social organizations. It is motivated primarily by repugnance to male-only groups, and seeks to recognize that some women-only groups were formed in response to discrimination. Here is their new policy, which is short of a ban on students who participate in such groups, but which imposes sanctions on such students. (The organizations themselves are typically privately owned and outside of Harvard's control).

Unrecognized Single-Gender Social Organization (USGSO) Policy

"Policy: Students matriculating in the fall of 2017 and thereafter who become members of Unrecognized Single-Gender Social Organizations (USGSO) will not be eligible to hold leadership positions in recognized student organizations or on athletic teams. In addition, such students will not be eligible for fellowships administered by the Office of Undergraduate Research and Fellowships. This policy does not apply to students who matriculated prior to fall 2017.
"Women’s Organizations: We are committed to treating all organizations that are moving towards gender-inclusivity fairly and to offering them Harvard College resources and assistance regardless of gender. As Dean Khurana noted in an open letter in May 2016, Harvard has a long and complex history of grappling with gender discrimination. The College is deeply committed to gender equity, inclusion, and non-discrimination and to advance women's full participation in Harvard's academic and extracurricular life. To that end, we welcome all organizations, and especially those whose membership is currently restricted to women, to partner with us.  We are excited to announce that Heidi Wickersham, Program Manager at the Harvard College Women’s Center, and staff members in the Office of Student Life will jointly partner with groups wishing to transition from having a women’s exclusive membership while maintaining a women’s-focused mission."

Sunday, March 4, 2018

Deceased kidney allocation in Australia

What does it mean for kidney allocation to be fair?  A recent paper asks that question in Australia, and supplies some background to the debate in the increasing age of both patients and donors there.

Fairness in Deceased Organ Matching
Nicholas Mattei, Abdallah Saffidine, Toby Walsh

Abstract: "As algorithms are given responsibility to make decisions that impact our lives, there is increasing awareness of the need to ensure the fairness of these decisions. One of the first challenges then is to decide what fairness means in a particular context. We consider here fairness in deciding how to match organs donated by deceased donors to patients. Due to the increasing age of patients on the waiting list, and of organs being donated, the current “first come, first served” mechanism used in Australia is under review to take account of age of patients and of organs. We consider how to revise the mechanism to take account of age fairly. We identify a number of different types of fairness, such as to patients, to regions and to blood types and consider how they can be achieved."

Introduction: "Kidney disease costs the Australian economy billions of dol-lars per year. Over ten thousand people in Australia are on dialysis,  each  costing  hundreds  of  thousands  of  dollars  in medical and welfare costs. Australia is especially challenged in this area as kidney disease is a major problem within the indigenous population. The incidence of end stage kidney disease in the indigenous population in remote areas of Australia is 18 to 20 times higher than that of comparable non-indigenous peoples.1

"A  significant  trend  in  Australia  (as  in  other  developed countries) is that age is now starting to play a major role in kidney disease. It is impacting both the demand and supply side of the kidney transplant market. On the demand side,the age of patients in Australia waiting to receive a kidney has increased significantly in recent years. In 2010, for example, just 11% of the waiting list were 65 years or older. In 2015, this had increased to 15%. Over the next 30 years, the proportion of the population of Australia aged over 65 years is predicted to double to around 25 per cent. This ageing demographic will likely further increase the age of people on the waiting list for a kidney transplant.

"On the supply side of the market, the age of donated kidneys has also increased significantly. In 1989, the mean age of  donated  kidneys  in  Australia  was  just  32  years  old.  In 2014, this had increased dramatically to 46 years old. Surgeons are now able and willing to transplant older kidneys into older patients. In 1989, the oldest transplanted kidney came from a donor aged 69 years. In 2014, this has increased to an 80 year old donated organ. A number of factors including  increasing  life  expectancy,  medical  advances,  and  improved road safety have been driving these changes on both sides of the market."

(The paper proposes a stability criterion that I'm not persuaded is well motivated in the present context, but the discussion is interesting...)

Saturday, March 3, 2018

First kidney exchange in West Virginia

Another first, not in a far off land, but in West Virginia:
 Doctors Perform First Kidney Swap in West Virginia
West Virginia has the highest rate of kidney failure in the country

"thanks to two Cleveland Clinic surgeons and the transplant team at Charleston Area Medical Center (CAMC), whose Kidney Transplant Center is affiliated with Cleveland Clinic, they completed West Virginia’s first-ever paired kidney exchange, or “kidney swap.”

Friday, March 2, 2018

The Economist discusses repugnant transactions

It's good to see repugnant transactions and forbidden markets making it into the (semi-)popular press.  Here's an article from The Economist, in part about my presidential address at the American Economic Association meetings in January.

Economists cannot avoid making value judgments
Lessons from the “repugnant” market for organs

It's nice to be quoted, not so nice to be misunderstood. Here's a sentence in which I object to the words "but mostly."

"Repugnance, he laments, tilts the political playing field against ideas that unlock the gains from trade. He recommends that economists spend more time thinking about such taboos, but mostly because they are a constraint on the use of markets in new contexts."

In fact I think that repugnant transactions are important for social scientists to study. (By "repugnant transactions" I mean transactions that some people would like to engage in while others think they should be forbidden, and for which there are no easily measurable negative effects on non-participants.)   For example, when you see laws all over the world against compensating kidney donors, it suggests that there are widespread perceptions that we economists would do well to understand, because understanding how and why markets enjoy social support is important.

Of course, repugnance sometimes constrains markets in ways that I regret. But not always: I'm not in favor of bringing back indentured servitude, for example.

Some of the misunderstanding of my talk seems to stem from how it was blogged about and live tweeted by Professor Beatrice Cherrier, of whom the Economist says

"But, as Beatrice Cherrier of the Institute for New Economic Thinking argued in an essay addressing Mr Roth’s lecture, these questions are fundamental to economics. The hard sciences deal much better with the ethical implications of their work, she says. And moral concerns affect human behaviour in economically important ways, as Mr Roth found to his frustration. To be useful, economists need to learn to understand and evaluate moral arguments rather than dismiss them."

She blogs as The Undercover Historian, and you can read her take on my lecture at the link below (worth reading, but she certainly never talked to me about what I think, and seems to me to have heard what she came to hear, rather than what I said...)

Not going away: on Al Roth’s 2018 AEA Presidential Address and the ethical shyness of market designers  Posted on January 7, 2018

You can hear (and see) my talk for yourself here:

AEA Presidential Address - Marketplaces, Markets and Market Design
Alvin E. Roth, introduced by Olivier Blanchard
View Webcast

I certainly don't dismiss repugnance: I wish I understood it better. You can see some of the things I'd like to understand by looking at my posts about repugnance on this blog. (As I write this, I see that I have 921 posts tagged with the label "repugnance")

I should add that I am often disappointed in the ethics literature that tries to address the appropriate scope of markets, and of economic transactions.  Much of it seems deaf to the idea that there may be tradeoffs that need to be considered when we contemplate public policies. You don't have to be a strict utilitarian to think that sometimes it may be reasonable to tolerate a small amount of harm in order to relieve a large amount of harm. (See my recent posts about harm reduction.)

In some organ transplantation circles, the version of the trolley problem that strikes a chord has to do with the universal agreement that if a hospital has eight patients facing imminent death due to lack of available organs, you still can't order a pizza and murder the delivery man for his organs, so that there will be one death instead of eight.

But some of the discussion in the ethics literature, which concludes that most attempts to increase transplants are ethically suspect, reminds me of a recent New Yorker cartoon. The picture shows what looks like a board of directors meeting, and the man at the head of the table asks
"Yes, it would save many lives. But to what end?"

Thursday, March 1, 2018

A liver for a kidney?

One consequence of the growth of kidney exchange is that there is more discussion of novel modes of exchange. Here's an article forthcoming in the American Journal of Transplantation that cautiously discusses the ethical issues that would be involved in a kidney-liver exchange.  I found the most interesting of the issues discussed to be those surrounding the excuse that medical teams give to prospective donors who don't really want to donate: they say e.g. that the kidney isn't suitable, or that the donor's kidney function isn't sufficient to allow him/her to donate. So the article discusses how this might pressure a reluctant donor if the question "but how about his/her liver"? could be asked...

The main case being discussed of course is one in which two lives could be saved by an exchange of donors, as in kidney exchange (or liver exchange, as has been employed a bit in Asia...).

(Incidentally, the article is written in the future hypothetical, but I wouldn't be shocked to hear that somewhere in the U.S. one such exchange has already taken place.)

New in the AJT:

A Liver for a kidney: Ethics of trans-organ paired exchange


  • Accepted manuscript online: 
  • DOI: 10.1111/ajt.14690
  • American Journal of Transplantation (forthcoming)
  • Abstract
  • Living donation provides important access to organ transplantation, which is the optimal therapy for patients with end-stage liver or kidney failure. Paired exchanges have facilitated thousands of kidney transplants and enable transplantation when the donor and recipient are incompatible. However, frequently willing and otherwise healthy donors have contraindications to donation of the organ that their recipient needs. Trans-organ paired exchanges would enable a donor associated with a kidney recipient to donate a lobe of liver and a donor associated with a liver recipient to donate a kidney. This paper explores some of the ethical concerns that trans-organ exchange might encounter including unbalanced donor risks, the validity of informed consent, and effects on deceased organ donation.

Wednesday, February 28, 2018

Liver exchange: prospects and challenges

Might liver exchange be attempted in the U.S.?  (Maybe at Penn?). Here's a forthcoming article that considers how the challenges would be similar and different from the development of kidney exchange.

Liver Paired Exchange: Can the Liver Emulate the Kidney?
by Ashish Mishra, Alexis Lo, Grace S. Lee, Benjamin Samstein, Peter S. Yoo, Matthew H. Levine, David S. Goldberg, Abraham Shaked, Kim M. Olthoff, Peter L. Abt
Liver Transplantation, Accepted manuscript online: 10 February 2018

Abstract: Kidney paired exchange (KPE) constitutes 12 percent of all living donor kidney transplants in the United States. The success of KPE programs has prompted many in the liver transplant community to consider the possibility of liver paired exchange (LPE). Though the idea seems promising, the application has been limited to a handful of centers in Asia.  In this manuscript we consider the indications, logistical issues, and ethics for establishing a LPE program in the United States with reference to the principles and advances developed from experience with KPE. 

Tuesday, February 27, 2018

Auctions and Market Design Section of INFORMS

Martin Bichler writes:

We are excited about the successful formation of the Auctions and Market Design Section of INFORMS! Please visit and bookmark the INFORMS Auctions and Market Design homepage.

Events organized by the new INFORMS Section in 2018 include:

Cluster on Auctions and Market Design at the INFORMS Annual Meeting Nov. 4-7, 2018 in Phoenix, Arizona

As in the last few years, the cluster (previously the Auctions Cluster) will be chaired by Bob Day. Please email Bob at if you are interested in being a session chair or want to have him find a spot for you in a session.  Please try to respond in the next two weeks (by March 4) to assure your session. Later requests by individual authors will be considered, but the sooner the better to lock in a slot.

Workshop on Mathematical Optimization in Market Design
June 18-19, 2018, Gates Hall, Cornell University, Ithaca, NY (co-located with ACM EC 2018)

We are pleased to announce a new focused workshop co-located with and immediately preceding ACM EC 2018. The workshop will have invited speakers from academia and industry including Itai Ashlagi (Stanford), Peter Cramton (Cologne), Scott Kominers (Harvard), S├ębastien Lahaie (Google), Sasa Pekec (Duke), Tuomas Sandholm (CMU), and many more.

The final program and registration will be online end of March at the event website. Please direct questions to Martin Bichler (

Section Officers:
  • President: Robert Day, School of Business, University of Connecticut
  • Vice-President: Martin Bichler, Department of Computer Science, Technical University of Munich
  • Secretary: Ben Lubin, School of Business, Boston University
  • Treasurer: Thayer Morill, Department of Economics, NC State University
Advisory Board

  • Itai Ashlagi, Management Science and Engineering, Stanford University
  • Karla Hoffman, School of Engineering, George Mason University
  • Paul Milgrom, Department of Economics, Stanford University
  • Sasha Pekec, School of Business, Duke University
  • Al Roth, Department of Economics, Stanford University
  • Tuomas Sandholm, Department of Computer Science, Carnegie Mellon University

Monday, February 26, 2018

Justice and Game Theory: DOJ inaugurates Jackson-Nash Address

Here's the announcement of a new lecture series at the U.S. Department of Justice Antitrust Division, the home of many fine economists with long government service.

Antitrust Division Establishes the “Jackson-Nash Address” and Announces Professor Alvin Roth as Inaugural Speaker

Professor Alvin Roth, Nobel laureate in economics, will address Antitrust Division attorneys, economists, and invited guests on Monday, Feb. 26, 2018.

The Antitrust Division is pleased to announce the establishment of the Jackson-Nash Address, and to announce that Professor Alvin Roth, the McCaw Professor of Economics at Stanford University, will be the inaugural speaker.  Professor Roth is the 2012 winner of the Nobel Prize for Economics for the theory of stable allocations and the practice of market design, and the author of “Who Gets What and Why.”  He will deliver his address on February 26, 2018, at The Great Hall, The Robert F. Kennedy Building, Department of Justice, 950 Pennsylvania Avenue NW, Washington, DC, at 2:00 p.m.
“The goals of the Jackson-Nash Address series are to recognize the contributions of former Supreme Court Justice Robert H. Jackson and Nobel Laureate economist John Nash, and to honor the speaker, recognizing and celebrating the role of economics in the mission of the Division,” said Assistant Attorney General Makan Delrahim.  “Professor Roth’s important contributions to game theory and market design make him an exemplary inaugural speaker.”
Justice Jackson served as Assistant Attorney General of the Antitrust Division prior to his appointment to the Supreme Court.  During his tenure at the Division, he set the stage for the expanded role of economics in antitrust, replacing vague legal standards with the “protection of competition” as the goal of antitrust law.

Professor John Nash’s research has provided the Division’s economists with the analytic tools necessary to protect competition.  In particular, Professor Nash’s strategic theory of games and his axiomatic bargaining model have had a profound effect on the Division’s enforcement mission.  The Division’s economists commonly rely on these theories to guide investigations and to help evaluate the effects of mergers, monopolization, and collusion.  
Non-Division attendees must enter through the entrance between 10th and Constitution Avenue, NW, and clear building security.  Any inquiries regarding security and logistics should be directed to Jeremy Edwards in the Office of Public Affairs at (202) 514-2007 or

Update: Assistant Attorney General Makan Delrahim Delivers Remarks for the Inaugural Jackson-Nash Address

Sunday, February 25, 2018

Appreciations of Paul Milgrom from the CME-MSRI prize ceremony

Here is a link if you can't activate the video above.

I blogged about the prize here.

Saturday, February 24, 2018

Debt traps and money lending

Credit for poor borrowers is a subject of importance in both the developing and developed world. Here's a new paper...

Debt Traps? Market Vendors and Moneylender Debt in India and the Philippines

Dean KarlanSendhil MullainathanBenjamin N. Roth

NBER Working Paper No. 24272
Issued in February 2018
NBER Program(s):Development EconomicsLaw and EconomicsProductivity, Innovation, and Entrepreneurship 
A debt trap occurs when someone takes on a high-interest rate loan and is barely able to pay back the interest, and thus perpetually finds themselves in debt (often by re-financing). Studying such practices is important for understanding financial decision-making of households in dire circumstances, and also for setting appropriate consumer protection policies. We conduct a simple experiment in three sites in which we paid off high-interest moneylender debt of individuals. Most borrowers returned to debt within six weeks. One to two years after intervention, treatment individuals were borrowing at the same rate as control households.

Friday, February 23, 2018

SITE experimental economics conference, August 2018, call for papers

Call for Papers
SITE Experimental Economics Conference
August 6 - 7, 2018
The Stanford Institute for Theoretical Economics: Workshop in Experimental Economics will be hosted this year on August 6th and 7th at Stanford University.  

The workshop seeks to showcase recent contributions in experimental economics. We hope you will consider submitting your work, and encourage others with interesting work to do so as well.

The deadline for submission is April 1, 2018.  To submit a paper, please follow the instructions at the following link:  The submission platform this year requires you to create an account. While this platform is outside of our control, if you have any difficulty with the online submission, please feel free to email your paper directly to Christine ( or to the SITE program coordinator, Dorian (

SITE Experimental Economics Organizers

Luke Coffman, Harvard University
Christine Exley, Harvard Business School
Muriel Niederle, Stanford University
Al Roth, Stanford University 
Lise Vesterlund, University of Pittsburgh